To strike or not to strike? This is the key question facing 13,000 junior doctors across the UK. For me, this is an easy decision, but not one taken lightly.
This decision hinges on an inconvenient truth: you are not safe; I am not safe. The profession and patients alike are suffering as a result of incessant, relentless real-term pay cuts for junior doctors. So, yes, I will be striking – for my colleagues, my patients, and to save a wounded NHS. We ask not for revolution, but resolution. Strike action is being mooted for a point after today, 30 September, the deadline given to the government by the BMA to reinstate pay.
As a recently qualified doctor, I’ve been thrown in the thick of NHS pandemonium. In my first two weeks on the wards I was doused in urine, and sent on a quest to find “scrotal support” (I was surprised to learn this wasn’t a prank!). Once in a blue moon, I may just leave on time.
Though, I must confess, I do love my job. It’s a privilege to work in a public healthcare system providing universal accessibility, free at the point of care. Yet no amount of love for the NHS can detract from the glum reality of making ends meet as a junior doctor and the grim working conditions forcing many of my colleagues to flee.
New analysis by the BMA shows that pay awards for junior doctors in England from 2008/09 to 2021/22 have delivered a real terms pay cut of 26.1 per cent. A junior doctor qualifying in 2009 earned £47,500 in today’s money with £1,000 a year tuition fees, while I will have to work five years to earn the equivalent amount today – with a total of £100,000 tuition fees.
This is all during a cost of living crisis with inflation running at 9.1 per cent. And with a shortage of 12,000 hospital doctors, and 50,000 nurses and midwives, we’re often forced to do the jobs of two people, day in, day out. Are doctors today worth 26 per cent less than in 2008? If anything, post-pandemic, I’d say we’re worth 26 per cent more. Wouldn’t you?
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The implications of doctors striking are often discussed; the implications of not striking are discussed far less. We’re living in the spectre of the Covid pandemic: with 6.5 million people currently on the NHS waiting list, doctors face a workload of unparalleled magnitude. Even before the pandemic, in so-called “normal times”, nothing was normal within the UK’s mismanaged healthcare system. It was a global outlier.
We had the shortest consultation times of any developed nation on Earth and a doctor-to-patient ratio of two per 1,000 people – dangerously low compared to other European countries. We were spending just £2,989 per head of population on healthcare, the second lowest of all the G7 countries as of 2019. This is a record of shame for the Conservative government.
The very fact the NHS survived the pandemic – going into it battered and bruised by incessant cuts – is a testament to the equally bruised doctors and nurses on the front line.
And we’re now sleepwalking into the biggest medical staffing disaster in the NHS’s 74-year history, as outlined by a recent cross-party parliamentary report. This is an issue of retention as much as it is recruitment: described as a “quick fix” for the NHS.
For NHS doctors, this makes for particularly gloomy reading. A phenomenon known as “Drexit” is a major factor: 89.7 per cent of doctors who have already left the NHS to work abroad blame dissatisfaction with pay in the UK, compared to overseas posts.
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This doctor drain leads to a vicious cycle of burnout by remaining doctors who are left picking up the slack. Unsurprisingly, 92 per cent of hospital trusts have stated significant concern over staff burnout and work-related stress. We, as doctors, often doing the jobs of two people, cannot outwork government cuts – how much stress, burnout and pay cuts are we expected to endure to provide a decent public service?
And for patients, the picture is equally – if not more – glum. With a waiting list which may reach a staggering 14 million by the end of this year, according to modelling by the Institute for Fiscal Studies (IFS), this may prove to be a winter of despair, not just discontent.
Those 12-hour waiting times, delayed discharges resulting in 1.8 million days longer in hospital, cancer referral waiting times at a record high, and tens of thousands of surgeries cancelled. That is the impact of doctor shortages. And winter is yet to come.
The NHS is in peril; by proxy, patients and professionals alike are in peril. To strike is not a win for one, but a win for all. To those ministers clapping at us through the pandemic: I implore you to put your hands in your pockets to reinstate our pay and protect our patients instead.