Am I part of your problem?






I have been thinking a bit about doing things I don’t want to do. About what makes people oblige when they wouldn’t obviously be inclined to, specifically when the rewards of doing so don’t seem to be particularly tangible. This train of thought took me back to a length of time I spent working as a medical SHO for a trust in special measures. Coming out of that time on top was a credit to the trust, to the staff that work there and the community that fought for their district general hospital to stay. My part was entirely insignificant, but I had a part and as I’ve come to realise the NHS is a shining example of emergence; the result is greater than the sum of its parts.

Recalling my time at that trust, it is entirely clear to me why I worked so hard, in my own small way, to help that trust achieve their goals: every single step of the way, I felt like part of the solution.

Is there vanity in that need? Perhaps, but we are all human. I am not ashamed to say that feeling like a part of the solution to something probably makes me more likely to achieve a goal, even when I know it will be difficult. In the case of my time at that hospital, it didn’t just mean that I was more inclined to fill in reams of paperwork and care bundles for which I didn’t always see the point, it meant that I felt secure enough to take responsibility for the things that needed to change. I felt safe enough to recognise that yes there were things I could do personally to help with patient flow. I felt secure enough to accept that my ward could communicate better with patents and their relatives. I was able to recognise there were problems because I knew that I was part of the solution.

Lets compare that situation to the employee relations disaster that has become of The Department of Health’s plans for a new junior contract. The difference, once you look for it is standing in the room like a great pink elephant; they told us we were part of the problem.

In July 2015, Mr Hunt told us that we had a ‘Monday to Friday culture’. We were part of the problem. He told us that we needed to bring back a ‘sense of vocation and professionalism’; we were part of the problem.

In the DDRB report NHS employers told us that they needed to create a contract which didn’t give us ‘incentive to work slower’; we were part of the problem. They told us that they didn’t want to create a contract where we could claim money for ‘every extra minute spent carrying out duties’. We require to be paid for the work we do; we were part of the problem. They told us that our incentives to stay and help patients who required it outside of our rostered hours were ‘perverse’ – we were part of the problem.

In October 2015, Mr Hunt told the us that our request for appropriate recompense for working unsocial hours is ‘punitive’ to hospitals; we were part of the problem.

Is it any wonder that junior doctors find themselves obliged to be at arms?

But the car crash in employee relations continued because when tens of thousands of junior doctors, like me, became unsurprisingly impassioned and enraged by this treatment, we were accused of ‘militancy’. Mr Hunt was quoted by The Mail on Sunday drawing on language synonymous with battle, that can only be viewed as harbouring a sense of aggression:

‘I have never crumbled in any of the challenges I have faced as Health Secretary….there’s no point doing this job if you aren’t up for the fight.’

His comments of course appeared the same month as this tweet where he apparently endorsed the alignment of part of the junior doctor campaign for a fair and safe contract as ‘militancy’.

JH tweet

NHS employers and The Department of Health had the opportunity to make 50,000 junior doctors part of their solution for a ‘better NHS’. Instead they told us we were part of the problem, and where do we go from there?


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