If you’re in the UK then you will no doubt have heard of the Junior Doctors Contract palaver all over the news.  I won’t go into too much of the details but just want to put my two cents out there on the interwebz.

Basically Jeremy Hunt – the health minister in the uk – has imposed a new contract on Junior Doctors so that more of them will work on weekends and out of hours.  The contract is “cost neutral” to the government, so basically Juniors will have to work longer hours for less pay to provide this service.


Jeremy Hunt

As a junior doctor (currently in my last hospital post), it is astonishing to think that the government are actually going to try to stretch the juniors even further.

I remember when I graduated and started work as a FY1 doctor in 2012.  I remember vividly how I’d have to be on the ward twenty to thirty minutes earlier than contracted to get ready for the ward round which started at 8am.  I would work continuously doing all the jobs, paperwork, seeing sick unwell patients and most days not finishing before 6.30pm.  I am a pretty fit guy and I would be exhausted after a days work.  It was emotional, physical and mental labour.  It was not an easy job.

Another thing I remember about when I first started working (and actually still hate about the job) was that weekends were incredibly tough.

During a normal working day there is usually a full team of doctors on the ward so that seeing unwell patients and ensuring all the necessary tasks that go into looking after patients gets divided up by the team.  This helps tremendously, but you will still never finish on time and are likely to have to skip your lunch break a lot of the time.

Weekends are a different ball game.  Usually on the weekend there is a team of doctors, but you will be covering a whole bunch of wards and also having to deal with new admissions and having to sort out all the patients who deteriorate throughout the day.  These shifts are the ones that all new doctors fear and they never stop being unpleasant even after years of experience.

I always thought that this type of work and abuse of doctors was a travesty for such a rich nation.  I always thought that once the public knew what doctors do (and heck most of the patients felt sorry for me when I worked in acute surgery, because they knew I was working my butt off!) then people would finally cry out for the NHS to get proper staffing levels.  It is unfair to treat junior doctors the way they are already being treated!  I don’t know of anyone else who works in such a pressurised system.  These weekend on call shifts often mean that you will be the sole doctor responsible for 100-300 patients!  What are you meant to do when more than one patient is sick and needs immediate attention?!  This will be a topic for another post…

But essentially what I’m saying is that with Hunts contract there will be less doctors on normal week days and maybe more on the weekend.  The doctors working weekdays are already stretched.  The doctors currently working weekends are at breaking point.  With this contract the doctors working both weekdays and weekends will be completely burnt out and demoralised continuously.  This will also cause patient harm as there simply won’t be enough doctors to provide the best level of care at any one time and as doctors will be consistently overly tired.

The solution to anyone with a brain would be to hire more doctors and other healthcare professionals, rather than making everyone work more when they are already working their butts off!

The crux of the matter is that we have a monopoly of healthcare in the UK.  This, combined with the fact that we have a government which believes in neo-liberal capitalism to the max is going to result in the destruction of the NHS.

I saw a patient in A&E a couple of months ago who was brought in by ambulance because he had the worst neck of femur fracture I’d ever seen.  After I sorted him out and put him in a Thomas splint ready for theatre, he asked my opinion on what all this contract stuff was about.  I explained to him that basically if this contract goes through then a lot of doctors will leave the NHS, there will be a recruitment crisis, the NHS will become privatised and doctors will end up being paid more, much more.  It is odd that right wingers often moan about how much doctors get paid and how spoilt we are, while at the same time believing in a free market economy.  The market rate of a doctor = locum rate of pay for doctors fools!  Having medical skills is still a rare and valuable quality in the market.  So how can these people justify their stupid opinion the way they are so vociferously doing so in the news, media and comments sections of newspapers etc.?!

I know that this was a very long rant, but it is just astonishing to me that the English public do not realise what they are losing.  What do they think will happen in the near future?  I mean,  how many other employers do you know of that knowingly work its employees far more than their contracted hours?  Why do the public stand up for employees being paid below the minimum wage at Sports Direct but not stand up for unfair pay for doctors who save lives every day?  Is it fair that an A&E registrar gets paid the same hourly rate as a bus driver?   Is it safe for an employer to remove the safeguards which would ensure doctors are not overworked to the detriment of patients in a system which is already as exploitative as it is?

Rant over.


Quite an apposite video


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