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CAMHS won't see you now

We must fight - and the time is now

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I don’t remember much about being a junior doctor in the 1990s, other than long hours on call for half my hourly rate. Who else remembers the gross sense of injustice and exploitation? This is exactly what the Department of Health is trying to bring back with its threat to impose a new junior doctors’ contract, which will result in a pay cut for working the same hours. 

The reason is obvious: the ministers want to introduce routine seven-day working without a significant increase in expenditure.

Core hours are to be expanded from 8am to 7pm Monday to Friday, to 7am to 10pm Monday to Saturday, resulting in a lower banding for the same hours. The theory is this money will be recycled to pay more for Sundays and nights, but we all know how recycled money works: we’re all pulled down to the lowest common denominator, as has happened with the PMS reviews.

For GP trainees, the situation could be even worse.

The banding that equalises pay between hospital and GP training posts will go, which could result in a GP trainee pay cut of £15,000 per year. These massive losses may be offset in other ways, but with all this uncertainty, why would anyone want to join the profession?

We are no longer in this alone. Juniors, consultants, GPs – we need to fight for our profession, which is becoming a laughing stock in the developed world. The only body that can unite us is the BMA and I am sure many, like me, would reinstate their membership if decisive action were proposed. We need to stop feeling emotionally blackmailed and devise creative ways to take industrial action without significant damage to patient care.

This will differ for all specialties, but here is my 10-point proposal for general practice:

• Stop all home visits except for palliative care patients. We are one of the few countries where patients can get to hospital appointments and the hairdressers, but not to their GP.

• Stop prescribing all OTC medications. This will inconvenience, but not harm, patients.

• Prescribe the most expensive option in each family of drugs. Let’s start dishing out rosuvastatin and esomeprazole.

• Stop engaging with the CQC. If we do so en masse, what can they do – close us all down?

• Stop engaging with revalidation and appraisal. As above – we can all be referred to the GMC. 
I don’t care that I will be out of a job as an appraiser.

• Stop signing sick notes. Let’s face it, we hate policing the system anyway.

• Stop writing reports for the Department for Work and Pensions. We aren’t paid for most of them anyway.

• Stop attending CCG meetings. It’s a good excuse to be rid of the poisoned chalice.

• Stop providing any out-of-hours service. When A&E is on its knees, ministers might realise we already provide a 24/7 service.

• Stop signing cremation forms. Granted, this will be the least popular but it’s not risking any lives.

How much more will it take before we stand together, shoulder to shoulder, and fight our corner? For how much longer will we accept these contract impositions? We cannot allow this to continue. We must act… and the time is NOW.

Dr Shaba Nabi is a GP trainer in Bristol

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Readers' comments (49)

  • OHP@6.17: I'm guessing you are unfamiliar with the concept of industrial action

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  • GPs are never United they don't stand up for themselves or each other, lots of GP trainees have been thrown out of training without any further chance to get back, they are left in all kind of struggles..... Anyone stood up for them? Nobody and nobody ever will..,Hunt is right let him play games because we deserve it!!

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  • No point I crying when you are already fucked!!!!

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  • JDC just announced strike ballot. Why stop at juniors? I'm a 25yr veteran GP and I'm itching to down tools and march.

    If we're going down, it may as well be fighting.

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  • It is time for industrial action
    Just do medicine
    And no nonsense ie
    Re validation
    Ccg work
    The public would support us as the quality of medical care would IMPROVE without the mountains of pathetic ludicrous bullying bureaucracy

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  • The greatest betrayal of the profession, is taking 'pieces of silver' to be an appraiser (GMC collaborator). Shaba have you got a reasonable justification? (have heard lots of lame excuses and only one person who admitted 'that it is good easy money').

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  • Sorry, I don't get the idea of stopping unnecessary home visits as a form of protest - why on earth is anyone still visiting the non-bedbound? It is in YOUR power to stop this NOW, for your practice.

    Seriously, cardie nonsense like this (which no other country has) is why we're in this hole.

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  • Best is for practices with more than 3000 per wte to stop accepting new patients. First the millions of young me who have not registered will rush to do so boosting incomes.

    The action would be taken on the interest of patient safety. The govt would cave in within days as millions of tax payers roamed the streets looking for somewhere to register.

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  • Lorna, I'm in and hopefully the rest will join once there is a plan. It's just about getting that date and time for action and once that goes viral things should happen. Question remains about coordinating the whole thing. Any ideas? Anybody?

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