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Gold, incentives and meh

'Striking is just something doctors should not do'

Dr Nick Summerton, a GP in East Yorkshire and a former NICE adviser, argues that junior doctors should be speaking to the Government, and not striking

We are supposed to be professionals and patient focused. This strike is so damaging to the profession and I don’t see what it will achieve.

It’s a symptom of what’s going on with the NHS at the moment - there has to come a point when junior doctors decide whether they are professionals or not.

There’s an ‘I can’t be bothered’ culture among some junior doctors - some can’t be bothered to send out letters when patients are discharged or give us calls to let us know about results or deaths.

I think it is right that patients have access to a seven-day a week health service and if junior doctors dispute this they should continue to oppose the scheme with dialogue and discussion, not a strike.

It’s causing a lot of disruption - there is certainly an issue of trust between the BMA and the department of health, yes, but striking is just something doctors should not do.

That junior doctors are willing to strike is a tragic symptom of the deprofessionalisation of the medical profession. Back when I trained, being a junior doctor was awful, you’d work days and nights and nights again but we had a dialogue, not a strike.

Dr Nick Summerton is a GP in East Yorkshire and a former NICE adviser

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Readers' comments (125)

  • I disagree almost entirely. Being "patient focused" means working for the benefit of patients in the medium and long term, not just the present.
    What you interpret as "I can't be bothered" might instead be the result of the fragmentation of consultant/SR/R/SHO/HO teams and direct chain of responsibility resulting in too many juniors being involved with each patient on a shift basis. I agree that there is an increasing tendency of "GP to do" but one might assume that to be ignorance rather than idleness.
    Patients already access to a 7 day a week health service - why imply otherwise? - and no-one is disputing the need, just the expectation to be paid accordingly.
    Dialogue and discussion both require more than one party to be willing to listen; monologue, political spin, selective deafness, misunderstanding of research and intransigence one one side rather preclude dialogue and discussion

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  • The Junior doctors have decided and what they have decided is that they are professionals and patient focused but that the NHS is not professional and not patient focused. They will not work for a non-professional organisation under conditions that are unsafe and unfair and that will decimate the professionalism of their chosen profession in the future. Please don't infantilise your junior colleagues who are probably brighter than and at least as well trained as you. After all who trained them? Back when you and I qualified it was awful being a junior doctor. But being abused by a system should not be passed down the generations as we would not condone the dreadful way that child abuse seems to pass down the generations.
    The juniors are saying it stops now. Enough is enough.
    A seven day service with no extra money and no more doctors won't reduce the death rate at weekends. It will increase the death rates during the week to those of the weekend.
    I suspect that we will look back on this as a moment to radically reform the NHS into an organisation that adapts to future needs with apps remote monitoring, telehealth and technologies that you and I will never understand. Old fogies such as myself and yourself will stand back in amazement as the current junior now senior doctors use technology to help patients and themselves achieve a work life balance.
    Striking is not deprofessionalisation but a recognition of what the future holds. Disruption is an apt choice of words. for disruption of health industry is what is going to happen, but that will happen with or without a strike. Why should Health be the only industry that is not disrupted?

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  • I think what they oppose most is the removal of the safeguards that limit trusts imposing unsafe hours.

    And there has been a strike in the past - some 40 years ago - or was that before when "people like you" trained?

    So the problem must be with people older AND younger than yourself, but not your generation of medical leaders who have left the profession in a fine old state.

    Wake up and smell the coffee, it's precisely the attitute and opinion that you express above tha't led us all up this creek.

    I think when you're the last GP standing in East Yorkshire you might reflect more on how you've go it so, so wrong this time.

    Solidarity is not a trait that comes easily to some GPs.

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  • Dr Summerton: are you Jeremy Hunt in disguise?

    You need to take a long hard look at yourself and your generation and ask how the NHS got to be in the state it is today. Far from 'not being bothered' us juniors are finally showing a bit of backbone and standing up for ourselves AND the NHS.

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  • A massive Tory cardigan-wearing pseudo-martyr if I've ever seen one.

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  • I am so pleased to have yet another senior doctor with questionable neutrality tell me what I should be thinking.

    It makes it so much easier. I'll just go back to doing as I'm told.

    Thank you for letting me know that things were better in your day. Gosh, what a time to be alive. If only they still made doctors like that now.

    I'm mean to think that at 25 years of age with 2 degrees, 1 national prize, publications, presentations, a teaching portfolio and a genuine ambition to work for the NHS that I'm still not as good as you were is simply humbling. Back to the drawing board I go. Must do better...

    Oh no, wait, I'll just leave the UK. Problem solved.

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  • Can't be bothered to send out discharge letters? More like do not have the time to type up the bloody things. Can't even get to the loo in a 15 hour shift, there are always more urgent patients to see, and discharge letters are not priority one and so don't get done.
    Ridiculous statement.

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  • Would this be Dr Summerton, who's surgery is not open on weekends or after 6pm, telling junior doctors that they should just shut up and work more weekends/ evenings/ nights.

    I would put to this chap that the professional thing to do, would be to volunteer to cover A+E every other weekend to help out. There is no need to be paid extra, because he is already being paid as a GP.

    Good luck with that.

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  • As a GP practice manager, I agree that the attitude of home junior doctors when it comes to discharges and follow ups can at times be atrocious.

    I have taken part in processes in which it was explained to the hospital doctors as to why it's not acceptable.

    The usual excuses cite workload levels, fluctuating demand etc. which I do not see as justifiable and as a matter for junior doctors to take up with their employers.

    So the fact that they have finally grown some and challenged their employers is encouraging.

    In essence, I think junior doctors have a duty to strike for the same reasons that Dr Nick Summerton think they shouldn't.

    Go figure that one out :)

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  • What an aggravatingly unfounded commentary, based on no real experience with on-the-ground JHOs/SHOs. Please actually update your experience by shadowing those that you're accusing of a lack of professionalism prior to engaging in further in-fighting and colleague smearing, that just feeds into the Tory/red-top machine.

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  • Could he actually be any more naïve ?😷

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  • Nick - I am really disappointed with this article. Whilst I admire your individuality and candour, you have got it so, so wrong on this one.

    Your genaralised smears about the professionalism of juniors is like something out of the sun article the other day, highlighting the fact that juniors go on holiday!

    You are repeating the stuck record mantra of old dinosaurs time and time again - I worked 150 hours a week down the coal mine so why can't they?

    I, too, worked these horrific hours and it was mental and phyical torture. I spend a lot of time with GP trainees in my role as a Programme Director and I am more concerned about them burning out through over caring and over achievement than being unprofessional. You have provided no basis for your assertions.

    You may wish to reflect why the juniors have so much support from GPs, consultants, nurses and HCAs. It is because we are all sick to death of the way this government is treating us and the juniors have the balls to do something about it.

    Let's hope the GPC follows suit at the end of this month.

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  • I assume this chap is a certain age given his comments and his NICE-ness. If so, how can he possibly say we had "dialogue". We had slave labour...that's what we had. Dialogue is a two-way communication. Government always wants unilateral imposition and, at last, there is the bravery and determination to oppose this. Yes, it is sad that it has come to this but it does when faced with unreasonable intransigence. I suppose our other favourite, Prof Field, is also having paroxysms.

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  • Dr Summerton - you can only have a dialogue if the other person is willing to talk.

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  • Dr Summerton may have worked over-long hours in "his" day but that is not a sign of professionalism. neither did talking to the Government correct that form of exploitation, European legislation was far more influential. Maybe not for much longer....

    There is nothing unprofessional about the junior Dr's, neither is there anything unprofessional about Mr Hunt. Our Junior Doctors are professionals who use science and understanding in order to help the public get and keep well. Mr Hunt is a professional who uses anecdote and misunderstanding (such as the multiply determined clinical "weekend effect") in order to help the Conservatives get and keep power. If Mr Hunt were prepared to listen he might hear what is being said.

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  • Internet Profile of Dr NS (staying focused)
    "Current areas of focus:
    - The relevance of Greco-Roman medicine to modern clinical practice. A TV programme is currently being planned and two new papers have recently been published"
    Relevance: Slaves are not allowed to strike.

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  • I am a GP of the same era as Dr Summerton. I find his lack of insight into the working conditions of the present generation of doctors and his paucity of empathy quite unbelievable. Is he totally unaware of the hours they work and the intensity of that work with few breaks and little time for a meaningful family life. If his patients were being treated like this by their employers he would probably be fighting their corner. Why then is he denigrating his hospital colleagues for fighting for their rights of a decent wage for their level of responsibility, knowledge and experience and also protecting their own health. High levels of Responsibility without the power to negotiate your conditions of employment ( one sided contract which can be imposed ) is a short cut to an early death. But then that is Jeremy's ultimate goal the death of the NHS by a thousand lashes. Then he can blame the doctors and nurses and bring in the private Giants
    Dr Summerton get off your high horse and try to walk in the shoes of today's junior doctors you will find it very different from the 70's when you trained. Many more interventions available and more IT hoops to jump through.
    I really am ashamed to call you a colleague

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  • Oh, sure, chat about it all with government and that should fix the problem. Negotiate with Jeremy Hunt, influenced by Letwin, Tory Strategist who recommends the NHS be abolished? I'm a GP now 60y but still doing 2 days a week because we cannot find a replacement for the previous senior partner, let alone me. But collecting pension and income pushes me into the income bracket where I lose personal allowance and therefore effectively would pay 60% tax. The work is very hard, with a high risk of complaint fuelled by government stoked expectation. I haven't had resilience training. Hard work + high risk is entirely incompatible with a 60% tax take; no wonder doctors of my vintage leave asap. I shall soon. I have had young aspirants attach to the practice to sample GP work and their possible future; my advice has been not with a barge pole. Anything but medicine unless you relish being administered by bureaucrats and sly/thieving politicians. Vocation is a much abused term by those seeking to manipulate, IMHO.

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  • Yes, back when I trained the hours were awful, the supervision variable and the risk to patients immense. Did I or others have the courage to complain?
    Not very often. Although one of my friends slept nn a hospital bed outside The London Hospital in Whitechapel.
    Well done the Junior doctors for standing up for yourselves and the NHS.
    Hunt isn't to blame. He is a small pawn in a bigger game.

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  • NS is entitled to is opinion. However, having worked 80 hour weekends wit 2-3 hours sleep or 168 hour weeks when 1:2 holiday cover, or 6 months single handed as an SHO, when the other chap left, I cannot imagine how this form of slave labour and torture was ever right.
    It was wrong then and Dr NS dialogue did not fix it. Not for me, and thousands like me.
    Exploitation is wrong now as it was then and I am concerned that for some strange reason, the Employers have no responsibility of care to it employees [ the doctors]
    Having said all this, it is the BMA who should define safety.
    Pilots do.

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  • I too totally disagree with Dr Summerton. I am sorry, but there are situations when the side with whom one is supposed to be talking is SO unreasonable, SO lacking in understanding of the real situation, SO manipulative and disrespectful, that they leave one with no option. What this government has done and is doing is destroying the NHS, destroying good patient care and destroying the people within it. I for one do not want to stand by and let the excuse of my professionalism stop me challenging such destructive forces. I support these young doctors who have the courage of their convictions. No one can doubt their compassion and their work ethic. They demonstrate that hour after hour, day after day. I salute them.

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  • Vinci Ho

    Thank you Nick, for your opinion and presence , which is the exactly why western democracy is so invaluable in this world:

    ''But there is only one thing which gathers people into seditious commotion, and that is oppression.''
    John Locke

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  • it's perfectly ok that some doctors don't agree with striking, it's ok that some doctors are happy to accept whatever they are told to do, it's ok that some doctors will literally bend over if asked to do so. Those drs don't speak for me. I want a fair terms and conditions. If the state/public don't want to pay for my professional advice - I will go elsewhere. We live in one of the richest countries in the world - it is simply priorities. The public can not have a gold plated service for free. Either properly fund the NHS or let us go (those that want to go). simple. Those that want to stay - by all means stay and do what you feel is right but do not bully or emotionally blackmail those that want to take action. You are just scared that you will have to deal with demand on your own but that is your choice. I find it hypocritical that 'drs' who don't do front line work have been vocal condemning the strike eg Sarah Wollaston. if they really cared they should roll up their sleeves and try front line work - we are short of doctors after all.

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  • My thoughts about this awful article are unprintable and display absolute ignorance
    To quote the unacceptable working practices of the past that I also worked in is totally irrelevant and did lead in fact to strike action and is Neanderthal reactionism
    I believe in progress for the sake of patient and dr health
    Runts plans introduced by the lowest deviousness lies and stupidity MUST be opposed
    What a stab in the back
    WHY?

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  • Sebastian Pillon

    Well done Dr Summerton, you got your name in lights.

    Unless you are working 7 days yourself, you need to apologise for your outdated and frankly pathetic attempt to smear junior doctors. If you had bothered to pay any attention whatsoever over the past THREE YEARS you would realise that junior doctors have been trying to engage the government in negotiation, only to have it fall on deaf ears.

    I hope that your practice does not train any juniors, and I'd urge any in East Yorkshire to ensure your Deanery is aware of this clearly unsupportive practice.

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  • I agree completely with the junior doctors decision to strike. Good on them for standing up for their working conditions!

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  • Clearly Dr Summerton feels he knows better than 98% of the junior doctors who voted. It is about time that HMG listened to the people who provide care- Doctors , Nurses and other care givers rather than government spin doctors

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  • I strongly suspect that you work directly for Jeremy Hunt's disgraceful team of liars, intent on throwing our beloved NHS down the drain.

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  • Dear Nick,
    Has someone paid you to write such Rubbish?
    I fully support the junior doctors - I'm a GP and also did the horrendous hours you spoke of - the world is very different now from when we trained.
    You're utterly wrong - I hope everyone disregards your comments.

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  • Nick Summerton - go away.


    It is people like you that purport to be leaders or representatives of our profession that have held us back, and not allowed us to negotiate proper terms for the work we do.

    Screw you and all you stand for.

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  • Unfortunately the reward for being a junior doc these days ie. becoming a GP or Consultant does not justify the sheer amout of work/stress/risk that you take as a junior. If we are expecting the brightest students to work like this then the end product needs to worth something. IF not, then expect more stikes/demotivation etc.

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  • Fundamentally disagree. We have sat wearing cardies on the sidelines for too long, wringing our hands. Time for action- If we really care for our patients, we'll fight for a properly funded service.

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  • I agree with the sentiments supporting the junior doctors but I can't help thinking that the problem with a strike is that it is over so quickly. Couldn't the BMA have come up with a more imaginative and ongoing form of protest that would have a cumulative effect of embarrassing the government and annoying NHS employers and managers?

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  • I have two choice words for this article and everyone who has commented so far can guess what they are. I assume the author is retiring soon otherwise lives in a different NHS world to the rest of us.

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  • I completely agree....the doctors should just bend over and lube up!

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  • Oh the nostalgia - Back when I was a lad we would never be so unprofessional as to look after our own interests - Forgetting the industrial action in 1975 that is.

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  • We got to 100 hrs a week. the manager (an ex car salesman) said we were lying about our hours. My fellow registrars marriage broke up, becausr she never saw her husband or 4 kids. mine slept in the hospital, so he could see me. i intubated a dead baby, nobody else came for 10mins, it was me and the baby, who lived. we carried each others pagers. We told each other to go home, sleep, if tears or exhaustion. strike juniors strike, this man doesnt know what the £€•% he is talking about. #malepalestale.

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  • I find it quite upsetting to read some of the overtly derogatory personal comment made here about Dr Summerton. Everyone is entitled to an opinion and if you disagree attack the argument, not the author.

    My own view is that the profession has to fight for the best work conditions for their own sake and for that of the patients. However, I am concerned that the BMA has become wrapped in political dogma. There has been exaggeration of the issues in dispute from both sides.

    The NHS is a political football and always will be, but my experience is that it has faced episodes of dreadful mismanagement fairly equally from both ends of the political spectrum. However the NHS being a political issue has one benefit: that it will never be dismantled (as many are claiming) - that would be utter political suicide and one thing politicians always want to do is to cling to power.

    Striking is a double edged sword. It will only take one potentially avoidable death or injury for the media to grab hold of and blame the strikers, and the profession loses public sympathy in a stroke. The risk of this happening will be huge if the 3rd 'all-out' strike goes ahead. If public sympathy is lost, then the politicians will obviously be more likely to prevail and may get away with even more.

    Be careful what you wish for.

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  • Dr Summerton, I realise as a Yorkshireman you are perfect to do the full Monty-Python 'when I were a lad' sketch with excellent dialect. Hats off for failing to deliver the humour that goes with it. Try it again: " Eeee by gum, when I were a lad, Down t'medical ward, , we'd have DREAMED of free tuition, cheap housing, quiet on-calls with little t'do, and respect galore'. Thaa youngsters don't know yet born'"

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  • @Janette Lockhart

    Your views are simplistic and at best Tory friendly. Who paid you to use such emotional blackmail tactics against us? Does every one thing we are stupid these days? Unbelievable!

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  • Although I wholeheartedly agree with the grievances, I too am against striking. However, the intransigence of the government has pushed the juniors into a corner.
    Like Dr Lockhart my concern is that this plays into the hands of the Government and the right wing media who want the end of the NHS. I do not blame the juniors one bit but the actions of HMG have been cynical and disingenuous.
    Finally, the article above is incredibly crass and divisive. I don't recognise a ' can't be bothered' attitude amongst our hard working junior colleagues but I do recognise a GP who, perhaps, doesn't match his views with actions. Does his practice truly do 7 day working and how many OOH sessions does he do?
    We can disagree with actions but should understadn the junior motives.

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  • Vinci Ho

    Although I agree that giving an personal opinion should not lead to his/her character assassination by others, especially he/she does not possess current political power or authority , one has to understand that the western parliamentary politics is a form of representative democracy which is , in fact,an indirect democracy . These ministers were elected directly by people to 'represent' them in the parliament . The representation then becomes the indirect democracy when they start to speak in House of Commons.
    When indirect democracy fails people , there is a legitimate right to revert to direct democracy . And that is also the reason why the legislation(recently changed by this government!) is so specific about the prerequisite of requirements qualified for an industrial action.
    This is fundamental principle of our democracy even people can have different feelings about it.

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  • Dr Nick Summerton is a GP in East Yorkshire and a former NICE adviser

    No wonder NICE is as crap as it is.

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  • You can please some of the people some of the time but you cannot please all of the people all of the time. We have to stick to our guns and keep the bigger picture in focus ALL the time. Many Tory agents will write comments on our forum trying to plant fears and doubts as evident by some comments already. Their weakness is that they think we are stupid hahahahahahahaha SURPRISE

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  • This is the same Dr Nick Summerton I presume, who is happy to endorse (and get paid no doubt for doing so) such tripe as the Bluecrest health screening private service. Of course. Only if you can afford the £269 to do so.

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  • Thanks very much for all the comments. But I remain unrepentant. Striking is not something that professionals should do - I might be old, conservative, conflicted and have an interest in Ancient Medicine but I do care about my patients and my profession still. I am also reasonably well trained and qualified! The one point I do take exception to is, however, the very idea that I have a cardigan! Nick

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  • Dr Summerton, what a masterclass in how to paint a bulls-eye on ones a$$

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