Interview with junior doctors during three-day strike - 'A lot of the NHS is run on good will'
Rish works as a junior doctor for a hospital trust in Wessex but is currently on a picket line outside St Thomas Hospital with members of the British Medical Association (BMA) on a three-day strike.
Standing across the river from the Houses of Parliament, he shared the ’emotional trauma’ experienced by junior doctors struggling to cope with excessive workloads, burnout and battling against funding cuts.
Exasperated at the ‘dire situation’, Rish said people had previously been scared to speak up about conditions for fear of losing their job, but they now had no choice.
“Doing nothing at the current pace is unsustainable and we will all be burnt out,” said Rish. “Then when we all get burnt out there’s nothing else left, so this is a cry for help more than anything else.”
He added: “Some of the things you hear are sickening, people have to do extra work on top of their 45-60 hour weeks just so they can afford heating and bills.
“In addition to that any of the extra things we must do for career progression we do outside our work hours, so a lot of the NHS is frankly run on good will.”
Rish is into his second foundation year as a junior doctor, the next step after six years at medical school, during which time he has racked up tens of thousands of pounds of student debt.
He hopes to become a surgeon which, on top of the extra work around normal working hours, involves going out of pocket to finance, with a recent course setting him back £1,500 and an exam costing £800, which is not reimbursed.
He wanted to set the record straight on a number of misconceptions junior doctors have been subject to since announcing taking strike action.
Rish said the idea that doctors are suddenly entering a fruitful profession is misleading, when you can be a junior doctor for 16 years before being able to progress in your career.
“When people say you’ll end up getting hundreds of pounds as a doctor, the thing is progression is not automatic, you don’t automatically become a GP or a consultant, you have to go through each different stage and life hits in many ways.”
The BMA recently said that newly qualified medics make £14.09 an hour, less than a barista in a coffee shop.
On top of the burdening financial cost is the crushing and normalised overtime expected of junior doctors.
“Our standard working week is 48-hours minimum, so when you’ve got doctors working ‘part-time’, a part-time doctor can still be working full-time by other standards, including on calls and doing unsociable hours.”
He added: “There’s a lot we do for the job because we want to and because it’s the profession we chose, but it’s simply not supporting us.
“When it gets to the stage where junior doctors are being demonised and infantilised and treated horribly it’s no wonder so many are just leaving or already left.”
Recent statistics show 79% of junior doctors are now considering leaving the profession, with many going abroad where remuneration is seen as fairer.
“Those of us who are left here are finding it more and more tricky as rota gaps are so unfilled.
“We want to be here, but there are so many issues.
“People go to Australia and other places where the quality of life is much better and you’re far better supported.”
On top of disintegrating working conditions, funding cuts have added extra pressure to NHS workers.
‘Bed blocking’ in hospitals caused by cuts to social care have meant patients are unable to be discharged, even when they’re well enough.
Rish reflected: “I’ve looked after patients who are well enough to go home but have not been able to for lack of carers and care provision, then they pick up an infection in hospital and die. Can you imagine, that’s someones grandparent.”
He said he’d seen ‘a lot of emotional trauma’ and that pay is just one issue in a multi-faceted set of problems NHS workers are facing right now.
‘It feels like we recognise the value of what we do but other people don’t’
Aayushi, who works at a hospital in East London, said the claps for key workers became ‘meaningless’ when what they’re now having to ask for is, ‘basic recognition and respect’.
“I didn’t like the claps because I knew how fleeting those moments were,” she told LFF.
“Getting free parking by the hospital and not being charger with a parking fine for having to stay late for a patient, those were our fleeting privileges we had at the time and those claps essentially became meaningless.
“We are asking for just basic recognition and respect because that’s what we give to every human life we encounter.”
Junior doctors have experienced a cut of more than 25% to their salaries since 2008/09, according to the BMA.
Aayushi brought up a BBC article stating that doctors are some of the highest paid members of society and said it was a ‘slap in the face’.
“It’s a slap in the face when you read that, because we did not go into this for the money.
“Job security is an incentive, but to dismiss our pleas and our humble request for some sort of fair wage or some compensation for the continued sacrifice that we do, the years you put into training, the anti-social shifts, the 70-hour weeks.
“You do this because you enjoy it and it’s incredible fulfilling and because this is the path you’ve chosen, however it comes at a cost.
“It feels like we recognise the value of what we do, but other people don’t.”
The staffing crisis has also made it hard to take annual leave, as Aayushi mentioned colleagues having to plead to get time off for their own wedding and to attend funerals.
On top of this, it is recommended to get a 30-minute break every 6 hours of work, and then two 30-minute breaks over 12 hours, however Rish and Aayushi said this just doesn’t happen as doctors are pushing through unsustainable workloads at the detriment to their own health.
She reflected: “We are seen as superhuman, but with all the responsibility and none of the reward.”
The Tories have refused to negotiate with the BMA so far on junior doctor pay restoration, with sources believing the government are holding off on pay negotiations with other health unions until a deal is met with the Royal College of Nursing.
Hannah Davenport is trade union reporter at Left Foot Forward
Left Foot Forward’s trade union reporting is supported by the Barry Amiel and Norman Melburn Trust