‘Morale still seems reasonably high and, while the desertion rate has risen, it is still limited to those who can walk.’
– Woody Allen
When I started this blog, I intended on keeping the fact that I am a doctor a secret – I’m still a bit afraid that the GMC will discover it and not approve, and I didn’t want to be seen as giving a medical opinion because that’s a tough thing to do in this medium and is not my purpose. Mainly it was because I didn’t want to be defined as a doctor alone. But sometimes events within my medical life get too big and start sending out tendrils of dissatisfaction that I cannot keep contained.
Because being a junior doctor, and particularly a female junior doctor, kind of sucks right now. Morale within the NHS is lower than I’ve ever seen it. I’ve even thought about quitting for the first time, and seriously might if I could think of anything else to do. Most junior doctors feel pretty worthless and its only getting worse as this conflict with the government continues.
Just when I thought we’d reached as bad as it was going to get, yesterday’s Equality Analysis on the new contract documented in clear, unambiguous terms that ‘any indirect adverse effect on women is a proportionate means of achieving a legitimate aim’ and I am completely floored. I feared that this would be true but I hadn’t thought that it would be so bold. Women are being sacrificed for the wider goal, and worse, single women and single parents are being disproportionately affected. How can this be happening? As Dr Rachel Clarke, a junior doctor in Oxford, told BuzzFeed, can you imagine if another social group were treated this way? “Suppose the Department of Health was saying adverse affects on Jewish people or Muslims were justifiable because it’s a proportionate impact, given how legitimate their aims are. You just can’t do that.”
And this is the straw that has broken the camels’ back. The last drop in the ocean. The light that has illuminated the fact that while we were all working to breaking point already, we weren’t being treated with such blatant disrespect before. We are all abused and mistreated and exhausted already and the new contract wants to stretch us further? Fine. But it wants us to forget that we live in 2016 and instead knowingly discriminate against women for the greater good? It wants me to pretend that I am happy to accept that having children will damage my career and my financial prospects? I just can’t do that.
Jeremy Hunt has said that doctors have chosen a vocation, not a job, and should be willing to make sacrifices for that. In some ways, he’s right. No one becomes a doctor without accepting certain aspects of our jobs as their new reality. I knew that my days would be long and I would be overworked. I knew that I would miss parties and weddings and dinners because I was working. I knew that I would always be sleep deprived. I knew that I might literally be shat upon. I knew that I would have to tell people that they have cancer. Or that there were no treatments left. Or that they were dying. I knew that I would be shouted at and screamed at and that people would cry at my words and blame me for the truth I had to deliver. I knew that I would have to find the strength to do this every day, and I do.
I had prepared for all of this, and I had accepted that this would become my life. But I felt respected. I felt valued. And that is so important, because it’s hard. Sometimes it’s too hard.
It’s so all consuming that, until recently, my work was my most important relationship, maybe even more so than my family. Back then, job satisfaction meant everything; the majority of my friends were medics, it took up all my free time and I never met anyone outside of work. It was all I had.
This has led me to joke, perhaps insensitively, that the junior doctors’ relationship with Jeremy Hunt has become emotionally abusive. He uses lies to lay false blame against us, manipulating statistics to over-inflate the significance of weekend deaths. He regularly demeans and criticises us, through articles in the media such as those about the #MoetMedics. He has hidden his true agenda from us, choosing not to declare his competing interests within private healthcare. He tells us that our friends are lying, blaming the BMA for misleading us while undermining our support network. He knows that we can’t just up and leave without changing career entirely or moving country, such is the monopoly that the NHS has on our training. We are trapped, and that is how this much criticised and disgustingly sexist contract will be signed…
In a way, it’s almost funny – every time I start to doubt that the strike is worth it, something like this happens and I am grabbing my placards all over again. I had been struggling with the effects that the strike has on my patients and others. Is care affected when junior doctors strike and provide emergency care only? Of course, that’s the point! But is it compromised or dangerous? No, we couldn’t justify it otherwise. But 8 hours without over two thirds of the medical staff for a full walkout? This is tougher, and I was conflicted.
But now I am so frustrated that such far-reaching decisions are being made above my reach that I am much more willing to take that risk, to do whatever it takes to make sure our complaints are heard because what we’re doing is clearly not working. Women will leave medicine. Doctors will quit and work somewhere where they are more valued. If the new contract goes through, patient care will be permanently affected and it’s too much of a risk. Personally, I am frustrated that my life is in the hands of the contract writers who have demonstrated that they don’t give a shit about me or my colleagues. My immediate seniors are supportive but impotent, shrugging their shoulders and telling me that I shouldn’t modify my career plans because of these proposals, but this isn’t a realistic approach. We are already compensating for deficiencies within the NHS, already compromising everything to keep it working, and a line has to be drawn somewhere.
And that line should be at the point where women are encouraged to use family members for childcare. Or when women are told that their loss of earnings is allowable in order to make the contract work for everyone else. Women outnumber men in all levels of training and, at registrar level, 18% of women work less than full time compared to only 2% of men. It seems an odd choice to alienate such a large proportion of the work force.
It’s just wrong; everyone seems to knows it and yet no one can agree on a solution. I feel powerless and unwanted, so I will strike because I don’t know any other way for us to be heard…