I originally wrote this post in September but deleted it after I became a local junior doctor BMA rep and realised it isn't exactly complimentary about them. I read the original post again and still agreed with the sentiment so am re-posting. I can still do a job for the BMA locally and not necessarily agree with what they are doing nationally (Stickers against imposition, anyone?)
As my twitter feed and previous posts here show, I wasn't too enamoured with the idea of the government imposing a contract that would result in worse hours and less pay. I went on strike in January and again in April. I waved a placard, canvassed for the BMA and put my point of view across on social and old school media.
Next week I won't be on the picket line.
The first reason is simple, I can't afford to lose £600. The other reasons are slightly more elaborate.
After ACAS negotiations the BMA emerged with what they said was a decent, albeit not perfect offer from the government. Upon reading the revised deal, I could see it was a vastly different contract to the original contract that was due to be imposed which I went on strike over. I attended a BMA road show where I was told that my concerns about a pay cut, unsafe hours, part time workers and reduction in pay progression had been addressed. New hours safeguards and adherence to EWTD were in place. A guardian of safe hours was to be implemented. An online hours breech system was to be introduced to accurately reflect how much we work. The BMA said this was the best they could get and we should accept it. I duly accepted it in the most recent vote. 58% of my colleagues didn't.
My colleagues have that rejected that contract offer can strike and do so with a clear conscience that their demands weren't met, and I support them. My conscience will not allow me to strike over a contract that I was willing to accept. This also leaves me looking somewhat like a government stooge which I'm very much not!
The fact that the contract is still felt to be discriminatory to women, part time workers, academics and career changers (like me) seemed to be lost on the BMA at the time. Why couldn't they use their considerable resources to have the contract reviewed by the country's top legal minds? Why not re-ballot about whether 5 day strike action is the way forward. Conversely, why bother with the "referendum" at all if the contract offer was so good. Why come out so in favour of the contract initially and aid implementation when the response to losing the referendum was to undertake more intense strike action than before?
For me the contract was always about pay, but we seemed to be too scared to say it. It was always about pay but not in the direction some people think. I'll say it again because people don't seem to get it.
I DON'T WANT A PAY CUT, I AM NOT ASKING FOR A PAY RISE,
The thing is pay IS linked to conditions and getting the same pay but working more difficult hours IS linked to patient safety. They are not separate issues. We shouldn't have let the narrative get shifted to "Lazy, greedy doctors want more money!". It think the BMA have been outmanoeuvred by the government and now news outlets are running negative stories and the BMA appear off the pace. They look silly now that they are striking on a contract they took great effort to endorse. Don't blame on malice what can be explained by incompetence.
The problem with more strikes is the possibility that this is used by the government to preface further erosion of the NHS as a free healthcare system. Rota gaps and service closures are de rigueur and all this can create a picture of a service in chaos. I posted lots of ways we could have had industrial action that wasn't all out strike, even in my BMA feedback but this is the way it's gone.
The market value of my service is more than I'm currently paid as I work in a monopoly, and a I take that difference because I like working in a service that places patients and not money first. Even though I want to keep the NHS, paradoxically a private system would benefit most doctors financially. Market forces can't apply to me as I only have 1 employer option if I ever want to be a consultant so any strike action was never destined to last more than 2 weeks. Any longer than this and I would not be passing my appraisal for the year.
So what was my solution? We use the systems in the new contract to our advantage. Currently when I work late because I'm helping a patient I don't spend more time filling out overtime sheets or "breach forms" as nothing useful comes from them and I definitely won't get paid any more. New proposals to link e-rostering for our shifts and actually pay us a proportion of current trust overtime charges and would mean filling out these forms could actually make a difference. I jokingly used to count up all my unpaid overtime and call it my "NHS Goodwill Fund", but it stopped being funny after it quickly started mounting up. This is overtime not because I'm lazy or slow, but because patients are sick, theatre lists and clinics are crammed and there are definite rota gaps.
Much like when GPs shocked the government with their excellent adherence to receiving QoF payments I think junior doctors should have strongly adhered to new e-rostering rules and tell hospitals how much they are working and pester their "Guardians of Safe Working" to be paid for all of this extra work they are doing and the BMA would have something to work with. I estimate that the government thinks we don't work as much unpaid overtime as we do and 50,000 doctors showing their time receipts and giving hospitals big bills for this overtime is the way forward.
I think the contract issue is unwinnable as I will definitely still be working for my CCT and will end up sign anything put in front of me to keep my training number and mortgage paid.
So, overall I won't be striking, but I don't condemn my colleagues who will be, and I hope the public doesn't haul too much abuse at them. After all the public won't know how good they had it, until it's gone.
My two pens
4 days ago