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Labour’s overtime pay plan for doctors is welcome – but not sustainable

How can clinicians work longer hours when they are already exhausted?

By Phil Banfield

I listened with interest last week as Labour proudly revealed plans to “beat the backlog” and tackle rising NHS waiting lists with extra funding for evening and weekend appointments. It was heartening to hear how the party intends to do this by properly compensating doctors for overtime, but this short-term fix is unsustainable without long-term solutions running simultaneously.

When I started my medical career the NHS was widely seen as one of the best healthcare systems in the world. Sadly, an analysis by the King’s Fund shows this is no longer true. Two of the major reasons for this are a lack of doctors and nurses – far fewer per head than other developed countries – and a lack of investment in equipment and facilities.

For more than a decade, what should be a superb health service has suffered from calls to “reform” and “modernise” when faced with increasingly complex needs, older patients, and worsening health inequalities from the political choice of austerity.

Record waiting lists – now nearly eight million – predated the pandemic and the doctors’ strikes. We do not have enough doctors for the current demand. Many doctors are tired, frustrated and looking to give up on either the UK or on medicine altogether, expected to work even harder and longer for pay that buys less each year.

It’s vital that we reverse this decline, so I welcome Labour’s announcement that in government it would invest £1.1bn to help clear the backlog with two million more appointments and extra pay for staff. But this relies on doctors and nurses working overtime when they are already exhausted. While this move may incentivise health workers, what we really need is a health service that enables doctors to get to treating patients. As I’ve said many times, doctors are the solution, not the problem.

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Growing and strengthening our workforce to address the NHS’s current recruitment and retention crisis is key to tackling waiting lists. Meanwhile, as we train the next generation of doctors, we must retain the experience, expertise and mastership of our most senior clinicians. This has a cost, but there is a much larger cost associated with losing them; the value to the country of clearing waiting lists is thought to be £73bn between now and 2027. It makes economic and moral sense – it’s an investment.

History is written in the future. We must wait to see if Labour really will value doctors – and those throughout the health and social care sector. The party still needs to win a general election first. But this is the critical point – we cannot afford to wait for a possible change in government, whenever that may happen. Our patients need action now. Yet again I implore the current government to engage meaningfully and constructively with a credible pay offer.

The irony of the current situation isn’t lost on me – the British Medical Association (BMA) initially opposed the formation of the NHS in 1948. But listen to us now when we say: take action to help secure the future of the NHS, or risk its collapse.

[See also: NHS doctors minimise menstrual health issues, celebrities tell MPs]

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