Wednesday 9th March started like any other day - the daily curse of the alarm, the fight against the snooze for that elusive extra 5 minutes, a cup of tea then the long rainy drive to work. Unlike a normal day, though, I haven’t stopped through the hospital doors; I’m stood outside on strike with my colleagues.
Fittingly, today’s strike is the same day that applications for higher specialty training close. As a junior doctor applying for a registrar job, I feel the unease and uncertainty many are feeling about continuing training in England. Many of my colleagues haven’t applied, instead taking temporary locum jobs waiting to see what happens.
Some have applied to Scotland and Wales, countries which have rejected the contract already. Some have booked their plane ticket to sunnier climes. Some have just decided to give up on medicine altogether. This includes a close friend who is a new mum. Due to the changes within the contract, she fears she will lose her work-life balance – so effectively she has been forced to choose family life over her career.
Not exactly progressive gender equality, is it? It’s especially worrying when nearly half of the work force is female.
The proposed rotas displayed by NHS England demonstrate our concerns about unsafe and excessive working hours. On the Intensive Care rota, we will be working 7 in 16 weekends (so just under 1 in 2), working long stretches (7 days in a row). In weeks 5 and 6 we will be working 114 hours – 10 days in 12. Nobody who wrote these rotas could ever have worked in Critical Care.
Critical Care is a truly rewarding but also physically and emotionally tiring. We deal with big decisions, have life-changing conversations and save the lives of people who no one else can fix. Working 7 days in a row would break most doctors - let alone the fact that after one day’s rest, we will be expected to work four 13-hour shifts.
In Critical Care, we are expected to be physically and academically alert. I am fearful with these hours we won’t. We deal with some of the biggest decisions a person could make; we reserve the right for reasonable breaks.
Our anxiety about regulation of excessive hours hasn’t be allayed. The changes to the external regulation of hours will change to internal monitoring. We have not been given adequate reassurance that these ‘guardians’ will able to ensure protection against unjust and dangerous hours.
Furthermore, with an imminent debate for a private members’ bill that will exclude doctors from the European Working Time Directive, don’t we have a right to be concerned?
I am fearful for the number of new recruits in August 2016. Over the past few years, there has been a decrease in overall numbers of doctors applying for training. Furthermore, there has been an astronomical increase in the number of doctors applying for their Certificate of Good Standing in order to work abroad.
Hospitals and Primary Care are breaking. We do not have enough people in training to appease the demand and we are losing some of our finest doctors in a catastrophic brain drain. The possible implications are severe and long-lasting. Put simply, the government’s attitude and contract imposition is hammering the nails into the coffin of our NHS.
Going on strike isn’t fun. We understand the consequences; we see it first hand. We accept that elective care is disrupted; but we are being ruled by a government who will not listen. We are tired of shouting, we are tired of the uncertainty and we are scared for the future. I hope and pray for the future of our beloved health service. All we can do is hope that Mr Hunt listens to our plea for a review of this harmful and dangerous contract.
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