In 1989 I was a GP trainee, doing my hospital scheme and working at the Royal London. At the time we were working extremely long hours, which often led to chronic tiredness.
We worked an average of 84 hours a week, and there were cases in which doctors worked as many as 120 hours. Research published at the time showed 28% of junior doctors had evidence of depression and 50% were emotionally disturbed – both linked to the long hours. Senior doctors argued they’d done the same workload in their day – but I felt this was bad for doctors and moreover a safety issue for patients.
In fact it had led to mistakes, and during the campaign I admitted one of my own. I had been sewing an episiotomy and the stitches fell apart. I felt terrible about it and I was dreadfully apologetic to the patient but I remember her feeling quite sorry for me, despite the fact she’d just been through labour.
So the junior doctors called for legislated control of the profession’s working day. To raise awareness for the campaign, I and a friend slept outside the hospital as a protest. It was Christmas, and bitterly cold – but we got great coverage from both the BBC and ITV. We had amazing public support, too, as passing cars sounded their horns for us, and some people even brought us pies and Christmas dinner.
Afterwards the BMA got involved and began negotiations with the then health minister Virginia Bottomley. In the end, we managed to secure a new agreement.
To me, the main issue for any campaign is public support for what you’re trying to achieve. Recently some NHS Direct staff did a ‘work-in’ – meaning they didn’t get any headlines about going on strike and risking patient health. What would it be like if a whole raft of doctors refused to go home, for instance, and carried on working until they dropped? There was a degree of theatricality in the sleep-out protest – it really got our message across.
It goes without saying there’s a raft of hidden messages in the pension debate. For instance, the Government might argue our pensions are very good, but they never mention the hours doctors have had to work to earn them. My average working week is 60 hours and has been for years. There’s not a waking moment when you’re not reflecting on patient care and I feel that point gets lost in the ‘strike versus no strike’ sort of headlines.
Our issue in 1989 was simple, but pensions will be a more difficult campaign because it’s a more complex issue – although again it disproportionately affects younger doctors.
Dr Sam Everington is a GP in Tower Hamlets, east London, and was formerly deputy chair of the BMA