It has been one month since the Department of Health announced their intention to impose upon junior doctors a contract which, to it's core, is both unfair and unsafe. The Doctor's and Dentist review body (DDRB) report we know contains the rotten bones of a contract who's only achievement could ever be to further demoralise an already over-stretched medical workforce. I stopped at the traffic lights on the way home from work on the day the news of imposition broke. I was surprised, and perhaps ashamed, to realise as I listened, my eyes had begun to betray all the feelings of frustration a junior doctor who works in the NHS comes to live with. I sat at the traffic lights and cried.
That evening I wrote a letter to Jeremy Hunt. To my surprise 24,000 people read it and in that instant, I knew 'a terrible beauty' had been born. Terrible of course because I realised I had not underestimated the seriousness of what I had heard and beautiful because I knew that I was not alone. Yesterday 20,000 doctors stood in Waterloo Place, over a thousand more in Belfast and Nottingham. I was one of many. And so, as W.B. Yeats put it, 'A terrible beauty is born'.
Jeremy Hunt's proposed changes have been repeatedly conflated with his party's manifesto promise of a 'seven day NHS'. The actual plans for this goal remain difficult to pin down. Those we do know appear poorly conceived and oddly skeletal. But for junior doctors already providing an around the clock service, this has never been a battle against a 'seven day NHS'. It is not a fight against progress. This is a battle against an unfair contract, one that would in every sense be a regressive move for the profession, for patient safety and by default for the NHS as we know it.
Yesterday as 20,000 doctors made their journey to London, we were dealt another insult by the department of health, with calls that we had been 'whipped up unnecessarily' and 'mislead' by the British Medical Association (BMA). Apart from the anguish I felt at this accusation, I also find it odd that this is the strength of defence from Mr Hunt. If his proposals are indeed reasonable and fair then there is no reason of course why the plans wouldn't already fall in line with the BMA's own five very reasonable requests. Proper assurance from Mr Hunt that these five things would be respected could have the BMA back at the negotiating table in a matter of days.
The department of health however, would rather suggest that tens of thousands of professionals do not have the faculties to read what is clear in the DDRB report and digest the information for themselves. Which takes me to another quote, from some writing of no less significance to me than the words of W.B. Yeats and it is one that has entered my mind many times over the past month. They are the words of J.K. Rowling, from the mouth of Dumbledore who tells us; "we must try not to sink beneath our anguish, Harry, but battle on". And so I will not seek to dwell on the many insults that have been thrown our way. I will not dwell on the rhetoric, shameful data manipulation or empty party lines. I will tell you why we will win this fight.
Junior doctors already have in their armour all the advantage we will ever need. We have already spent every day of our working career balancing and respecting the needs of patients against our own. We know that mainstream media may chose to be our friend or foe. Indeed, as history has taught us, their allegiance may change on a daily basis. We are grateful for an immense amount of public support, yet we could never forget and so will continue to respect that there are millions of vulnerable, sick patients and their families who do not have the luxury of prioritising anything but their next few hours. Patient care is our business. We have the ability to interpret data correctly. We are in the business of respecting evidence base and facts. We are in the business of protecting patients. We are in the business of ethics. We are in the business of effective communication, even in the most difficult of circumstances. We are in the business of high moral standards, accountability and integrity. We are in the business of dealing effectively with uncertainty.
We have more than enough within us to win this battle. We simply have no need for for rhetoric, shameful data-manipulation or party lines. That is not our fight song and we will not sing it.
Politics is from the Greek word politikos; 'of, for or relating to citizens'. Junior doctors are of course not politicians, but like every other citizen in a democracy, we have a stake in politics. This junior contract issue has awakened many to a responsibility to engage with healthcare policy and over the past month we have finally added strength and unity to the tools of our trade. To the department of health we say 50,000 junior doctors; 50,000 reasons to listen. To the 64million people of the United Kingdom we say you can count on us to do the right thing.
We will win this battle.
This post originally appeared on Aoife's blog here