The Blog

Junior Doctors: Drowning, or Riding the Waves?

Just over a week ago, Einstein's theory of gravitational waves was finally proven. Queue a lot of scientists, jumping up and down. Meanwhile, some spectacular and unwelcome waves in the form of a Tsunami were unleashed through the medical profession when Jeremy Hunt announced he would impose NHS Employers' latest contract offer on all junior doctors. Unless you've been living under the same rock Mr Hunt is currently hiding under, this follows months of ACAS peace talks and two days of industrial action amongst thousands of doctors across England.

So this Tsunami, which has been rumbling and rising for months has finally crashed around us. Devastation has ensued. Many picked themselves up, dried off and booked a ticket on the next plane to a friendlier climate. Most have not admitted defeat, planning instead our next defence. At present, the chap (Did someone say 'Jeremy'...?) who created the Tsunami is cruising around on his catamaran (most likely capitalising on peoples' fear of a further disaster by selling off essential lifeboat services for less than market value). Despite many of his lifeboat's engines having been poorly maintained for decades, he's assuming they'll survive for a few more years; until of course he can replace them with either engine 'assistants' or maybe even a bottle of diluted 'engine' essence.

Before the Storm

Despite headlines describing our 'pay dispute', a 'militant' trade union, all those excess deaths we cause at weekends by not being in work (must be those invisibility cloaks we wear, sorry for any confusion) or even what champagne we drink (its Moet, by the way) - we have been relentless in our campaign to negotiate a contract which delivers for both patients and doctors. We have done this with our heads held high, while our Health Secretary repeatedly puts the reputation of his party into disrepute by the persistent manipulation of medical statistics for political gain.

What should have been a respectful and straightforward discussion between employer and employee has turned into a devastating, six-month cyclone whereby our contract has become a political football, going from pillar to post and back again. Currently, the football probably resides somewhere in the metaphorical equivalent of a blocked toilet; minimal possibility of Dynarod.

So after six months of bitter disagreement, who is sinking and who is swimming?

Since July 2015, over 500,000 people have signed e-petitions relating to votes of no confidence in Jeremy Hunt. Public opinion polls have found between half and two thirds of the public support junior doctors. While we have the signatures of thousands of consultant physicians, surgeons, paediatricians, academics and official statements of support from virtually all the Royal Colleges - Jeremy Hunts' rescue negotiator David Dalton recruited only 20 'signatories' to his letter in support of imposition, 14 of which rescinded their support within 48 hours of its publication.

While we get delivered thank you cards and 'save the NHS' cakes to our picket lines, a Jeremy Hunt piñata gets attacked on live television. As a profession, 90% of you trust us. Since 1983, politicians have consistently been the UKs least trusted group of professionals, with only 18% of Britons admitting to trusting one.

What's next?

As the population gets older and frailer, that poorly oiled and fragile NHS engine starts to splutter and smoke. 'Major internal incident' due to lack of beds before 9am? Just another day. One fully qualified nurse per ward at night? She's used to it. Exploding cost of agency staff? Absolutely! How else do you fill dozens of permanent rota gaps? Yet this government's current priority is to continue waging war with us; to spread the service we provide in the face of all of these challenges even thinner, with not one penny offered for the funding or training of extra doctors.

The main problem? Despite being one of world's largest employers and national health services, we simply don't fund it. The Kings' Fund tell us that spending on social care has been cut in real terms by 40% since 2010, with annual percentage GDP spent on healthcare lower than other European countries. You don't have to be an economist (or even a doctor) to realise that investment in healthcare and robust numbers of doctors is worthwhile. So with the NHS supposedly at the top of this governments' agenda - why must they leave our healthcare service, this country's biggest workhorse, begging for more?

It is now clear that the motivation behind a drive to flush the working conditions of junior doctors down the toilet, is a political one, with the 'Seven day NHS' election manifesto permeating contract negotiations like a virus. To deliver this 'Seven day NHS' in the form Jeremy Hunt is eluding to, without committing the billions of extra pounds in funding which are needed, he needs to find the Pound Shop option. How does he do this? By championing a contract which devalues the professional and personal lives of doctors, by making our time effectively worthless.

The Next Wave...

The implications of the proposed contract for the delivery of safe and high quality care by a finite number of doctors, with far and deep reaching impact upon morale will amount to a signature on the death certificate of the NHS as we know it. Last week, BMA meetings up and down the country acted as a medium for doctors to unite even further and voice concerns over recent 'nuclear' events. The next wave is coming; but with an entire profession united in our resolve not to accept imposition, it will certainly be heading in the opposite direction. In conjunction with a legal challenge, three new dates for industrial action have now been announced.

Recently on Radio 4, Sarah Wollaston (Chair of the Commons Health Select Committee) described the Government's responsibility 'to follow the evidence' when deciding whether or not they would vaccinate children against meningitis B based on cost. Given what we know now, the same approach must be used in addressing the question as to whether or not Jeremy Hunt's contract is capable of delivering its promise, is economically viable or is even lawful.