In November, a ballot of over 37,000 of junior doctors resulted in 98per cent backing full strike action as a result of new contracts being imposed on them by the current Tory government. To get a better understanding of the situation, I spoke with five junior doctors, some of whom wish to remain anonymous. They work in different hospitals all over the United Kingdom, making one thing clear from the start: this is a national crisis; no one area can shoulder the burden for its neighbour, if every hospital in the country is overstretched.
The negotiations themselves are far from over. Wider cuts to the NHS have led to bed-blocking, which John Moore, a Newcastle based junior doctor, describes as, “elderly patients medically fit for discharge from hospital but unable to leave without care in the community”. Pete Campbell, a junior doctor in the North East, mentions staff shortages and trusts facing bankruptcy. As a result of all this and more, there is a greater need for junior doctors, however, due to the contracts being imposed, several junior doctors have told me that the incentive to work in England is waning. One solution to this is moving to Australia or New Zealand, as many junior doctors already have, but one doctor tells me, to my surprise, that many junior doctors may move to Scotland or Wales, where the new contract will not be imposed. “The doctors remaining will have to fill many gaps in the rota and will be at higher risk of burnout”, John says, “and, of course, making more mistakes due to tiredness”.
Normally, when interviewing someone, I would arrange to meet them in person or conduct the interview over the phone. I feel it’s important to note that not a single junior doctor had enough free time between their long shifts for a phone call, instead, they could only answer my questions one at a time via email during the rare breaks in their day. This took a fortnight. Bearing in mind that they’re all already being stretched thin, I asked what exactly it is they hope strike action will achieve.
Pete points to the threat of industrial action, rather than a strike itself, which he believes has, “brought the government back to the table for meaningful negotiations”. John echoes this. He says, “Industrial action is not a goal in itself, the aim is return to negotiations”. Every doctor I spoke with attributes the ACAS statement and government climb-down at the end of November to dialogue as a result of the threat of strike action.
We are, without any doubt, heading towards a, workforce crisis, as one doctor puts it. John says this is due to, “Doctors applying for a specialty (after two foundation years) plummeting from 70per cent to 50per cent”, and that was before the contract problems began.
The most obvious source of these contract problems is the Health Secretary, Jeremy Hunt. One doctor stated that doctors, in general, aren’t very politically active. John says, “The only impressive thing that Mr Hunt has done is unite a profession against him”. But how has he done this? By insulting their professionalism, John thinks, going on to list, “describing our job as Monday to Friday and saying we lack a sense of vocation”, ignoring the common 12 consecutive dayshifts, and seven back-to-back nightshifts, “conflating the seven-day service manifesto promise with a junior contract that already allows for weekend working”, which “amounts to being accused of causing patient harm because of a reluctance to work weekends”. There’s an irony in Hunt calling junior doctors “militant”, given their reticence to strike in the past 40 years.
Pete takes a slightly different view; he states, “Jeremy Hunt has failed to settle this because junior doctors and the rest of the NHS aren’t negotiating with Jeremy Hunt: they’re negotiating with the Treasury”. It seems that every doctor I speak to believes Hunt’s main issue is ignorance; he wants a seven-day NHS, but there simply aren’t the resources to fund it.
Buried amongst 429 separate reports released by the government on Parliament’s final day last year, was a consultation, which resulted in a 97 per cent negative response rate to seven-day services as the NHS currently stands. The government are continuing with this plan regardless.
“The OECD estimates that we are already short an estimated 45,000 doctors and 27,000 nurses”, Pete says, which another doctor only sees rising during this government. He continues, “Hunt seems to be playing the Michael Gove role.” When Gove was in Education he became the villain, when he moved on it became the victory, yet education policy didn’t change. Pete adds, “I find it very hard to believe he’s as ignorant as he’s playing”.
But is there an alternative? Everyone I spoke with is a supporter of Jeremy Corbyn, albeit, perhaps for slightly different reasons. John seems to appreciate Corbyn for, “recognising the importance of trade unions”, another doctor concurs, feeling as though the Tories have united junior doctors through their attacks on trades unions and the NHS. Years of privatisation are also a concern of many doctors, with John telling me, “NHS trusts saddled with PFI deals cost them millions each month”, but, “a reversal of this policy could allow for much greater spending on doctors and nurses, instead of ending up in the pockets of private companies”.
There is a consensus among the doctors I spoke with, as well as all of their colleagues, that they admire Corbyn’s convictions and principles but are even more impressed with the Shadow Health Secretary Heidi Alexander, as Corbyn has not been as vocal on the subject as Alexander.
Pete, however, has been, “thoroughly unimpressed with the Labour Party”, during his political lifetime but sees Corbyn as a, “fantastic breath of fresh air for the Labour Party”, resulting in his joining Labour to support Corbyn and, “continue the fight against austerity”. Austerity isn’t just another bit of jargon to junior doctors; Pete has seen its effects on people’s lives, from, “mental health worsened by benefit sanctions and workfare, to patients who have died in hospital from hospital acquired infections waiting for a social care bed”. He states plainly that, “The Tories know this and choose to ignore it; this is an ideological decision.” And yet, he and the other doctors are optimistic, thanks to a, “renewed Labour Party that fights for working people”.