View from the ground, by Dr Sarah Merrifield
The junior doctor strikes in 2016 over the new contract brought disruption to many. Like many of my colleagues I participated in what seemed like endless social media activity, protests, and letter writing. Like many, I also became disillusioned with the fight over time. The amount of energy expended seemed futile; I just wanted to be a doctor with reasonable working hours, was that so unreasonable?
As I commenced an out-of-programme experience I gave up. The hope of us, as doctors, achieving anything in the dispute over the contract seemed impossible. A sense of defeat overcame me, could it really be so bad?
When I reached the point of returning to training I began to research this infamous new contract in more detail. The first thing that struck me was the significant pay decrease in comparison to the old; disappointed, I resolved to make things work regardless. Talking to other colleagues, however, I realised how much harder this made things for those with childcare commitments or other increased outgoings.
On receiving my rota from my new training practice, I felt a sense of guilty delight. Gone were my 10- to 11-hour days, replaced by 8-hour days with tutorials and teaching built in. Perhaps this wasn’t so bad after all, I surmised. Admittedly, with an 80-mile round trip to work every day, the idea of shorter days was somewhat appealing.
Unfortunately, the reality was quite different. I soon came to realise that the new contract did not mean less work, it merely meant squeezing the same work into fewer hours. On several days my work schedule allows only 30 minutes for a visit—and that’s if everything else that day has gone according to plan. Isolated from the rest of the team, we snatch hurried conversations to catch up in a corridor before rushing to start our afternoon clinics and frequently stay late to catch up on missed admin. We are told to exception report but often feel reluctant due to a sense of loyalty and fear of repercussions. Nobody wants to be the ‘difficult trainee’.
I have also seen the impact that this has had on many educators’ relationships with trainees. I have heard trainers who are shocked that their trainees would want to go home at their contracted time, suggestions of a clocking on and off mentality, and speculations that we will never be able to cope with ‘real life’.
We did not ask for this contract; we fought actively against it. Many trainees will now be in a situation where they are paid significantly less, contributing to an ongoing sense of injustice and disgruntlement at having poorer working conditions imposed upon us. We want to work. We want to learn. But why should we work for free? In fact, why should any doctor, qualified or unqualified, work unpaid hours?
The new contract is not ideal; I think we are all in agreement in this respect. There are ways to make the terms and conditions work better for both trainees and trainers. This takes work and time that many do not have, but I am sure most trainees would be more than happy to contribute to organising their own work schedule in discussion with trainers and practice staff.
Worth a thought at least? A GP versus trainee standoff is not going to reduce anyone’s stress levels.
Dr Sarah Merrifield