I am a junior doctor – enough is enough

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Working in the NHS now can feel very much like being put onto a ship after it has hit an iceberg… Our industrial action is a demand for action. A message that we will tolerate this poor treatment of our service, ourselves and our patients no longer.
We all deserve better.’

Aislinn Macklin-Doherty, a junior doctor working in the South East of England

I am a “junior” doctor nearly 40 years old, I qualified in 2008. I have 15 years post-graduate experience, have taken over 6 post-graduate exams with specialty royal college membership, have a PhD in cancer treatments, and have undertaken nearly 3 years post-doctoral research in how to improve cancer treatments, alongside 10 years’ experience in treating patients with cancer.

I am currently being paid 26% less in real terms than when I finished medical school in 2008, despite my cumulative skills and knowledge and despite the experiences we have undergone in the NHS over the last 2-3 years. 

Since 2008 I have personally witnessed how the NHS has gradually been eroded and then since the pandemic how that erosion has accelerated and alongside it how the quality of care we can provide has been devastated.

When people talk about “underinvestment” in the NHS, or “tightening of belts” after the pandemic, these are not just words to us. This means seeing people where their cancer has spread when they could have been seen earlier and watching their and their families’ heartbreak with the life-altering implications of diagnostic and treatment delays.

This has meant breaking terrible news to patients at the end of their lives, watching them pass alone in their beds with the isolation of masks and without the comfort of their loved ones, alongside personal fear of risk to you and your family. This means seeing the tears and holding the hands of people who might have been cured who couldn’t have an operation for many weeks or months because of lack of staff, resources and beds because of “underinvestment” or investment in the wrong hands.

This means constantly apologising to understandably upset or angry patients you are ringing at 8pm or 9pm at night with results of scans or to discuss their care because you were so busy you haven’t stopped for 14 hours. And you will do the same again the next day, never mind not seeing your own family or your own exhaustion.

This means looking patients and relatives in the eyes and profusely apologising that they might not be able to have life-prolonging cancer treatments for many weeks because there aren’t enough staff, resources or beds and feeling that dismay, anger, fear and even terror. This means day in and day out feeling the absolute devastation of walking into a room with human beings you have dedicated your life to trying to help with one of the most difficult diagnoses anyone will hear and not having the tools to do the job you are trained to do. 

This dispute is ostensibly about pay and value for our work but it is about so much more than this. The working conditions within the NHS have now become a tinderbox with the pressure building up for many years, and the issue of pay is the final straw that has ignited the fire. This is why not just doctors, but nurses, paramedics and now potentially our consultant colleagues, are all expressing their total distress and anger en masse.

Every single one of us has dedicated our lives to caring for patients. We wake up in the night thinking about our patients. We leave our families, travel across the country, take countless exams, read papers into the night, volunteer for extra hours, work 1,000s and 1,000s of unpaid hours across our careers, all in the interests of caring for patients.

But enough is enough.

Working in the NHS now can feel very much like being put onto a ship after it has hit an iceberg and being told it is now your personal responsibility to get everyone on that ship to safety without any additional help and without any equipment. Meanwhile the crew in charge of the boat have all of the necessary resources, equipment, and ability to get everyone to safety and have their own “private” life raft, but they are just choosing not to help the rest.

The enormous amounts of money the Government found very quickly during the COVID pandemic for PPE, Track & Trace, and for investment in companies with close ties to Government have not gone unnoticed by us in a service where we are constantly fed the line “there is not enough” – when there clearly is. It is just constantly earmarked for profitability and not for public service. Now with the daily ongoing revelations leaked about the flippancy with which this Government have communicated about and approached the mortality and health of the nation, it is absolutely unacceptable and a total disgrace for those of us who are ready to do so much for our patients.  

Our industrial action is a demand for action. A message that we will tolerate this poor treatment of our service, ourselves and our patients no longer.

We all deserve better.

Aislinn Macklin-Doherty is a junior doctor working in the South East of England

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  1. I left medicine mid-career before the pandemic because of a catalogue of factors, among them steadily increasing and unrelenting workload, being sick to death of the working cultures of the NHS, stress that was slowly killing me and pay erosion. I am in awe of doctors who have not quit already. I read with no surprise and some sadness the BMA article summarising the survey that the vast majority of UK medical practitioners would not recommend medicine as a career to their own children. The elephant in the room which nobody in the press seems to mention (probably because it does not reflect well on the effects of the press) is the effect the news is going to have on attracting and perhaps more importantly, retaining the smart, hardworking and ambitious recruits medicine needs so badly. Any smart teenager planning their A levels and future careers will, if they have two brain cells to knock together, avoid touching medicine with a bargepole in favour of something more lucrative, family friendly and less unhealthy. How much damage has been done by all this and how long will it take to entice them to apply and stay? It takes 15-25 years to get a fresh faced Y1 medical student to seasoned consultant/GP. That’s 20 years on top of how long it takes to find a government with even a shred of competence to achieve not only pay restoration but also restoration of the NHS as a whole. That’s 20 plus years of a dysfunctional health service to look forward to while incompetent government upon incompetent government of every shade of political persuation dither and line their own pockets. I despair.

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