On Feb. 11, U.K. Health Secretary Jeremy Hunt informed Britain's 55,000 junior doctors that he was going to force a new health contract on them despite overwhelming union opposition. The contract will make junior doctors work longer hours at lower pay, and remove previous safeguards that had prevented them from working too many hours. The move has been widely condemned as unsafe for patients and unfair to doctors. Shortly after announcing that the new contract would be compulsory, Hunt was slammed for launching an enquiry into junior doctors' “morale.”
Sample rotation schedules released by the National Health Service on Friday caused further outcry, showing that doctors could potentially be made to work up to three weekends in a row – contrary to what Hunt had previously promised. Britain's 152 NHS trusts – which are not under government control like the country's 17,000+ standard NHS hospitals – have been told they will be punished with cuts if they exercise their legal right not to adopt the new contract.
Junior doctor Rosie Polge, 25, went missing from work a week ago – and made headlines when she walked out during her shift, leaving a note behind that blamed Jeremy Hunt for her distress. Similarly, junior doctor Rich Bowman was asked to meet with his superiors to discuss his behavior after using social media to criticize Hunt's decision and highlight how overstretched the NHS already is.
“Last night I was the sole doctor on site caring for over 100 patients who were acutely unwell with complications from their cancer,” Bowman wrote on his Facebook page. “Some couldn't breathe, some were fighting overwhelming infections with literally no immune system, one had bleeding in their head, one had a blockage in their bowels. If I made a mistake because I was tired, any one of these patients could've died.”
Strikingly, the day the new junior doctors' contract was imposed, applications from junior doctors for documentation to work outside the U.K. shot up by 1,000%. “The precedent set by this move consists of largely removing the recognition of unsocial hours but predicated on a 'seven-day NHS' model that is simply unproven and is more about ideology than evidence or even political mandate,” Alan Taman, campaigns and media officer for Keep Our NHS Public, told Occupy.com.
“This is no idle threat. These are gifted, highly trained people who can vote with their feet," he added. "How stupid must a government be to call that bluff?”
Hunt's contract is pouring oil on troubled waters, with recently proposed changes to visa rules already encouraging overseas medical students to leave the U.K. after they qualify. “U.K. medical graduates from overseas, and international medical graduates are essential members of our medical workforce and the NHS is dependent on them to provide high-quality, reliable and safe services to patients,” said Mark Porter, the British Medical Association's council chair.
“What these recommendations propose is that students from overseas who have obtained a U.K. medical degree will be last in line to get a job. This will... leave them with little option but to take their much-needed medical training and expertise to another country’s health service where they are able to continue their training, [and] would be a completely obstructive move at a time when the NHS is facing unprecedented pressure and huge staff shortages, with rising concerns that junior doctors will leave the NHS after the government’s imposition of a new, unfair contract.”
Not only that, a document leaked last week suggested that the new “seven-day NHS” might not actually reduce death rates, as originally suggested. “This just proves the point that the excess deaths claim is far from based on robust evidence. It isn't,” said Taman. Rather, “it is being hoisted as a banner for ideology that is all about privatization.”
Porter was equally unimpressed, saying the revelations "make clear that more seven-day services will require not only thousands of extra doctors, nurses and support staff but an additional investment in both the NHS and community care. Its findings also show no proven link between weekend mortality rates and consultant presence, and suggests that other investment is more necessary.”
Since the latest round of contract negotiations concluded last week, many are expressing fear that General Practitioners, or GPs, will be the next swathe of NHS workers to suffer like the junior doctors. “The real battle to revive general practice... will require far broader solutions than tweaking the annual contract,” insisted Chaand Nagpaul, GP committee chair for the British Medical Association.
“The BMA’s GP committee was clear from the outset that these annual variations to the contract could not resuscitate general practice from the brink of collapse following years of underfunding, rising patient demand, staff shortages and unresourced work being moved from hospitals into the community,” added Nagpaul.
“GPs are already under attack, as are nurses,” said Taman, and "it will be all NHS staff next: a deliberate process to undermine, fragment and cheapen the entire workforce. Why? To enable a transition to a U.S.-style, insurance based system, which increases health inequalities, is less fair and is not cheaper. Far from it."
"We didn't vote for that. And people are not being told the truth. This is just wrong. The NHS must stay as a public service, paid for through taxes.”
The new contract deals arguably one of the biggest blows to date to the National Health Service, which has offered healthcare “free at the point of use” for almost 70 years. With too few trainee doctors willing to work on Hunt's new contract, there will be no choice but to move over to privatized services. Exactly, one is forced to conclude, what Hunt wanted all along.
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