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GPs buried under trusts' workload dump

I still think that doctors should not strike, despite the abuse I've received

Dr Nick Summerton responds to his critics

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

Leaders of the junior doctors claimed success for the first day of strike action last week. But at what price?

How many people had their lives and work disrupted last week? What impact will the delays in testing and surgical procedures have had on individuals? How much additional distress has been generated amongst patients who are already anxious?

I strongly believe that going on strike is something that doctors should not do

If the BMA does win in its dispute with the Department of Health I worry that it will be nothing more than a Pyrrhic victory. The toll on the reputation of the medical profession will be tantamount to a defeat.

As a doctor trained in the early 1980s I strongly believe that going on strike is something that doctors should not do. Using patients as ammunition in an argument with any employer – public or private – is simply wrong. Sadly when I expressed this view in an interview last week for Pulse my comments were met with a torrent of abuse from many medical colleagues. Hardly the sort of responses I would usually have expected from a group of professionals.

But what concerns me most about the strike, and the responses I have received, is that it seems to highlight a different set of values held by many younger members of my profession. Do they subscribe to the same principles as those of us trained in the last century? If a patient arrives with a problem 10 minutes before the end of their shift would they look after this person or pass them on? If a relative asks to have a chat in the evening during visiting hours will they be there? If a GP asks for a call back will they bother?

I appreciate that caring for patients in the modern NHS can be challenging – resources and time are limited whereas expectations and technology continue to grow. But, looking after patients in general practice would be so much easier if junior doctors could send me prompt and legible information after a person has been seen or discharged from hospital. My patients also constantly grumble to me that they don’t know who is looking after them when they are in hospital, there is no continuity of care, and families never know who to speak to about their concerns.

Over the last few days I have spoken to a number of consultant colleagues, many of whom seem to share my views about striking. One also outlined the difficulties he now experiences in persuading his junior colleagues to work beyond their shifts, even in extraordinary circumstances. Another suggested that there is a requirement for a balance to be struck between working hours and acquiring clinical experience – tiredness certainly impacts on patient safety, but so does inexperience.

In 1985, as a junior doctor, I was severely reprimanded by my consultant for not calling a GP about one of their patients who had died on his ward. I took the lesson to heart and never made the same mistake again. In contrast when I phoned up a junior doctor myself recently to grumble about the way they had discharged a child who arrived at my branch surgery one afternoon from the hospital very unwell, I did not get an apology and nor did the parents, just a letter telling me off for upsetting this doctor.

Two further strikes are planned. But I do hope my junior colleagues will rethink their strategy and consider the broader consequences for our profession of such ill-considered action.

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Readers' comments (47)

  • Everyone is entitled to their opinion. If you want to persuade people to agree with you however, it usually helps to be respectful, professional, and use a sound argument. I suspect the "abuse you received" was largely because you managed to insult and alienate your junior colleagues. Sadly you have either failed to realise this, or consider it appropriate, as you have only repeated more of the same.

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  • My opinion/fear is the JH is a bully as are the conservatives. JD are just the first victims. All BMA members will follow. GPs, nurses, hospital staff etc. There is a concentrated effort to kill the NHS bit by bit and indirectly kill those most vulnerable and blame us for all that happens. My humble opinion as the softest of the eggs against that mightiest of walls (ref to Vinci Ho ) is that all of the NHS should strike together. And get our loving patients behind us to support us. We are all one, we were all once JDs, and we hv needed everyone along the way, secretaries, prac managers, nurses, porters, pharmacists etc. It's time to stop fighting and start being a united bunch and supporting each other, like family members do inspite of how different we all may be.. stand by those who are being wronged/bullied and be proud of your family!....like that consultant who supports his juniors.

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  • Ivan Benett

    I'm with Nick Summerton on this 100%. Well done for sticking your neck out. You're not alone.
    I'm afraid the abuse from mainly younger colleagues, and often anonymously, is all too familiar. It is a symptom of the loss of professionalism, and an erosion of the traditional values that took many of us into General Practice.
    I didn't become a Medic to become rich, but to make a difference to the lives of ordinary people. Striking is not an option for me nor one I would ever support.

    For all their bluster, I doubt that more than a few GP would strike in any case. Unsigned resignations won't happen either, but may actually play into the hands of those who want to Privatise General Practice.

    We have turned ourselves into no more than contractors, and will loose the affection of the public because of it.

    I can only hope that there is a silent majority that do not support some of the more extreme and unprofessional views expressed by some of those who comment in these columns.

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  • Sadly, just vocational love for medicine is not enough anymore. Nor should it ever have been.
    A doctor, like everyone else, needs a fair pay, fair conditions, fair ours and so on.
    To NS and IB, it is fair now.
    To the vast majority [98%], it is not fair pay or conditions.
    Perhaps doctors should not strike.
    But equally, they should not be abused either.

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  • Agree with 8.43pm above. I’m on a permanent ‘work-to-rule’, because of the decline in conditions.

    I remember with nostalgia the days, as a partner, when I used to have something called a ‘lunch break’. Incredibly, I used to finish by 7pm as well! Then the workload increased, the day became at least 12 hours long and the lunch break disappeared.

    The morning’s work not only took up what would have been a lunch break, it became impossible to finish it before the afternoon’s duty started. This led to cutting corners: diagnosing and prescribing over the phone, declining to visit, and all manner of unwise practice. It also made me very stressed and miserable.

    So I quit partnership last year, at the age of 48, and became part-time salaried. Now I make no attempt to meet demand, as it’s not my responsibility anymore. I see far fewer patients and ensure that my sessions don’t last longer than what is indemnified (5 hours, including paperwork).
    I also pay much less tax/pension, so get to keep most of my earnings, instead of losing most of it to HMRC.

    It’s understandable that GPs might want to strike. But, in my opinion, the more honest, decent action is to quit partnership, and get a job where the working hours are strictly defined.

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  • Doctors shouldn't strike the same as humans shouldn't kill. Self defence and malice happens. Doctors are humans but somehow society and politicians expect us not to err or have emotions. Time to break those misconceptions and even though doctors should not strike, we have to.

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  • I hope Dr summerton's appraiser reads this. He clearly has no reflection skills at all.

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  • Vincenzo Pascale

    I could agree if the relationship were between doctor and patient. But when a profession is subjected to a series of ties by ignorant politicians , at that time every injustice done to the profession, if accepted, can only destroy the doctor-patient relationship. Moreover, as in the whole civilized world it happens, when there is a strike essential services are maintained. Is a task of the doctor, if he emphatize with his patients, to explain the causes of the strike. He must explain, overall, that a serene doctor and is the best option for a patient

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