Today – 13 July – doctors in Sussex will join the longest national strike in NHS history. Here’s why…
For five days doctors will be leaving wards, operating theatres, GP practices and clinics, withdrawing both elective and emergency care.
No one wanted it to get to this. Myself and my colleagues have only ever wanted to get on with our job of caring for patients, but the current situation is unsustainable as doctors increasingly work under more pressure for less pay.
Simply put, being a doctor in the NHS is no longer the attractive career it once was.
I am an anaesthetics registrar, giving safe anaesthesia for operations ranging from emergency caesarean sections to elective hernia repairs. I started my medical degree in 2010, I graduated in 2016, and I have been working as a junior doctor caring for patients for seven years. I have at least a further five years as a ‘junior’ before I hope to become a consultant.
I am highly trained, highly motivated, and care deeply for my patients, but I do not feel I am worth significantly less than my predecessors were in 2008.
Doctors leaving in droves
This dispute is the culmination of 15 years of wage suppression which has now come home to roost and is driving doctors to leave the NHS in droves. In 2010, 83.1 per cent of doctors continued in training in the UK two years after graduating. In 2018, this was just 37.7 per cent, according to General Medical Council (GMC) data.
Those doctors not continuing in training may be pausing before progressing, working in other countries or, worse, have given up medicine all together. The lack of doctors progressing through training results in rota gaps both at junior and consultant levels at a time of rising complex medical conditions.
This directly results in worse care for patients – with an estimated 442 people dying in the UK every week due to long waits that patients experience in emergency departments, which is partly due to understaffing.
A recent BMA survey found that four in 10 junior doctors were actively planning to leave the NHS as soon as they could find another job, with poor pay and working conditions among the top reasons for wanting to leave.
Largest real terms pay drop
Doctors in the UK have had one of the largest real terms wage drop of any comparable profession in recent history. Using the Retail Price Index (RPI), junior doctor wages are down by over 30 per cent since 2008, and even using the Consumer Price Index (CPI), wages are down by 24.2 per cent in real terms to March 2023.
Comparing this to the national average (a 3.5 per cent drop) or the financial services which caused the crisis (a 4.8% rise), emphasises that we are not all in this together.
The newly released workforce plan does little to address this fundamental issue of retention.
One of my recent colleagues is moving to Adelaide, Australia, in August for a salary which is literally double what mine will be in August. For the same level of seniority, for the same level of responsibility, for the same specialty, he will be paid double.
It is little wonder why so many people are leaving. I regularly get advertised these jobs whilst browsing social media or direct to my email inbox.
Goodwill well has run dry
Without making moves to fix this aspect of the NHS staffing crisis, any long-term workforce plan will not succeed. You cannot fill a bucket which is full of holes, and this metaphorical bucket has been so neglected that we are haemorrhaging doctors faster than we can produce them.
Even if we had the capacity to double the number of medical students, as the workforce plan outlines (we don’t), even if it would be appropriate to shorten the length of medical school to four years (it isn’t), it would still take a minimum of 13 years to produce the new consultants to even start reversing this trend. Previously this historically low staffing was compensated with the goodwill of doctors and nurses alike, but the well of goodwill has run dry.
Maybe it was seeing colleagues dying from Covid due to inadequate PPE, maybe it was due to seeing colleagues committing suicide, maybe it’s due to working in hospitals where the roofs are literally falling down, there are many possible reasons.
‘Pay us what we are worth’
Whatever the reason, people are saying that if the working conditions are this poor, then at least pay us what we are worth. My wife, my parents, and my entire family are all patients of the NHS. We are like every member of the public in this country. We need it to be functional. We need it to be safe.
The only way to safeguard the future of healthcare here is to recognise that pay erosion is damaging to the health of the nation and we need to fix it. We are asking for a restoration of our pay to 2008 levels. If we were worth it in 2008, we are worth it now. That equates to the wage of a newly qualified doctor after five or six years of medical school to increase from £14 per hour to £20 per hour.
I would like to think that most people would agree that paying £20 per hour for a qualified doctor to save your life at 8pm on a Friday night is money well spent.
That is what we are asking for.
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