Junior Doctors and the NHS Culture of Management

Junior Doctors and the NHS Culture of Management

The junior doctors' strike this past September protested the proposed salary cuts of up to 30%, an increase in these doctors working antisocial shifts, the pay protection for women who have children being removed, and a reduction of 40% in GP trainee salaries. And there was great public support for this strike largely because of the sympathy with doctors making a starting salary of £22,636. And the BMA (British Medical Association) has warned that the proposed new contract will prove to be both "unsafe and unfair." And on 28 September approximately 5,000 junior doctors protested outside Westminster Hall, rotas which cause doctors to burn out due to the twelve day stretches of 13-hour shifts.

More and more doctors have taken to write anonymous and named editorials protesting their conditions where the complaints range from the complete isolation of personal life, the lack of money for professional formation and conferences, the economic hardship to join the Royal College of Surgeons much less to have enough petrol to get to work, the increase in debt for medical studies, and the dire need for 40% more NHS staff.

Now there is another full strike being proposed and it looks like this could be the first of its kind in the history of the NHS with the union announcing that all doctors would strike with the exception of emergency care workers beginning on 1 December with a full walk out planned for 8 December and 16 December. It is reported that should the changes in contract go ahead that seven in ten doctors plan to leave the NHS with many planning to leave for countries like Australia and New Zealand where the working conditions and salary are much better. While the hours that doctors and nurses are expected to work can be unbearable in the UK, the proposed changes would also redefine what anti-social working hours are.

Recently Sir Robert Francis QC warned England's 53,000 junior doctors about the dangers of a strike while admonishing the government for its mishandling of the situation stating: "It is of course possible that some modification in the contract may be achieved, but at what cost? The history of large scale industrial action suggests to me that it can be a catalyst for the replacement of the relevant service by often less satisfactory alternatives."

The real question is why are these doctors' complaints not being taken seriously? According to NHS For Sale, junior doctors who are leaving the NHS have stated the reasons: "the volume and intensity of their workload, too much time spent on unimportant tasks and introduction of a seven-day working week as major contributors to their decision." And when you speak to the doctors about why they are unhappy, they will tell you about the increase in administrative work, the reduction in actual health care work (which was the reason they entered into this profession), and the inability to efficiently carry out their profession. I recall the visit to my GP, a walk-in appointment, many years ago when she asked me what was wrong. I then listed my symptoms and she stopped me after the second symptom stating, "I am sorry but I can only hear two symptoms." I was perplexed and asked why and she responded, "Because I am authorised to hear only two problems. If you have another you will have to make another appointment." I was on the verge of laughter at this point and I pointed out that the symptoms were collectively important for her to be able to diagnose what I might have. After all, how would I know which symptom could be omitted from the list of three from which my doctor could adequately help me?

But then, given the fact that doctors going on strike usually leads to a drop in mortality rates, this strike might just be a blessing in disguise while allowing these junior doctors the opportunity to fight for their rights and the conterminous amelioration of the NHS.


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