Why The Proposed Junior Doctors’ Contract Is Sexist

This week’s news has been dominated by coverage of the junior doctors’ strike, which occurred on Tuesday and Wednesday. It is likely you will have seen coverage of the strikes splashed on the front page of newspapers and spread all over social media. Talking to those I know, however, it seems that few students know exactly why the junior doctors are striking. So here is a summary, courtesy of The Guardian, which should demystify things for you in just 90 seconds.

(Video Credit: The Guardian)

So, we know that the contract is changing; basic pay is to be increased by 13.5% on average (BBC News). But this increase comes with strings attached. Other parts of the junior doctors’ pay package will be curbed, including what constitutes unsociable hours. Therefore, the junior doctors will find that they are working more weekends, which, under the existing contract, would have led to extra pay. This contract will make doctors work for longer hours, for less pay, potentially driving them out. And what is the NHS without junior doctors? 

Facts and figures have been spun by Jeremy Hunt to make it look like their are more deaths occurring in hospitals on the weekends, but this is a purposeful misintereptation of statistics. This is in fact not true. Jeremy Hunt Claims he wants seven day elective services in the UK; if so, it is not the junior doctors' rotas he needs to change, but the rotas for all other elective services, such as social workers, pharmacists, and so on. However, Hunt seems convinced to try and impose these changes to the junior doctors' rotas. 

Not only do we know that the contract is changing for the worse, but we also know that the new junior doctors’ contract will negatively impact female doctors more than men. Even the Department of Health has admitted this.  The DOH has explicitly stated: "Any indirect adverse effect on women is a proportionate means of achieving a legitimate aim." To me, this seems to be politician speak for "the new contract discriminates against women but the Government doesn’t care."  They even admit that the new contract "may disadvantage lone parents (who are disproportionately female) due to the increased cost of paid childcare in the evenings and weekend."

(Photo Credit: The Telegraph)

Caitlin Moran, I couldn’t agree more. The detrimental effects of the contract, if imposed in August 2016, can only be guessed at, and feared. But my hunch is that the damage that will be done to the NHS, especially because some women will no longer be able to afford to continue on in the medical profession, will be catastrophic.

Although I am an English literature student, I come from a family of doctors. My parents are both consultants so didn’t have to face the decision of whether or not to strike this week. However, when I was a child, my mother was still a junior doctor, having taken time out of work to have me and my older sister. She often worked unsociable hours. My mum would work overnight, on weekends, bank holidays, Christmas Eves, Christmas Days and New Years. The thought that the junior doctors of today will have to give up these special times with family with no form of reward for it in terms of pay is not only nonsensical, but brutal. My older sister is approaching her end of her medical degree, ready to knuckle down and excel as a junior doctor: I have no doubt that she will. But for her, and for others of her generation, the public needs to make sure that they back the NHS and support a system which is the greatest and most civilised institution this country has.

I leave you with a powerful and moving letter by my friend Svilena Dimitrova, a talented doctor who explains why she did strike this week.

(Photo Credit: Svilena Dimitrova) 

“Dear patients and colleagues,

I am an ST7 in Paediatrics (Neonatology) in London. Let me start by saying that I love my job. I am one of those lucky few who are doing what they have always wanted to and enjoying it. I wouldn't choose to do another job. But I may be forced to. Let me explain why.

Ultimately, each one of us wants to be happy and satisfied, not just in their professional lives. I have a little baby and more than half of my salary goes on childcare. If I had two kids, I would have to pay £300 in order to be able to go to work. The calculations are ridiculous if I were to have 3, so I won't even consider it. As it stands, I am a part time trainee, but due to the way the rota works, I worked 60 hours the week before and 48 hours this past week. 48 hours of those were on the weekend.

If I weren't lucky enough to have a husband who works 9.30-5.30, the costs of childcare would have meant that I would not be able to work, and I would have to go on benefits. Cost analysis is fairly simple - one doctor less, one lot of locum fees more, and one more person on benefits that your taxes would pay for. It doesn't take a statistician to work out that won't be good for the economy.

I work in a specialty that is heavily staffed by IMG graduates (btw, for the record, I am not one of them, despite my foreign name). Most of the ones I have spoken to have said that if their pay were cut, they wouldn't stay in Britain. Most of the bright medical students I teach are looking to train abroad as we speak.

I am not a junior doctor, but I am classed as one, and many people don't understand that this definition includes doctors with 10+ years of experience who are well into their 30s and 40s. Most of you would be grateful when "the senior" comes to review their child, and not realise that they are classed as a junior doctor, after they have just resuscitated their baby, or done a life-saving intervention on any one of their loved ones.

Perhaps the wounds wouldn't run so deep if the government hadn't portrayed us as work-shy clock-watchers who let patients die on weekends. Perhaps it wouldn't have hurt so much if I didn't have to worry about whether I will be able to financially cope whilst Jeremy Hunt is implying that I am being greedy by wanting to make sure I actually make any money out of working. And perhaps the financial hit would be taken better, even if we are at a loss by the end of it, if we were told it was in the name of saving the NHS...

But the sad reality is that this is all done in order to dismantle the NHS. To drive the doctors out (and next will be the nurses, paramedics, HCAs etc etc) so that it becomes unsafe. Then, when patients die (and they will), it will be easy to blame it on a failing system and to dismantle it in favour of a shiny new private healthcare dream.

Please be careful. The above governmental dream is soon to become a reality. Please speak to your American colleagues and friends and find out what happens there if you have no money or insurance. Don't trust me when I tell you, it won't be a world you would want to live in. Please find out for yourselves that it's true!

Don't let the NHS die a well planned political death. Support junior doctors. And we will look after you. After all, isn't the point of a functional society to look after after its sickest and most vulnerable?”