I feel like the doctors of this country have had some big decisions thrust upon them in the last couple of weeks. It’s unfair really – just as our country is plunged into uncertainty, the fate of our profession lies at our feet before we even have the chance to process what just happened. New contract – yes or no?
Right now I’m wondering whether I even should vote, given that I’m no longer practising as a doctor, and yet I feel compelled not to waste this chance to contribute to something that will affect so many of my relatives and friends. That’s a choice to make on its own.
And if I do indeed decide to vote, the real choice begins, and the considerations are far from simple.
1. The sheer complexity of Medicine
Part of the problem is that the working life of doctors is incredibly complicated.
Be honest, how many of you really read our old contracts before you signed them? How many of you, like me, didn’t even see a contract at all? In the three hospitals I worked in in my brief time as a medic, I signed just one set of papers.
The only time I actually read the old contract and contacted the BMA was when Queen’s Hospital tried to take the doctors’ Mess away while I was Mess President – at that point I read the terms and conditions word for word, and pulled out everything pertaining to the availability of food and overnight accommodation.
So deciding how the new Ts&Cs will affect day to day working life in the NHS is proving damn near impossible.
2. The LTFT dilemma
Judging by the conversations on Facebook, less than full time training is proving to be a real bone of contention, with many people confused about wording. If we, with our advanced degrees, can’t figure out what it all means, how on earth are payroll going to make sure you’re paid correctly?
In general actually, the wording of the new terms and conditions is poor, to the point where Justice for Health is actually challenging the writing itself.
3. The elephant in the room: pay
In all honesty, I rarely used to query payment issues when I was a doctor – the process of sorting it out was so flipping complicated that I often decided it wasn’t worth it. I also felt like a bad person for talking about money.
Now that I’m removed from Medicine, I can talk about money without feeling guilty or greedy, and I can say with conviction that doctors in this country are shoddily paid for what they do. This new contract might be cost-neutral, but it does not change that fact. I know doctors in general don’t want to be paid more than they get now though, so that’s probably not a consideration. What I’m saying to doctors is this: you should be.
4. Working hours
I do worry that the new ‘Guardian’ for working hours will turn out to be just as complex. Call me cynical, but accurately tracking and safeguarding doctor working hours is going to be a big job – it will either have to be paid for, or done badly on the cheap. My bet is on the latter.
Say nothing of the fact that LTFT is defined as 40 hours a week; I’m sorry, but in the real world, 40 hours is a full time job. Calling it part time is a very clever way of making ‘full time’ hours ridiculous, and fooling part time trainees into thinking they have a good deal. Does the £1500 supplement make up for that? Well, I don’t mid telling you that, under the old contract, I worked as an LTFT for 40 hours a week, and received just under £20k p.a. pre-tax. Having the supplement would have made my salary marginally less insulting.
Understandably, for many doctors, our current political mess is making the issue seem even more complicated. Many believe that we’re in enough turmoil as a country as it is, therefore a ‘no’ vote would be unwise. Rachel Clarke has said that no one will care about junior doctors in the fallout of the EU referendum.
What I would say, though, is that politics will always change, and one way or another, our international situation will eventually settle down. In ten years, these politicians will be a distant memory, whilst doctors will still be very much working. The PR and Research teams in my office are predicting massive overhauls in the NHS independent of the referendum, so it’s not really a reason to vote yes.
So, what to do…?
The last consideration on my mind – and it’s not a justifiable reason at all, so I haven’t included it on my list – is the thought of that pesky little fool, Jeremy Hunt, claiming that one reason he’d make a good PM is his ‘ability to negotiate’. If this contract is voted in, I have no doubt he’ll gloat over it and take credit for the whole thing.
It’s not a reason to vote no. But my God, it’s intolerable.
I still don’t know how to vote, or whether to vote at all; but what I do hope is that doctors will vote based on their true convictions, and not because they’re afraid of losing public opinion or of Brexit.
Whatever happens, this is my final message to doctors voting in this referendum: don’t let fear hold you back from fighting for what you believe is right.