It pains me to say it, but Jeremy Hunt is a clever man.
He may have the constant smug expression of man who’s just hit 21 three successive times on the Blackjack table, but he’s a canny operator. Faced with the task of cutting costs in the NHS, he’s set his crosshairs on an easy target. Perhaps playing on assumptions of many that doctors are privileged, overpaid and error-strewn, he’s also identified the nature of the workforce that’s he’s dealing with.
Probably aware, too, of the lack of truly viable alternatives available to doctors, the health secretary has realised that if he can cope with a short-term tirade of abuse on social media, and a longer-term resentment from the majority of NHS staff, he’ll soon have succeeded in his aim.
Doctors are stoical. There are very few who haven’t regularly stayed late at the end of their shift, often for many hours, for one reason or another. We’ve known we’re not going to get paid for this extra time in the majority of cases, but do it anyway, either through a sense of duty towards those we look after, or simply because if we didn’t, someone might die. We may get home and moan to our flatmates, partners, or family, but we return the following day and do exactly the same.
Striking is not a long-term option, primarily due to the duty of care we have towards our patients
I fear that the new junior contract implementations will elicit a similar response. There will be indignation, there will be discontent, but ultimately there will be acceptance. Although job satisfaction is at a new low for GPs, most doctors still love their job, and care deeply for their patients and the concept of the NHS.
What other options do we have? Many are threatening to go abroad to work, enticed by financial incentives, and the promise of a better work/life balance. Uprooting and moving to the other side of the world is a drastic step though, and for many with families and ties in the UK, not one that is realistic. Besides, in many countries traditionally associated with accepting British doctors into jobs abroad, the emphasis is now on training home-grown medics, and it is they who will receive preference when it comes to filling jobs. Gone are the days of sending an enquiring email to a hospital in Melbourne or Sydney, and receiving a job offer the following day.
Striking is not a long-term option, primarily due to the duty of care we have towards our patients rather than any trade union bill. There’s also no chance that the startling lack of media coverage dedicated to the contract implementations would be repeated should doctors go ahead with industrial action.
I find scant consolation reading the vitriolic responses from doctors on social media. It’s admirable that people still seem to care, and still have the energy to summon a degree of outrage to this prolonged attack on our profession. There is talk of action, and of taking on the government with the full backing of the British Medical Association. There appears to be genuine hope, albeit tinged with desperation, that we can fight the injustice and apparent madness of these reforms, and come up with an alternative that will benefit both patients and healthcare professionals.
Sadly, but I can’t see a satisfactory way out of this dire situation. The future of the NHS is far from certain, but the Health Secretary will be happy to call its doctors bluff. He knows we will cling to it for as long as it lasts, like a captain loyally going down with his ship.
It’s impossible to see how this will achieve anything other than potentiate the recruitment crisis in general practice. As for those of us already in the job, many are threatening to quit their jobs in the light of the new contracts. Rather than resignations from doctors though, expect widespread resignation, and a further fall in morale from a crumbling workforce.
Dr Mike Forsythe is a GP trainee in Kingston, South West London