Shades of Grey

greyscale-259x300People are confused; they are right to be. In actual fact, I’m confused and if you’re a junior doctor and you think our situation is black and white, well then you are probably not being honest with yourself.

There are some absolute truths:

  • That junior doctors are qualified medical practitioners. They are not students or apprentices. All doctors are life-long learners, we develop more and more acumen as we progress. Consultants are life-long learners too.
  • That junior doctors are not a road block to ‘7 day services’. This was true before the #juniorcontract war erupted last year and it is true now.
  • That the #juniorcontract has been wrongfully and willfully conflated with a pretense to provide ‘7 day services’. This conflation is deeply distressing for junior doctors and it remains the biggest roadblock to resolving this dispute since the beginning. In order not to repeat myself here, I would ask you to read this and you may also be interested in this and this breakdown of previous television interviews given by Mr Jeremy Hunt.
  • That this dispute is escalating the imposition of a contract which has not been either costed or funded appropriately.
  • That this dispute is escalating a contract which uses tax payer’s money to fund something that doctors believe is not in the best interests of the NHS. Something which has no evidence base.
  • That this dispute has become too centered on the absolute inability of Mr Hunt to appeal to and lead a massive part of the NHS workforce in any meaningful way.
  • That junior doctors are genuinely concerned that the imposition of this contract has become a vanity project for the secretary of state for health.
  • That the struggle of junior doctors to oppose and mirror the whirring machine of government policy has been a clear demonstration of everything that is wrong with achieving progress in the NHS and at the risk of repating myself, perhaps you would like to read this.
  • That junior doctors are not politicians.
  • That junior doctors rightly reject policies which see discrimination of the valuable female workforce as collateral damage (detailed here)
  • That doctors want a contract which allows them to provide a safe service to patients.
  • That doctors require appropriate pay for their work. That the pay should appropriately remunerate the effect our work has on our home lives. This dispute is partially about pay, I make no apologies for that.
  • That junior doctors already provide their services at a good price to the NHS.

But there is also lots to be confused about.

  • That the BMA negotiated for us what they publically referred to as something which ‘is a good deal for junior doctors and will ensure that they can continue to deliver high-quality care for patients’.
  • That this deal was not only endorsed by the BMA, but by numerous high profile faces of the junior contract dispute, unequivocally and in public.
  • That the original mandate for strike action is almost a year old.
  • That the response to the BMA survey designed to gauge appetite for further strike action was poor to say the least.
  • That the BMA have failed to discredit talk that the committee’s motion for industrial action was separated by a minimum of votes.
  • That voices from within the BMA comittee have failed to make their voice the most consistent one in this argument and you can see how it may appear that they are  running after, rather than leading the pack.
  • Mr Hunt’s lines are polluted with spin and mistruths, but they seem to be consistent.
  • That surely these things have grossly undermined the perceived effectiveness of our union.
  • That as a junior doctor, I don’t actually know what the BMA see as an ‘ideal contract’. If Mr Hunt gave them the opportunity to write their own contract tomorrow, what would it say? Not in a hypothetical, vague over-arching principles sense, but in a real line for line, these are our terms and conditions sense. This should be done by now surely? Perhaps it is, but why haven’t I seen this and how can I support the next industrial action when I can’t find the answer to this question?

These points could go on for longer. I am opposed to the new contract. I am opposed to imposition and I am opposed to the government backed conflation and spin which has led to the escalation of our dispute to this point. However there are many ‘buts’ and in the wake of plans for 5 day industrial action they are buts that that have been echoed by every single one of my colleagues. Not some of them; all of them. There are more than two sides to this argument. These are perhaps not the voices you hear on social media, but the inconvenient  truth is that people are so loathe to further discredit the struggle and the credibility of the BMA, that staying quiet seems like an option. Not because people are frightened of a backlash (or at least I am not), but because we do all still want the same things ultimately.

So where do I stand today? Honestly, I stand with my patients. On the week of the 12th of September I will be the intensive care registrar on night duty, I will be in work.

Am I relieved by this?  Yes.

Do I think I would be on strike if I was working normal days?  I don’t think so, no

Can you take my lack of surety as an endorsement of current department of health policy or leadership? ABSOLUTELY NOT

This may be unpopular with the vocal, but you only have to take a cursory glance through my previous writing to know that I am on the same side as the BMA. I am on the side of junior doctors and I am on the side of patients. Striking is an individual decision and again I will not re-iterate previous posts like this one at length. It is up to the individual to decide if it is justifiable in the context of their own job. If I am going to walk away from my particular job providing critical care to patients, well then I need to be as sure as I one can be that this method of withdrawing services for 5 days at minimum notice is a possible means to a better end.

Right now, I am just not sure it is. That’s not how you win at politics you say? Please remember, I am not a politician. I am doctor.

 

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One thought on “Shades of Grey

  1. As a Critical Care Outreach nurse I will be working on the strike days within the hazy lines between traditional roles of doctor and nurse. Feeling uncomfortable, as an old left winger, that my actions although within my remit in caring for the deteriorating patient,are undermining the strike. Have to agree that the medics I have spoken to are ill at ease, they are not happy with the contract and the Hunt spin, but are apprehensive of the length of the strike. lots of minor harms but major inconveniences for patients and erosion of public support.

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