I’ve seen you on the news recently. You’ve certainly got yourself a lot of coverage! Seems not a day goes by without your voice belting across the airwaves or your face covering our TV screens.
You’ve got a lot to say about how your brand new contract for junior doctors will revolutionise the NHS, enhance patient care and generally make the world an entirely better place.
It will be so good, in fact, that you will do whatever it takes to see it comes to pass.
But what about the debris left behind? What about the long-term consequences? The effect on morale and recruitment? What about the state of the country’s Health Service then?
My wife is in her final stage as a junior doctor. She studied, hard and long, at Medical School for five years, racking up tens of thousands of pounds in debt. She essentially worked free for two years on placements – as do many other devoted health service professionals in training – before qualifying in 2010.
The next stage? More training. Long, gruelling hours as an FY1, with huge levels of responsibility followed by a step up into FY2. Yet more punishing shifts, round the clock and for many days at a time.
7 day NHS? You betcha. There’s a reason why #I’minWorkJeremy went viral…because so many doctors do already work 7 days a week. Late into evenings. Through the nights.
When my wife worked A&E she would often finish at 4am. Not a night shift in total but it might as well have been!
Does work stop for doctors when they leave the hospital/the clinic/the surgery? No of course not! That kind of pressure, that kind of stress, that kind of emotional attachment lives on. My wife would worry and stress about patients, occasionally waking up in the middle of night panicking about a potentially incorrect diagnosis or missed prescription.
There’s not many other jobs where a mistake can truly have life-threatening consequences.
We barely saw each other during FY2; the demands of a particularly heavy out of normal hours schedule and her working 30 miles away took its toll. It was intense. It was difficult. Yes, she got paid extra for the inconvenience and that was helpful. However, for the responsibility and the pressure endured, the payment almost appeared token.
For Core Specialty trainees, the workload only gets heavier, the responsibility (and accountability) greater and the family time smaller.
With her interest and obvious expertise in Medicine/Surgery/Obs and Gynae/Paeds (I could go on, she’s very good!), my wife could have done anything as a specialty. Ultimately she chose GP – possibly hoping she’d get to see us a bit more than the crazy antisocial hospital shifts you believe doctors don’t do.
At least with GP, the shifts are generally weekdays and there is some inherent flexibility which would allow my wife to see her daughter, do some things as a stay-at-home mum at times and be available to parent her!
And yet… a few years ago, your government piled on further expectation onto GPs by requiring them to become managers and business owners, adding an extra layer of administration to a job which already requires great investment, time and emotional commitment.
If it wasn’t for GPs offering that trusted first point of contact, the system would collapse. As for “General” Practice, to do her job properly she has to be good at everything. You can’t just say “Oh I’m sorry, I never learned about that.” Leading to long hours, weighty responsibility and constant anxiety
Now, you want to load yet more responsibility (and blame!), antisocial hours and burden onto the very people who keep the system afloat in the first place!.
On the surface your aims are laudable. A National Health Service which runs every day at the same smoothness, a well-oiled machine whereby weekend service is exactly the same as in the week. Imagine being the Health Secretary who delivered that! You’d go down in history!
There’s just one small problem. The country doesn’t work like that. Weekends are different. And they will continue to be. To get an NHS that works like it does in the week, you need every single aspect of that NHS up and running at the weekend.
What about the injured patient who needs urgent physio? Sorry, it’s the weekend. Or the lady who needs an Occupational Therapy assessment in order to get out of hospital. Sorry, that’ll have to wait until Monday. Or the suicidal man down in A&E who needs Crisis Team and Mental Health Provision urgently. We’ll do what we always do and look after him, but things crank up again on Monday. When everybody’s in.
If you can change the country’s week from 5-day to 7-day, you’ve got a chance.
But not even your all-powerful, “hugely popular” Conservative government, with it’s naturally all-important “mandate for government” which you are so happy to remind us of can deliver that.
So leave off the doctors. Rethink the contracts.
And maybe we can all get on with living our lives.
A Concerned Husband