Exhausted? Of course I am.

imageJeremy Hunt’s strategy now is to exhaust the junior doctors.” Guardian 1/2/16

I am, like many of my colleagues, indeed, exhausted.

I’m exhausted of going to work to find huge gaps in the rota where doctors used to be, where nurses used to be, where physiotherapists and OTs used to be. I’m tired of never seeing a contract, never being able to plan to see my family. I’m exhausted by the deaf ears of faceless administrators.

I’m tired of endless top-down reorganisation, target-chasing and publicity managing. I miss looking after patients. I miss training to be a better doctor.

I’m exhausted by the media. I was on BBC radio during the last strike, and a rather hostile presenter asked me “Why are you on strike? Why aren’t your doing your job”. I gave a PC, measured answered. But what I wanted to say was this ; “I’m striking today to protect the long-term health of patients. That’s my job. But what about you and your fellow ‘journalists’? Are you doing ‘your job’? When a Secretary of State and Prime Minister can say anything and it is reported verbatim; unscrutinised,unchallenged and uninvestigated? When they can lie about stroke care, perinatal care, weekend hospital care, consultant cover, NHS funding, NHS safety and privatisation and not a single journalist will take the time to report the utter lack of credibility on any health issue in any way? I’m doing my job to the best of my ability- are you doing yours?”

Sigh.

I’m exhausted by the politics and the endless endless lies and spin. I’m tired of having to counter the same propaganda ad nauseum. A ‘seven-day NHS’ sounds great- but what is it? Is it urgent emergency care? We already have that. Is it routine care? We don’t need and can’t afford that- not when the NHS has never been poorer. Can we make it better? Of course- but we need investment, policy based on evidence not sentiments. Should I go to hospital at the weekend? Emphatically, categorically and unreservedly YES.

I’m sick of noxious columnists pumping out toxic nonsense; d’Ancona, Baxter, Lawson, Vine…the cogs of the Tory spin machine are many, and they are all dirty.

Most of all I’m exhausted by fighting for an NHS on the brink of destruction- and the public remains wholly unmoved. When you go to the doctor and she tells you something is seriously wrong- how do you respond? Do you then go to the Daily Mail to fact check it? Do you ask for a balanced opinion from a government think tank, deeply invested in privitization? I’ll declare my vested interest right here; I’m a junior doctor and I think the NHS is the best healthcare system for my patients- in equity, in outcomes, in value for money. Now the junior doctors are striking, the GPs are resigning, the consultants are halfway between both. The student nurses are striking, the staff nurses are planning, and pharmacies are closing. Meanwhile NHS services are already being sold- to Virgin, Circle, TDL. Domestic and domiciliary have been private for years already. PFI hospitals are £80 billion in debt for £10 billion of services – does that sound efficient to you?

The end of the NHS is here- not in five or ten years, but here, now, collapsing from August. Do you really believe this government is ‘the party of the NHS?’

Did you vote for this? Did you look at the Tory manifesto and read the pledge ‘Seven Day NHS’ and think- “That’s got my vote, now bulldoze the thing and where’s that private health insurance brochure?”

We haven’t explained ourselves properly and for that I wholeheartedly apologise. The junior contract is simply a means to make lucrative weekend work cheaper, and reduce the pay bill and pension bill on hospitals for private takeover. There really is no other reason to do what the government are doing. They don’t care about the safety of patients- they’ve cut hospital budgets in relative terms the deepest in NHS history, we have less doctors and spend less % GDP on healthcare than most of Europe, and they tried to suppress reports on safe staffing levels for nurses. They don’t even care about ‘balancing the books’- the NHS will be £2 billion in debt this year. The national debt in 2007 was £500 billion, now it’s £1.6 trillion. In 2007, the deficit was £41 billion – now it’s £90 billion. I hear your cries of ‘the financial crash’. Exactly- and here is the cost- years of private debt generated by illegal banking practices absorbed into the public purse. Banking and corporate tax evasion remain unchecked. The NHS and every other public service for sale. It’s a crime too huge to see.

I’m exhausted. Yes. And alone, perhaps, defeated. But I’m not alone. 250,000 doctors in this country, 400,000 nurses, 150,000 allied health professionals. 19 million families. 66 million people.

Dear other normal human beings, join us, and help save our NHS, if we can.

Second Junior Doctor’s Protest, Saturday 6th February, 12.00 Waterloo Place, London

Second Junior Doctor’s Strike, Wednesday 10th February, picket lines at every local hospital.

juniordoctorblog.com

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50 thoughts on “Exhausted? Of course I am.

  1. Genuinely not being pedantic – I want to come along and support, so I need to know : is the second strike on Tue 9 or Wed 10? You’ve put Tue 10. Thanks.

    1. Perhaps if there was less waste onthe NHS there could be a cure. Heart goes out to doctors and nurses but we must take every care to make sure overseas visitors PAY their way and also have items returned to hospitals to be recycled. This has been going on too long. Bring back the matron and stop paying BIG sale ties to so called managers.

      1. These are not the main problems. Some parts of the media would have you believe they are. Underfunding and the issues clearly spelt out in that blog are the problem.

  2. I am moved to tears – of frustration and sadness: how true and how desperately frustrating, particularly how the truth is distorted and lies propagated by those who control the mass media.

    1. Is that opposed to the lies and distorted truth of this very article. Its littered with rhetric, fallacy and political partisanship. That does not invalidate one of its core messages. That the attacks on the terms and condition of the NHS workers is unwise and damaging. That changes are led by political agendas beyond delivering the best evidence lead service. It does mean its diminished by an anti Tory bile and the obvious rage of the author. That rage may be understandable but its simply not true that only one side spins and lies in this discussion about the future of the NHS. Until we can stop spouting tripe tropes about either side and have a serious discussion about what we want from our NHS, what we are willing to pay for and whats reasonable to expect from those who work in it things will continue to get worse.

  3. This is an excellent post, it’s pretty comprehensive and even.
    But…
    It also highlights the multiple points of stress in the system and the various bested interests which are causing it to break. I have given several interviews to papers, radio and even Internet video interviews during the last strike. The problem is they use soundbites and getting even a fraction of this information across is nearly impossible.

    If you don’t mind can I post/ share this message.

  4. You have my unconditional support.
    My grandfather was a doctor prior to the NHS and was a part of it from it’s beginnings.
    He believed in it wholeheartedly, as do my family and I.
    We must continue to fight for our NHS and all stand together.

  5. My daughter wanted to be a doctor from the age of 6. She studied hard all the way through and achieved her dream by becoming a doctor 3 years ago. In the 3 years since, she has taken to the brink of physical and mental exhaustion. She is no longer a practicing doctor……. she works in an office. I dont think i need to say anything else. How sad.

  6. an exhausted community is an oppressed country .. that’s what they want … and to feather their nests from corporate coffers whilst they are rich enough to go ‘proper private’ ….. thank you to junior doctors and all healthcare staff in the NHS that have had to take this ‘abuse’ and still manage to treat people …. you deserve to be treated better- fairly instead of being treated contemptuously by the bean counters of privatisation …. the public are with you .. part of the problem is the multitude of battle lines created by the incumbent government across ‘daily life’ for citizens …

  7. This government is not to blame-has been happening for years. I was a registered nurse-when in charge of a ward I would be asked “How many beds do you have?” I used to reply- 28. Do you want to know how many patients I have?? I got so upset at how I couldn’t care for people in the right way (I was once told by a manager that sitting talking to a patient was not using my time in a good way and I should find more important things to do). It made me ill-so I gave up nursing 😦

  8. The most intelligent ant well thought out post I’ve seen in a while. I whole heartedly agree. I have been a consultant for less than 2 years and can already see the huge decline in working conditions. I fully support the jd strike and hope it comes to fruition. Especially with the added pressure of very real criminal prosecutions now taking place in the courts against doctors who “have failed in their role”… We absolutely must protect our position, and that cannot be done with the new contract imposition. The criminal and litigation side will only worsen over time, and we will reach a point where training to be a doctor opens us up to this more than any any line of work. I don’t have the answer, but striking is a good start.
    Best of luck for a good result!

  9. What can we actually do to stop this systematic destruction of the NHS? The government were voted in and will privatize it, they have the power. We can’t just vote them back out again. What can we actually do, they not interested in listening, only in dismantling. It’s a real worry.

  10. I am a third year medical student. I have made a recording of myself reading your post. May I have permission to post this up on multimedia outlets such as Youtube? I would of course afford you the credit for writing the article, in the video and the description.

  11. We would, with your permission, like to print out this blog and put it up in our Practice waiting room for the day of the next strike. Our practice is 100% behind you and your colleagues. Would this be OK?

  12. I joined the picket line at the RD&E in Exeter for the last strike and will be there again next Wednesday. I believe in the NHS.

  13. I now live in Switzerland, which spends more than the UK per capita on health care, for which you still have to pay (very expensive) health insurance, and then 100% of costs up to your excess, and then a certain percentage thereafter. Yes, the quality of care is excellent, but I now think twice before going to the doctor. It is a system under which you only have access to the best care if you have a decent salary. If you want the NHS to survive and thrive, it needs more funding. We pay so little compared to other countries- the NHS does not cost as much as is made out in the media. And as someone who has experienced both private and NHS, trust me, you want the NHS to survive, and preferably to thrive.

  14. 100% with you. My daughter is a Junior Doctor and is on the point of giving it up. She is exhausted and fed up with the government feeding lies to the general public.

  15. Absolutely! the media has become a government propaganda machine and most people haven’t even noticed. It’s terrifying. A thorough investigation is promised (which, without howling hordes demanding it first, frankly astonishes me) but I’ll believe that when I see it.

  16. Such a well argued piece I’m with you all the way. I don’t know if you were one of the panel on the James O’Brian LBC show, but I was glad that he dedicated the whole show to the strike. I hope that can happen again for the next strikes. As an ex SRN I have seen the way it is going, and am horrified. Good luck i shall be going to a picket line. And I hope that Jeremy the No Fact Hunt resigns.

  17. I agree whole heartedly, spent my working life in the NHS, now retired but feel sorry for my colleague still trying to offer exultant care under trying conditions. ALL clients not in titled to free care MUST be charged up front and any refunds given after care has been completed.

    1. Sorry I have experience on the other side and believe that the strike is financially motivated. It is not just bankers who are greedy. Doctors and BMA have been noticeably silent and absent when their colleagues from other professions have been in similar situations. None of the reporting I have seen is about earnings- not sure general public would feel so sympathetic if they knew about salaries and enhancements because relative to the average wage. Doctors are well paid. I work in a place where junior doctors demand up to £100 per hour to cover front door services and boast about how much they can lever out of the service. It feels like blackmail sometimes and the thing that is never mentioned is patients or quality of care. I have little sympathy for the doctors and think their greed is what is bankrupting the nhs.

  18. Excellent post with points well made. I, too, cannot understand/believe how no journalist seems to have read the proposed new contract. It’s not long and it’s not difficult. It IS unfair and frightening. We, the ordinary public, are extraordinarily indebted to you and every junior doctor: you study for years building up debt (medical students have no time to get jobs through training) and working for free in clinical settings; following that by working at one of the hardest jobs; in a place not necessarily of your own choosing; for hours certainly not of your own choosing; and all for a pittance. I will never trust journalists of politicians again. Having said that, it might be helpful if the BMA could get their message out more clearly to counter the spin, as well as being more upfront that to a certain extent this IS about the pay – the pay is ridiculously low for the quality of the employees and their dedication, and the importance of their work. It is the government abusing its position as a monopolistic employer. It is not shameful to hold out for a wage that is enough to buy a house, have childcare, eat decently when you are the cream of your generation working hard for the ordinary man and woman. If a large number of you up sticks and go abroad, or go into an easier and better paid role with a pharmaceutical company, or just stop work, we will not get you back, and the country will be diminished for at least a generation. The government’s treatment of you is nothing short of shocking. I SUPPORT YOUR STRIKE. The short term impact on patients of a strike is NOTHING compared with the long term harm proposed by Jeremy Hunt. Good luck.

  19. I fully support this strike and the public and all political parties that want to keep the NHS Public just fight to keep it public

  20. Doctors would not strike unless it was a last resort. I support what you are doing and I hope that you will be able to win the argument. I think many people fear what this government wants to do to the NHS and don’t trust them. I’m lucky to be healthy but my parents are elderly and rely on the NHS. I fear for them if it is destroyed.

  21. The NHS as designed originally cannot exist, due to current life expectancy, drug costs, medical innovation, and increasing expense on staff salaries. You just need to hold on a few years until a consultant, and you’ll be schlepping around in your E-Class Merc feeling superior to the rest of us.

  22. I am going to argue a point here, and I know I will bring on the wrath of many… But what is the point of the strike? I watch many different news shows and read many articles yet still have not seen a simple answer. From what I gather it is due to changes to working hours for pay categories – I.e changing what you get paid for regarding unsociable hours and also a shortfall in staffing. Whilst I share your stresses and agree the NHS is failing, but still usually providing me with excellent care when I see a doctor or similar, I do have to think it is a lot of fuss about not very much. I work in hospitality, and I receive no unsociable hours pay, work far over my contracted hours, am low paid (I would need at least 2 promotions and a substantial pay increase to get paid on a similar scale), I am in management and am in call every hour of the day to deal with emergencies and often end up being dragged in at 3 or 4am to deal with a fire evacuation or flood or coordinate 500 people being relocated. I get screamed at, abused, punched and kicked by guests. I have too much work to do in a normal day and I do the jobs of three or four different departments. I am stressed to the point of my health being adversely affected and have very tight budgets to work to experiencing the same rota gaps and ending up pulling 16-24 hours on shift being responsible for 500 or so people in a very large building with little to no break. My point is that I too have a lot of the stresses and strains that doctors talk about, yet I do this for low pay and little reward because I LOVE my career. I am passionate about hospitality and hotels and I truly enjoy my working time. I do it for my love of it and not for the money – I took a £10k pay drop to go back to hospitality as I hated a well paid but boring job. I feel that using pay as an argument with one hand and then hammering spending cuts with the other hand to be rather hypocritical! My GP earns in excess of £50k a year, working Monday to Friday 8-6 – Outside of these times is an out of hours service by locum at my local a and e and what do I get out of his time? One 8 minute appointment when I can eventually ring and get through to book one, in which I can discuss only one ailment! It took 8 weeks to be referred for a colonoscopy to check for bowel cancer! (All clear by the way) – the system is too heavy and too clunky – what happened to the doctor ringing the consultant and booking the appointment for you? Now they refer you, you get a letter a week later to ring them and make an appointment, then you wait 6 weeks to be seen and then the surgery runs late so you end up disrupting a whole day for a ten minute appointment that you had to jump through fifteen hoops to arrange.
    My point – many other people do hard work and long hours for minimum wage, I understand lives are in your hands, but surely you don’t do it just for the pay? And making sociable hours a bit longer will save money and mean more for you long term with staffing and spending? Hate me for saying it if you like, but I am yet to hear an argument about the strikes that truly makes me think ‘yes, you are right to cause such a drama about it and affect people’s lives – that routine operation that cancelled today was worth cancelling and making someone’s life that bit more frustrating’ – the strikes disrupt lives of ordinary people who themselves can do NOTHING to actually change your contracts, you are driving support away from those people. If I cancel someone’s booking at the hotel, I feel like the devil incarnate for doing so, but very few interviews I have seen show doctors caring for little but their own pockets and being, dare I say it, selfish? You all do an amazing job and I am entirely undecided if I support the strikes or not as there are arguments both sides, I just wanted to make a point.

    1. Hi Matt,

      I mean no disrespect but the fact is that if you quit your job (and the same is true of mine and jobs of lots of people on minimum wage of whom you speak, sadly), there would be a queue of others willing and able to take your place who would probably be just as good at it. In the worst case scenario, if 30% of hospitality specialists all quit their jobs together, nobody would die as a result. Furthermore you didn’t need A* school grades and 5 or 6 years of academic training (although of course you may be the exception in the hospitality industry, and have done that).

      The point is that we have a very valuable, scarce and highly skilled workforce in the form of Junior Doctors that might well walk with their feet if their pay and conditions fall low enough. These are the best of their generation who have already foregone much higher salaries elsewhere to pursue their vocations but ultimately they have to think about what is best for them and their families too. Yes, people get paid less than Junior Doctors who also work hard but the distinction for JDs is that they are able to walk away from hospital and earn more money for fewer hours either abroad or in other sectors. And if they do that then we will have lost a generation of medics who will NEVER be replaced so that your care, my care, and the care of those we love will be compromised for decades. The JDs who stay on , exhausted and demoralised, will make slips and be overstretched which will have WAY more impact on patients over the years than the rescheduling of some routine operations on a strike day. Personally, I would happily DOUBLE JDs’ pay and accept the tax rises needed to achieve that. We are letting down and abusing this fabulous group of people and it is a disgrace for the results on them, and also self defeating as we will lose them and suffer the consequences.. Sorry but I can’t say the same of hospitality workers, much as I love a good party!

      1. This reply illustrates one of the issues that isn’t explored in reporting imo. The nhs and its patients provided the opportunity for you to train and learn your profession. Why is it okay to hold the ounstitution that helped you get where you are to ransom because you can earn more elsewhere? The salary levels for medical staff are not minimum wage (no where near) so I think it is immoral to be protesting about money- there are other nhs workers far worse off than doctors.

  23. Now that it seems Mr Hunt is minded to impose the new contract on junior doctors I just wanted to add my support to your cause. I work in the fire service and remember well all the lies, smears, double dealing and dirty tricks the government doled out to us with the aid of the press in all its many forms. I wish you all well in your just cause and give only simple words of advice… Stay strong, stay united and fight for what’s right.

  24. reblogged this as I’ve been lost for words to write my own. I’m angry at a government who thinks the NHS is theirs to destroy and frustrated at not knowing how to stop their destruction of it.
    I don’t work in the NHS…I just use it…I just give thanks for the times NHS staff have saved my life. (three and counting)

  25. Just had a minor op today, quick, clean and professional – as a nation we really take our health service for granted, but it’s an amazing thing, and should be protected, even if that means taxes go up. We adopted things like the NHS because fundamentally, society WORKS. When people work together, we’re more efficient, we perform better.

    Any politician trying to sell you on ‘small government’ is most likely in a position where they’ll never have to rely on it, and the low taxes they’ll promise you will just get eaten up by those little price increases that we just shrug our shoulders and accept.

    The doctors have my full support in this, even if that eventually means they leave the country for a better deal elsewhere. No-one should be forced to accept the spin, lies, and disrespectful treatment they’ve been subjected to.

  26. Reblogged this on Roy Marshall and commented:
    I’ve worked in and been looked after by the NHS. This is the first time I’ve used this blog for anything other than talking about writing. I thought I’d share this for those in the UK and abroad who don’t know what is happening here. The NHS was set up in the aftermath of World War two and has been rated by independent bodies as the most cost effective in the world. Unfortunately the current government has an agenda to under fund, undermine and sell off this world class service.

  27. Fully behind you. I used to work in the NHS in theatre, and countless are the times that a surgical JD would end up sleeping for an hour or two in the little side room after having been up all night, all the day before and most of the night before that on call.

    I don’t think the public in general know what it is to work in the NHS or how hard people work, what lengths one goes to in order that the patient is best cared for, even if that means stretching one’s own energies to snapping point. They see the government mention “money” and “hours” and they believe the lies. But they are the minority. A recent poll showed nearly 90% of the public are behind you.

    It’s shocking what’s being done to the NHS, to its staff – clinical, admin and allied professions – it seems compassion and dedication are dirty words to the number-crunchers. Hunt’s behaviour has been abominable. Now I hear he wants an enquiry into doctors’ morale, but then he follows that with an appearance on Newsnight in which he suggested that the JDs were militants. I think he needs an urgent referral.

    Be bold, stick stick to your principles. If doctors decide to leave, then there are other places outwith England that will treat you better and fully appreciate you, and one of those places is a country at the top of the A1. 🙂

  28. We know you are tired, but stay the course and keep this going, you are not alone, the public is a slow thing to move but inertia is a slow thing to start and pretty inevitable when it’s going.

  29. As always, truly representative and articulate views. This is so fustrating and demoralising but we must continue our fight. We cannot allow our healthcare system to become like that of America.

  30. “The junior contract is simply a means to make lucrative weekend work cheaper, and reduce the pay bill and pension bill on hospitals”. Since I, the tax payer, pay for these costs why should i object to them being lowered? I object to the conflation of the issue of Junior Doctors pay with that of wider funding for the NHS. Junior doctors are not some sainted species who are the sacred guardians of the NHS, they are on their way to a very well paid professional job that they will be rewarded for by large salaries and high status for the rest of their working life. They attained these positions through University training which has largely been funded by the taxpayer. They have not signed up to the priesthood, they have opted to pursue a very lucrative career which will generate (I hope) high career satisfaction. The issues of funding, privatisation, service rationing are critical to the future of the NHS, but they are not about Junior doctors pay and conditions. That is the BMA’s concern as a trade union. I happen to belief strongly in the value of trade unions in representing the interests of their members, but i do object to being told that they are fighting for “my NHS” when there concern is principally their conditions of service.

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