The new Battle of Britain!

He has started his final years and all being well, by 2017, he will have passed all his training and examinations and qualify as a Doctor.

Let me also say that any young person who decides to enter Medicine, absolutely has to have the support of his or her parents; the parents take that journey with them in support!

The path of Medical Training is dominated by copious note taking, long hours of study and very thorough examinations. In between all this, a Medical Student will have to live a life; some students try to achieve this on limited financial support and many offer time to their societies and raise money for charity. They do so knowing that by the time they qualify, their contemporaries have established careers and a developing family life.

OK, so I hear some of you say, 'well that's the life they chose' or 'they have the potential to earn a lot when they qualify' - those points of view may be reasonable to hold, but do the facts support these notions?

Firstly you should consider that many Medical Students will carry a debt ranging from £50,000 to £75,000 when they finish Medical School. Their starting salary is £22,636 and don't forget, they don't just become for example a GP on qualification, they have to complete a 2 year Foundation period and then a further 5 years to train as a GP - other specialisms have similar training periods, so many Medical Students will only get to the chosen point of their medical career when they are in their early 30’s.

So why is this important? Simply, The Rt. Hon Jeremy Hunt MP, Secretary of State for Health wants to radically alter the contracts of Junior Doctors (those being anyone who occupies a post below Consultant); this will have a radical effect on the quality of medical care you will receive and in my view, fatten up the NHS for the undoubted invasion of US Private Healthcare Companies.

I wanted to know exactly what the issues were, so I carried out some research.

This all began because the government wants a 7 day a week NHS; this is something that Doctors generally agree with.

In support of his argument however, Mr Hunt claimed that 6,000 people die in hospital at weekends every year because doctors don’t work weekends (one study put that at 11,000).

The article quoting '11,000' actually states that patients who are admitted at weekends are normally much sicker than those admitted during the week and that this is the likely cause of the higher death rate.

The researchers even state that they cannot correct for this in the statistics and that the conclusions that can be drawn from their data are limited; here's what they actually stated:

"It is not possible to ascertain the extent to which these excess deaths may be preventable; to assume that they are avoidable would be rash and misleading”.

In response to Mr Hunt's recent comments, doctor’s posted photos of themselves in work at weekends with the hash-tag – #IminworkJeremy – demonstrating that most doctors work weekends.

One Freedom of Information Act request found that only 1 out of over 4,000 Consultants didn't work weekends!

I then decided to look at the proposed junior doctor contract. The first myth to be aware of is that a Junior Doctor is basically any doctor who is not a Consultant.

The cohort of Junior Doctors therefore include those from their first day out of University to 10-20 years+ of being a doctor; as such they make up the majority of doctors in the NHS.

If you see a Foundation Doctor, a Core Trainee, Specialist Trainee or Registrar, you are effectively seeing a ‘Junior’ Doctor.

The second issue I found, as demonstrated above, is that a junior doctors basic wage starts at just over £22,000 and increases to around £60,000 after 10-15 years working in the NHS.

Junior Doctors are paid a bonus based on the number of unsociable hours worked (evenings, nights and weekends); this is called banding.

This 'banding' payment is designed so as to apparently pay for the additional childcare costs and to help take the sting out of having to miss family/life events.

The more unsociable hours you work, the higher your band and the more bonus pay. As I understand it, if you are initially in the highest band, your salary increases to just over £30,000; the downside to that is that you work almost every weekend and work 15 hour days/nights and do this for around 320 days a year.

Contrary to the wild stories offered by the media, it is not normal for any doctor (consultants included) to earn over £100,000 and when they do, this is because of work they do on top of the NHS, for private healthcare, law firms, medical research companies etc (the lawyers reading this will know that!).

This government wants to redefine sociable working hours as being from 7am-10pm, Monday to Saturday, and to remove the banding payments I have referred to above.

Negotiations broke down over this contract because the government said that if Juniors didn’t accept the contract, they would simply enforce it.

The reclassification of hours means that 4 extra hours a day are classed as sociable, as well as the entirety of Saturday.

To combat any loss in earnings, the government is proposing that the basic salary be increased slightly, but it appears that they are refusing to say by how much - why?

Equally embarrassing for Mr Hunt are the comments from the former Minister for Health, himself a qualified Doctor, Dr Dan Poulter MP who claims that Mr Hunt 'set aside an in-principle agreement' with the BMA, agreed before the election, but since May 2015, it appears that Mr Hunt has changed the deal! Why?

Despite apparent attempts to soften the blow, this strongly suggests that most doctors are now facing a pay cut of between 15-30% (after years' of pay freezes – real term pay cuts to you and me!).

GP Trainees are facing a 40% pay cut, this is despite the current recruitment crisis for GPs (only 60% of training posts filled), which is now set to increase.

This staffing problem will continue, leading to the necessity to use locum agencies. Private companies will obviously charge a premium to send doctors to the places they are needed to fill staffing shortfalls - is this not madness? This will only serve to increase the bill for the NHS and you and me, the tax-payer. In addition, banding offers pay protection to those wishing to take maternity/paternity leave, and those wanting to take time out to do medical research. The new proposed pay scale will effectively 'punish' people for having a family life, or for undertaking medical research that could benefit patients.

You also need to remember that Doctors have to pay for registration fees, portfolio services, medical indemnity insurance and training courses out of their our own pockets; I understand that this amounts to around £3,000 per annum.

The biggest concern of doctors though, is a section of the proposed contract that states that doctors must work 72 hours over a 12 day period with no regulation by hospitals; liberalisation of the employment market to you and me!

Remember, most doctors are already contracted just under this and yet put in over 12 hours a day for 12 day stints to make sure the public get the healthcare they need and deserve!

I understand that doctors under-report their hours so that trusts don’t get fined!

Under the current contract, hospitals must record the number of hours a doctor works, so that if they are understaffed and forcing their doctors to work unsafe hours, they can be fined; it acts as an incentive to the hospital to ensure that doctors are not being overworked and becoming exhausted.

The new contract does away with the monitoring of hours by hospitals, and in effect they will be able to get doctors work 100+ hours a week, something previous governments had been moving away from since the 1990’s; previous political responses really appear to be common-sense to me!

I certainly don't want an exhausted, demoralised, depressed, undervalued doctor, looking after me or a loved one, at the end of a 12 day set of 12 hours+ shifts; do you?

As the placards in the photo attached to my article suggest, tired, distracted, undervalued doctors can make mistakes; is that any different in any other profession - shouldn't we be moving away from some 19th Century idyll or is it really all about a fundamental politic?

In 2007, the documentary activist, Michael Moore produced his film on the American health-care system, Sicko. The film exposed how the American Dream was an illusion in that many of its own citizens simply could not afford to be sick and how the health-care companies callously dealt with their clients. Moore visited other countries and discovered how they invested in their public health-care systems, in stark contrast to the USA.

The late Tony Benn was interviewed and amongst his many comments he stated:

"If we can find money to kill people, you can find money to help people”.

And that is the nub of the issue; progressive responsible politics has given way to a wild fundamentalism which is not about trimming the national purse, but has an eye on the commercial possibilities. This is no more and no less than a battle for the heart and the soul of the NHS; they have attacked the Police, Nurses, Teachers, The Disabled, Trade Unions, now its the turn of the Doctors. 

We have to decide how far we want this to go, because when this rampage is over, there won't be many more 'interests' left to attack - what will the career politician do then?

© Frank Brehany 2015 - All Rights Reserved (First Published on 4/10/15)