England on brink of mass walkout by doctors, warns GP trainee's letter to MP

A Midlands GP trainee who joined protests over plans to impose a new junior doctor contract has written to her MP urging him to challenge the government's 'aggressive and alienating approach' to pay talks, warning that a generation of young doctors could quit the NHS.

Junior doctors in Nottingham protest over contract changes (Dr Sarah Hamer second from right)
Junior doctors in Nottingham protest over contract changes (Dr Sarah Hamer second from right)

GP trainee Dr Sarah Hamer, whose husband is also a junior doctor, said she and other doctors were extremely worried about the personal impact of potential pay cuts, and about the impact on the wider NHS.

'I personally feel devalued, and I am not alone,' the Alfreton, Derbyshire GP trainee told GPonline. 'There is frustration at the desultory reporting of the situation in the mainstream media. There is stress resulting from the uncertainty of what will happen - anticipated pay cuts, large numbers of doctor resignations creating impossibly increased pressures on those left behind, particularly if locum caps stretch permanent resources even further.

'It is particularly unnerving for doctors who are partnered to other doctors as they find it impossible to budget for the future. All reasonable expectations of future earnings, on which mortgages have been calculated and families planned, have been savaged.

'Sadly there will ultimately be one guaranteed loser: patients. No staff means no service and the NHS collapses, and collapses very quickly.'

Read Dr Hamer's letter in full:

Dear Mr Mills,

I am writing to you regarding the proposed imposition of a new junior doctor contract.  As you are a member of the current Conservative majority, I would like you to hold the government accountable for its aggressive and alienating approach to negotiations with the BMA. The country is on the brink of a mass trainee doctor exodus - out of the NHS and out of the profession. Please let me know what you are doing to ensure our healthcare system is being protected.

My husband is a registrar in obstetrics and gynaecology. I am a trainee in general practice. We are both junior doctors and had planned to be for the next 4 years at least. We have already been working as doctors for 5 years.

Your website states your interest in the NHS and in particular the role you played in securing funding for what will replace the former Heanor Hospital. As someone who professes to wish to protect the NHS as a free at the point of access service, and who proudly states on your website that it is one of the best healthcare systems in the world, I imagine that you must share some of my concerns regarding the current governments plans.

I am concerned that my husband and I will be subjected to a pay cut on an unprecedented and unjustified scale. Just like many hardworking people, we moved into your constituency and took on our mortgage on the basis of our current and projected pay. I have recently had a baby. It looks as though we will not be able to afford our house if these changes go ahead. We are not alone. Being a doctor is not cheap (indemnity, registration). Being a GOOD doctor is expensive (courses, exams, college enrolment). Many doctors will not be able to afford to continue to practice in the UK. Heanor hospital's new guise will not be able to attract quality staff. Local GP practices will be unable to staff the clinics and services patients require, to a standard they deserve. The health of your constituents will suffer. Your efforts in securing funding for the Heanor health centre will be wasted.

I reject the notion that working a Saturday is "sociable". That is when my children will be home from school. This is when my friends will be home from work. We accept the need for doctors to work unsociable hours but they need to be paid fairly and proportionately for them.

I reject the claim that automatic pay progression through the 5-12 years of junior doctor training is unfair. To say that it is, grossly undervalues a doctor's incremental accumulation of professional proficiency, experience and skills. Automatic pay progression sends out a message that a junior doctor is valued. The president of the Royal College of Physicians wrote a bulletin in which she points out that mortality is higher in hospitals where staff morale is low. Trust me, morale has been extremely low since the current government came into power.

I reject that our current banding system for out of hours pay is outdated and needs revision. My husband's on-call commitments have been increased in his current post at a local hospital in order to cover rota gaps. This was negotiated with the doctors involved but only because an increased banding supplement was able to be offered in order to facilitate proper cover. This provides some evidence of how our current pay system incentivises and facilitates appropriate medical cover. As junior doctors we will do what we can to ensure adequate provision in our hospitals, but we should be compensated for the loss of this premium social time. We are humans with lives, family and friends.  Though we are all in public service, we do not live off our sense of vocation alone any more than you do as an MP.

Recruitment in the East Midlands for general practice training is already in crisis. July 2015 data from GP magazines states that only 57% of available GP training posts in the East Midlands were filled. This can only get worse if the proposed changes go ahead. Even if the NHS were to disintegrate in the medium to long term as a result, over every timescale imaginable it is actual patients who will suffer.

Please let me know what you are doing to ensure they are being protected.

Yours sincerely

Sarah Hamer

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