3 Strikes and You're Out

The only health related things that seem to be increasing under this government are waiting times and blogs by angry healthcare workers. But with the prospect of further junior doctors strikes, I've written some advice for junior doctors, the public and Jeremy Hunt. (Not that he'll listen mind you, it's like shouting at pigeons in the park, but at least it gets it off my chest).

For Junior Doctors:

1.       This is a contractual dispute. The intricacies of doctors’ rotas/banding system are about as interesting as the Galactic Council debate scenes in the first Star Wars films. Some managers don’t understand the system, and the government sure seems like it doesn’t, so keep messages simple: “We don’t currently have enough staff or funds to operate a 5 day service. Without increasing staffing or funding, stretching Junior Doctors more thinly over 7 days is unsafe” and “By the government’s own admission, this contract discriminates against women. This is unfair”

2.       The government may be underfunding and understaffing the NHS, but they are also underestimating junior doctors and the medical and nursing professions. The “divide and conquer” tactics haven’t worked. Consultants, nursing colleagues and the public have backed us so far. We can’t throw future doctors under the bus for short term compromises

3.       However badly aggrieved we feel, being a doctor is a privilege. Really. We must not forget medicine is still a good career with job security better than many other professions. Sure, we get a worse deal than doctors in virtually every other developed country, but we get a good deal better than a lot of others and we shouldn’t line up to play the world’s smallest violin.

4.       Support each other and support colleagues in other medical and non-medical professions. The whole public sector is being squeezed by ideological austerity. Next time you read articles about teachers’ strikes or rail strikes consider how our dispute was spun in the media. Our public service colleagues also deserve our support

5.       The junior doctors of today are the medical leaders of tomorrow. Instead of getting angry, get motivated. The phrase “Don’t sweat the small stuff” is bullshit. Sweat all of the small stuff. Consistently. Start making small changes, and big changes may follow. Consider taking managerial roles. The biggest challenge in the NHS is inertia. Don’t be that doctor who sighs and shrugs their shoulders with the system, try to change it

6.       Patients come first. Always. That’s why we do what we do

For the public:

1.       Remember when nurses and doctors crashed the financial system? No. Good, because it didn’t happen. The financial crash resulted in the biggest squeeze on public services ever seen. The austerity agenda has led to enormous (and often hidden) cuts and a huge drop in people’s wages. When I say “peoples wages” obviously I don’t mean MPs (11% pay rise) and bankers (30% pay rise)

2.       The NHS is failing. The medical profession thinks it’s because the system is underfunded and understaffed. Despite government promises, the NHS has been suffering the biggest financial squeeze in its history. Workload has increased, but funding hasn’t matched this. The % of GDP spent on healthcare in the UK is one of the smallest in developed countries and is set to decline even further. Despite claiming to be a “patient safety champion” Jeremy Hunt buried safe-staffing recommendations as he wants to cut staff costs.

3.       The government claims the NHS is unsustainable. But they are making the financial choices. They had the money to award MPs pay raises, to protect banker’s bonuses, to cut corporation tax, inheritance tax etc. A fraction of the spend on Trident would eliminate the “deficits” of NHS trusts. The government could chose to fund healthcare properly. But they chose not to. They want the NHS private. Under this current government, further rationing of services is both inevitable but unnecessary .The government isn’t subtle about privatisation. Jeremy Hunt co-authored a book called “Direct Democracy” which called for it

4.       Privatisation has been happening in the NHS for a number of years. It is difficult to detect as private companies can use NHS signage and work on NHS property. NHS 111 is run on private contracts, Urgent Care Centres are run by private firms, and mental health services, community child health services, addiction services and cancer services in certain regions are run by profit making companies

5.       Privatisation selects out “profitable” areas of practice. Hinchingbrooke Hospital in Cambridgeshire was taken over by private company Circle. Under private management it went into Special Measures and Circle pulled out of the contract. The “profit” of the NHS is surely returning people to health. Because having a healthy population benefits us all

6.       Whatever you think of doctors, this isn’t a dispute about money. Doctors have never asked for a pay rise. The government has never explained what it means by “a truly 7 days NHS” and has misrepresented data in it's efforts to force contract change. 7 day emergency cover already exists. “Non-emergency” care on the weekends isn’t a priority when funding already isn’t sufficient. Without more doctors, stretching a system already struggling to carry out “emergency work” to cover “non-emergency work” makes no sense. The benefit for the government of this new contract is that it reduces staff costs and increases services that are extremely profitable for private companies (namely non-emergency things over the weekend)

For Jeremy Hunt:

1.       F**k off