UK junior doctors walk out over proposed NHS contract they say is unsafe and unsustainable

Junior doctors and their supporters staged a walk-out in January, 2016. When their demands were not met, they staged more actions. The fourth walk-out began April 6, 2016. (Photo Credit: Roger Blackwell)

Junior doctors across England are staging mass walkouts today in response to a new government contract proposal they say would create unsustainable hours and put patient safety at risk. It’s the fourth such action taken this year by doctors in training in all units but emergency medical care. Filip Warwick reports from London.

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Junior doctors, or medical practitioners in postgraduate training, make up more than half of all doctors in the UK’s National Health Service. And many of them are unhappy with terms set forth by the government in its new contract proposal for public healthcare workers.

Twenty-five-year-old junior doctor Melody Redman of Yorkshire says the proposed contract lacks proper safeguards for doctors working long hours.

“The British Medical Association [BMA] is the Trade Union for Doctors and it entered into negotiations with the government about a contract,” Redman explains. “But the problem is throughout the whole negotiation process, the BMA consistently raised concerns about patient safety and about fairness for doctors. And things really came to a head over the last few months when the government threatened to impose a contract on junior doctors.”

Junior doctors say the government contract is unsafe for patients because it exposes medics to even longer working hours. The contract also calls for junior doctors to work in the evenings and on weekends for no additional pay, and medics say it’s unsustainable, with some doctors already leaving the UK as a result.

Kitty Mohan, a London based registrar and a member of the BMA Junior Doctors Committee, says funding cuts and increased demands on staffers are fueling burnout.

“So I think one thing that’s evident is that at the current time morale is low amongst NHS staff,” Mohan says, adding that the decision to consider a full walkout was not taken likely, especially given the potential for public backlash. “People feel they are being asked to do more with less time and less resource put at them. And that’s doctors, nurses, all areas across health in the UK, and feel very pushed to deliver care that in circumstances that aren’t ideal really due to the lack of resources and the lack of time that they can put in.”

During the strike, medics are standing down in all departments except Accident and Emergency units, as they have done during the previous three strikes.

“It’s something actually that we’re having to think very, very carefully about and if there were other options at this moment in time we would be desperately trying to take them,” Mohan continues. “The whole point of doing this and being forced into this position is so that the government will drop the imposition of the contracts and come back to negotiate with us. At the moment they are not willing to negotiate.”

The NHS Performance Department Press Office declined interview requests and refused to answer questions in writing, stating that the government’s position on the issue is unchanged and has been widely covered. Nevertheless, a Department of Health spokesperson did email a statement, calling the strike, “both desperate and irresponsible,” and saying the action, “will inevitably put patients in harm’s way.” Further, the Health Department held the BMA responsible for the impasse, saying the doctor’s groups had refused further negotiations.

Ruhe Chowdhury, a clinical research fellow at King’s College London specializing in breast cancer research, says the current workload strain is already emotionally affecting many of her colleagues.

“A couple weeks ago, one of my colleagues we were sort of discussing about the NHS, we were sort of discussing work but this time round it brought her to tears,” says the 34-year-old oncologist. “We’re quite a stoic group of individuals but if talking about your working conditions is making you cry that’s a definite low for the profession. We usually cry when it’s about our patient and the emotional aspects of the work that we do but we don’t cry about the working conditions of the work that we do.”

The current chief executive of NHS England, Simon Stevens, used to be an executive vice-president of UnitedHealth Group, a private American health care company with revenue of $157 billion in 2015.

As Britain’s National Health Service asks more and more of it’s junior doctors, the system creeps closer to the exploitative U.S. model in which medical residents regularly work as as many as 80 hours per week, and up to 24 hours in a row.

Chowdhury sees the UK headed down the path of U.S.-style for-profit medicine, and worries not only about the current conditions for physicians in training and patient safety, she’s concerned about the long-term implications for the country as well.

“If you look at the [United] States, one of the biggest problems that people have is bankruptcy, the highest level of bankruptcy comes from medical fees,” Chowhurdy notes. “If you want to be able to provide people with safe care, with good care, people shouldn’t have to worry about when and how they are going to pay for their hospital bills, how they are going to pay to see their doctors, how they are going to immunize their children, how they are going to afford antibiotics, that’s not the kind of society I want to live in.”

For now, the labor dispute is firmly divided with both sides refusing to budge. The power to tip the scales may lie with the very public the healthcare system is designed to benefit.

Should the government’s position remain unchanged, all medical units covered by junior doctors – including emergency care – plan to stage the first full walkout in the history of the National Health Service on April 26th.

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