Junior doctors are set to strike this week, despite winning little public sympathy with their demand for a 29 per cent pay rise. Doctors in their self-righteous mode – as many recently have been over this – are insufferable. I sympathise with their situation, but they should do themselves a favour – and get back to work.
I will be one of the consultants covering shifts for the juniors, and I am looking forward to doing so. Never having worked in an elective speciality, weekends and public holidays, like evenings and nights, have always been part of my working life. My speciality never closes its doors or takes a break. Reading of the tussle between the government and the British Medical Association (BMA) about whether elective work should continue over the strike period – some consultants appear to regard it as unthinkable they should cover their own juniors – leaves me sympathising with the government.
For most of us covering the strikes, the shifts will not be arduous. The level of cover will be generous and the hourly pay higher than normal. More importantly, the sense of camaraderie makes such shifts memorable. Esprit de corps is easy to speak of, but precious to find. As a medical student I wished to be a GP, which is perhaps the hardest of all medical jobs to do well. But the solitary life did not appeal.
In hospitals, I have always been part of a team, and that has been what has made work worth getting up for in the mornings. When I worked in A&E the nurses were the core of the team; in my current specialty, since our work is spread over many wards, it is my fellow medics. The company of junior doctors, in other words, has long made my professional life worth living.
Some are lazy, shiftless, incompetent and untrustworthy. But very few. Most are excellent, hardly ever conveying the self-satisfaction seen in recent media calls for more money. These kids – for kids they seem, by virtue of my age rather than theirs – are bright, thoughtful, industrious, deeply concerned about doing a good job, and full of hope.
Many come from a background that they will not be able to afford for their own kids. They grew up in nice homes – the sort of places where doctors live – that full-time NHS consultants could not now afford. These problems have little to do with the wages of junior or even senior doctors; a twisted housing market is to blame, to which few young people are immune.
Junior doctor careers have been turned from a competition into a lottery with too few tickets
The Review Body on Doctors’ and Dentists’ Remuneration was meant to ensure fairness; a profession which could not strike (as was accepted to be the case), but which had no free market protections, needed pay set independently of government. That principle has been eroded, to the point that a mildly paunchy man with a bit of grey hair – me – will spend his weekend trying to recall his blood taking skills, filling in forms designed by people who believe that the magnitude of healing is proportional to the number of mandatory entry fields, and all the other tasks with which we waste junior doctor hours.
How much doctors should earn is not clear. I have myself no interest in money – but have found, as I have aged, a great interest in some of what it buys. The invisible hand cannot solve the problem. Milton Friedman argued anyone should be able to call themselves a doctor, with consumers deciding which to choose. Until his arguments prevail – which they hopefully won’t – wage decisions cannot be left to the free market.
Junior doctor careers have been turned from a competition into a lottery with too few tickets. Reform would profit everyone, and might allow the juniors to back down and save face. Pay rises for the first year or two, when headline figures are lowest, could be an affordable addition, without setting wider precedents. No serious government could accept a huge precedent-setting pay rise.
Junior doctors are young, and the young are not slow to feel the world is treating them unfairly. They have grounds for complaint, but I sense no widespread conviction about these strikes. I suspect many will turn up for work as normal. I will value their help finding a computer that works – a precious skill – but value their good company more.
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