The NHS needs us now more than ever
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This has been an unprecedented time to be a doctor. For a brief moment we had unity within our profession. We’d come together, F1 to consultant, like we’d never done before. And personally I’m so proud of us.
At a time of constrained funding and the seemingly relentless public sector cuts, multiple professions and public services have felt attacked. Yet it is doctors, the famously apathetic doctors, who stood up this time. Given our past record with pension changes and MTAS we could so easily have put up a token resistance. But we didn’t.
Interestingly the background to the dispute lay with clinicians deciding that care should be better at weekends. And let’s be honest we’ve all worked weekends which feel dangerously understaffed. What perhaps was not appreciated in governmental circles was that we’ve all worked weekdays and nights like this too – and that spreading already meagre resources beyond breaking point was a recipe for disaster. We all know the background to the government seizing on the catchy ‘7 Day NHS’ with an ill thought-through manifesto pledge and a subsequent unprecedented and unwarranted attack on doctors’ vocation and work ethic in the summer of last year.
Much of the press was unsupportive, while some even condemned us for taking holiday and tried to convince the public we swill Moët every day of our working lives. This, in addition to what was widely accepted to be an unsafe new contract, focused minds and united us like never before. The difference this time was that we were not just standing up for ourselves, our pay, our futures, our time with our families, equality in the workplace, our clinical researchers, our less-than-full-time doctors and the NHS as a whole – we were also standing up for our patients.
Social media has been phenomenally useful, to such an extent that I doubt we would have developed such a unity of purpose without it. Suddenly we weren’t just junior doctors in far-flung locations – someone from Trelisk Hospital could easily and instantly reach out to practically all junior doctors in the country and make contact with someone from Kent and Canterbury Hospital or Newcastle General Hospital.
The BMA, although criticised, has played a key part in uniting junior doctors under a common purpose. But in addition we had the support of doctors on the frontline. Some trainees wrote articles for the press, some wrote letters, some were interviewed by national television networks, some stood out in the cold, repeatedly, on strike. We stood together and we made our voice heard.
So what can we do to sustain this unity? This is the most important question. We need to be savvy, we need to be proactive and we need to become leaders. We must engage with the current management structure of the NHS, develop our management experience, and seek out the problems that we all face on a daily basis and do what we can to resolve them.
Let’s be honest, how many of us have ever written a business plan, or a standard operating procedure? Which of us knows who the managers are in our hospital, or what they do on a day-to-day basis (hint: they’re more than the people who refuse our leave requests and call us up at 4pm to ask if we can cover the night shift)? How many of us can describe the structure of the NHS? Who really knows the difference between Monitor and the CQC, NHS Improvement and NHS Engagement? How many times have we watched that King’s Fund video on the structure of the NHS and still felt confused?
And who can blame us for not knowing all this? The NHS is fiendishly complicated, and our jobs are so busy both in work and out that it seems unrealistic to expect us to have the time to find out everything there is to know about the NHS by ourselves. This is where FMLM can really help us out, pointing the way to information, resources, training and development.
Leadership and management have become essential in our profession and will soon feature on all our curricula. This has become much more than a box-ticking exercise. I hope that we can utilise FMLM to step up and take charge of the NHS. Clinicians in charge of the NHS? There’s an idea we can all raise a glass of Moët to.
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About the author
Gareth Hynes
Gareth is a PhD/DPhil student investigating airway immunology. In addition to his FMLM Trainee Steering Group (TSG) communications role he is the joint Oxford Deanery representative to the trainee committee of the Royal College of Physicians (London) and the FMLM TSG representative to the Academy of Medical Royal Colleges.