On Whether To Support The #JuniorDoctorsStrike

Tuesday 26th April will see one of the largest doctors strikes in living memory in the UK. And of course, the evening prior is the perfect time for my knee to slip out. (It’s been bothering me all day, then in bed I looked down and thought “bollocks. That kneecap isn’t meant to be there.”)

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Of course, faced with a trip to A&E on the eve of a doctor’s strike,  I mused over whether the vague inconvenience to me was worth having a grump about…

On the face of it, this seems a simple issue. The politicians saw data that shows people are more likely to die if they go to hospital at the weekend : solution – a 7 day NHS where there are no ‘down days’. To create this, junior doctor contracts are being changed to require them to work shifts covering 24 / 7 available care. Doctors are not pleased by this.

But what about the finer points of what’s being played out?

Firstly, what is a junior doctor? That’s not age or longevity – a junior doctor is anyone who isn’t a specialist consultant or GP.

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More people die when admitted to hospital at the weekend.
My inner mathematician loves this argument. It’s like giving a Bible to Tim Minchin; nothing good will come of this, but it’ll be funny to watch from the sidelines.
Now stats can prove anything. Using this most basic of correlation vs. causation argument,  we could argue that shark attacks cause people to eat ice cream. People eat more ice-cream in better weather. They also swim in the sea. By being in the sea, there is a higher risk of shark attack. There is a correlation in the data, but one does not cause the other. Using the same logic, it may be that people who go to hospital at the weekend are already more unwell, or that people put off going until the weekend, or that the injuries caused at the weekend are more life threatening, or indeed that hospitals are more dangerous to enter at the weekend. Without the relevant data analysis, all we can infer is that there is a correlation of data between it being the weekend & mortality rates.

There are fewer doctors working longer to cover the shortfall
Right now, doctors already work 7 days. Yeah, ok, it might not feel like it when we’re playing GP appointment roulette at 8am, but when their funding is based on a numbers game & appointments must be “made available within 24 hours”, if you’re that unlucky bastard that is on hold for 40 minutes & there’s no appointments left, you’re not part of the all hallowed waiting time statistics. Not so long ago, Mr Hunt himself took his child to A&E for neither an accident or emergency as he had no desire to wait patiently.

Hospitals are falling into debt left, right, & centre due to mounting private contracts and the staff are told there just isn’t the money to keep going. (For the record, public sector workers have seen little more than a 1% pay rise in over 4 years compared to the 11% the politicians awarded themselves last year).

The Contracts Are Not Safe?
There’s a lot of misinformation being whirled about in the press. One message that isn’t very clear from the doctors is that the contracts they aren’t happy about include some rather worrying adjustments to working conditions. So far, the BMA (British Medical Association) have been negotiating for:

no doctor to work more than 72 hours in a week; With an EU working directive of no more than 48 hours, how is the government demanding more than 72?

no more than four nights in a week on-call; This would be in line with most private industry. We’re all perfectly aware of the strain shift work puts on people. The proof of this is the special consideration given to MPS working past 7.30pm, or on Saturdays.

a rest day either side of nights before starting back on day shifts;  Again, a similar shift pattern to private industry where the physical and mental toll of shift work is considered.

facilities to sleep-in for those who otherwise make a dangerous long drive home; Not often something that is provided for others, but clearly not a bad idea to prevent extra emergency patients.

So far, this doesn’t appear to be anyone asking for a “cushy number”. And a working week of less than 72 hours for £23 – £45k seems quite reasonable. Especially when making a mistake might actually kill someone.

And possibly here’s the crux of it. Doctors are generally paid above the national average wage. And we Brits do love a stereotype to rage at. Some genuine comments I’ve heard:  “Why are they complaining? They earn enough!” – are we suggesting there should be Tesco Value X-rays? Essentials stitches? Everyday Value apendectomies? If we hate everyone that earns more than us, why are we not lynching the footballers? The politicians? Pretty much anyone who works in the investment banking sector? It’s not a race to the bottom. Just because someone else’s job is worse, we shouldn’t lower the bar!

“They don’t live in the real world. Private workers do shift work.” – and they do, however when you suggest The real World is a factory as opposed to fixing a bleeding human I’m not wholly sure you’re right. What doctors (nurses, physios, etc) do is very real indeed. In fact so real that it’s best not to think about it.

I’m very open that it took me many years to be diagnosed with my own chronic illness, and my diagnosis came too late. By the time we realised what it was, I had dislocated & subluxed so many times that my nerves were trashed. I could easily rage against the NHS, but do you know what?
It wasn’t their fault that my GPs only had 10 minutes at a time to discuss my rare condition.
It’s not their fault that the only specialist clinic has such a long waiting list right now that they have closed their doors.
It’s not their fault that they can’t provide long term physio.
The buck stops with the Minister For Health. With an appropriate funding structure & money not being wasted on private investment and gimmicks to make the government look good, treatment could have been available.

My personal view is that strikes don’t help matters. It’s too easy to use them as a stick against those trying to get their voice heard. Just like when you’re battling Voldemort, patience is required. And the ability to use the power of his own wand against him.

With that said, I’ve done my bit to lighten the load & physiotaped the hell out of my wonky kneecap. It can wait until their voices are heard. So my leg is coming out in support of the doctors. You do a good job of fixing people, but you need better PR people.

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3 thoughts on “On Whether To Support The #JuniorDoctorsStrike

  1. I just heard about the strike today, and was glad to hear your thoughts and get more information. A slightly relevant aside: Some years ago I did some free-lance editing, and one of the books I worked on was titled “Twenty-four/Seven or Die” (I’ve always thought that title was overly dramatic). It was written by a woman whose husband came down with a life-threatening but mysterious illness, and her main point was that he nearly died several times over the weekends, in the months he was in the hospital. That’s where the title of the book came in – that if she or a close relative hadn’t been with him 24/7 she was certain he would have died due to poor medical care. She had quite a bit of evidence that the weekend danger is real, but it was so long ago that I read it I couldn’t cite any of it now. And, quite honestly, I’m not sure her perspective was entirely trustworthy. But I have been told by medical professionals that the staff on duty over the weekends is always “C-string,” meaning not even the second-best but third-best. In the end I don’t know how true the theory is, but I think it’s interesting. And I think all your points are valid.

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    • There’s a reduced number of staff at weekends, and in my personal experience if they want 7 days, then it’s not just doctors, but all the other services that they’ll need to make 7 days, including the specialist consultants.
      Anything emergency based is already there all the time, but my personal experience is that many consultants work part time for the NHS, but spend most of their time in private clinics. In fact one particular professor I saw now only takes on private work. Conversely, some NHS consultants can be very weird with you if you’ve been so bold as so pay for treatment privately to avoid the waiting lists.

      I don’t blame them. It must be a much nicer job. I do worry that we have a very much 2 tier system.

      Liked by 1 person

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