In March 1974, I served as the house surgeon on call at Westminster Hospital. While watching the 9pm news in the doctors’ mess, the transmission was interrupted by a flash: Princess Anne had been the target of a kidnapping attempt on her way to Buckingham Palace, and her bodyguard, a police officer, had been shot and was being taken to Westminster Hospital.
I hurried down to A&E, and the casualty officer and I quickly assessed the patient, set up intravenous lines, and ordered blood. Almost immediately, the senior registrar and our boss, Professor Harold Ellis, arrived. They had also seen the news and rushed to the hospital.
These senior medics, who worked tirelessly every day of the year, were always there to support and train junior staff and handle emergencies. They did not receive overtime pay, as their commitment to the job was part of their nature.
It is mythology to claim, as the strikers do, that providing emergency cover (‘Christmas Day service’) means patients will not die as a result of this action (File image)
However, the way consultants are contracted to work has changed. The British Medical Association has recently balloted consultants on strike action for higher pay and 86% have voted in favor. Following the five-day strike action by junior doctors, consultants will also cease routine work for two days from July 20, resulting in seven days of reduced activity across the NHS.
Claiming that providing emergency cover during the strikes will prevent patient deaths is a myth. Delays in certain investigations, such as endoscopy for rectal bleeding, may occur, leading to delayed diagnoses and potentially endangering the patients’ lives.
Biopsy delays for suspicious lumps will also result in diagnostic delays. There have been cases where patients’ appointments have been postponed for weeks or even months due to other hold-ups in the system, and similar delays are expected after the strikes.
In my opinion, and likely many others’, doctors are well paid. However, inflation, poor government planning, and financial constraints in the NHS have caused doctors to fall behind in comparison to the financial rewards of 15 years ago. It’s important to recognize that this is partly due to the 2008 world financial crisis and the societal changes impacting income expectations.
There was a time when NHS consultants could afford to send their children to private schools or purchase family homes near the hospitals they worked at, but those times have changed. The rising cost of living has made it difficult for consultants to sustain mortgages even for modest properties.
Moreover, benefits such as exclusive dining arrangements in the doctors’ mess and guaranteed parking spaces have been removed, leading to a decrease in workplace satisfaction.
Striking Junior Doctors march from the BMA HQ to Parlaiment square on June 16, 2023 in London (File image)
The working world for doctors has changed, along with the culture. The vocation that consultants once had, where they were admired for their skill, judgment, and experience, has been downgraded to a technical job, with managers making many of the decisions. Patient care has become fragmented as they are treated by different specialists for each area of the body.
The NHS itself is facing fragmentation and instability due to overwhelming numbers and lack of resources, as well as frequent top-down changes. The earlier culture of optimism has been replaced by anxiety and mental health strain for many doctors. The loss of privilege and status, combined with this pessimism, has fueled the discontent and anger driving the determination of the 86% of consultants who voted to strike, but unfortunately, patient care will suffer as a consequence.
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