28 Jan

The junior doctors’ strike: which relationships matter most?

Junior Doctor's strike

Letter to the Times (unpublished) – On Tuesday 12th January, across the UK Junior doctors went on strike in a dispute over pay and working hours. The dispute centres around the Healthy Secretary’s (Jeremy Hunt) proposals under which ‘normal’ working hours will include weekends and evenings. This means that doctor’s pay for these anti-social hours will be greatly reduced.

This is part of a move by the government to turn the NHS into a ‘seven-day-a-week’ service. Jeremy Hunt wants to get more work out of the same workforce for the same overall cost. And as it will make it cheaper for hospitals to roster doctors during these hours, more will be working time for which they were previously paid a premium.

The important question to ask, is who are the ‘stakeholders’ in the junior doctors’ strike? Which relationships matter most?

The government argue that relationships between patients and the NHS trump all other considerations; patient care can be improved by a 24/7 service, so it is an open and shut case. But is it so simple?

Which relationships are the ‘losers’ if the government succeeds in its plans? There is no point in junior doctors working without other related professional groups – anaesthetists, bed managers, nurses, radiologists, pharmacists, social workers, and ancillary staff. Has the government thought through the effects on relationships among professionals if they come under the stress of a 7-day work pattern?

Has it considered mental health and burn-out effects, which all damage relationships both inside and outside the NHS? Has it also considered the cost to partners, children, extended families and communities if another chunk of the workforce is removed from being present in their households over weekends?

And it is not even clear that the public either want or need additional medical services on Sundays. Early trials with 7-day GP surgeries did not demonstrate public demand. There is in effect already a 7-day NHS. Those who urgently need help always get it.

Are the ‘market men’ really more important to government than those concerned for public sector efficiency and social well-being which is most people’s priority?

Author: Dr Michael Schluter CBE – founder of the Relational Thinking Network

Photo: West Suffolk Hospital, Not Hunt’s to Sell (By sasastro from Flickr).

  • Hilary Papworth

    I would suggest that the author of this article has never had the experience of attending an NHS hospital with a seriously ill patient at a weekend or bank holiday. I have experienced this more than once. It is terrifying. It is false to say, “Those that urgently need help always get it.”

    • admin

      Thank you for responding to my blog Ms Papworth. I have in fact had the experience of attending an NHS hospital with a seriously ill person on a weekend. I am sorry that your experience has been so much worse than mine. However, it is not so much either your experience or mine which matters, but what the general experience of the public has been who have had to face such a horrible situation as you have had. I am sure you would agree that it would not be right to make all junior doctors work at weekends just because of one or two exceptional cases where the system failed. However, if it could be shown that the sort of experience you had was a regular occurrence for thousands of patients, then it would obviously be necessary to consider increasing the amount of cover provided at weekends by junior doctors.

      I hope you would agree that doctors also need time with their partners/spouses/children like everybody else and thus it is unfair to expect doctors, or anybody else, to work regularly at weekends unless there are truly exceptional circumstances requiring it. The government does not seem to put much value on our children and their needs for parental time these days, nor does our society value long-term, committed relationships which provide the security and care which are important both for parents themselves and their children.

    • Marjon

      Thank you for responding to my blog Ms Papworth. I have in fact had the experience of attending an NHS hospital with a seriously ill person on a weekend. I am sorry that your experience has been so much worse than mine. However, it is not so much either your experience or mine which matters, but what the general experience of the public has been who have had to face such a horrible situation as you have had.
      I am sure you would agree that it would not be right to make all junior doctors
      work at weekends just because of one or two exceptional cases where the system failed. However, if it could be shown that the sort of experience you had was a regular occurrence for thousands of patients, then it would obviously be necessary to consider increasing the amount of cover provided at weekends by junior doctors.

      I hope you would agree that doctors also need time with their partners/spouses/children like everybody else and thus it is unfair to expect doctors, or anybody else, to work regularly at weekends unless there are truly exceptional circumstances requiring it. The government does not seem to put much value on our children and their needs for parental time these days, nor does our society value long-term, committed relationships which provide the
      security and care which are important both for parents themselves and their
      children.

      Kind regards,
      Michael Schluter

    • Hilary Papworth

      Mr Schluter, In reply, I do not accept that mine was an exceptional experience – when a system is unprepared to undertake urgent diagnostic tests because most of the hospital down because of the day of the week or because it is a bank holiday, this is bound to have a serious effect on the patient. I find that the hospital workers take the view that the patient will have to wait and that this is normal and that is just how it is – what else can they do in the circumstances? The John Major government had a ‘Patients’ Charter’. As I recall, one of it’s aspirations was to see to patients before their condition got worse. This is unthinkable today. Delays are routine and accepted as normal.

      It is obvious that medical care should be seven-day and not the current kind of medical Russian roulette we have now. I have been employed in work that requires six and/or seven days cover. It is no big deal. It just means he pattern of the week is different. The medical unions like to tell us how hard their members work, how much they care about their patients and how well the old NHS systems work. Unfortunately glaringly inadequate care – take cancer survival rates for example, mainly due to late diagnosis – and other obvious stresses on the system, tell a different tale.

      Kind regards, Hilary Papworth