Enough is enough: why juniors are considering industrial action
As the BMA campaign for pay restoration gathers pace, The Doctor has spoken to a range of junior doctors about why they are considering industrial action ahead of a ballot expected in early January. In the second of a series of interviews, Ben Ireland speaks to foundation year 2 Vanya Gurr
‘Family and friends were questioning why my knees were bruised. It was because I knelt in front of a computer all day to work.’
Dr Vanya Gurr, now an F2 working in emergency medicine at Barking, Havering and Redbridge University Hospitals NHS Trust, recalls the first four months of her career as a doctor at a different trust.
‘The next four months I regularly sat on a bin lid because there wasn’t space for enough chairs,’ she adds. ‘And the last four months I often sat on a step ladder maintenance happened to leave in the office because it had a little back support.’
Hospitals’ inadequate working conditions are well-known, but most people might expect junior doctors working long life-saving shifts for about £14 per hour to at least have access to a chair.
Dr Gurr was troubled recently when a social media video circulated showing facilities such as curved screens, wellness rooms and touch-screen coffee machines for NHS managers in a trust she had worked in, while doctors and nurses were left with inadequate facilities on the frontline.
‘I can’t explain how frustrated and upset we were to see that,’ she says. ‘The disparity is insane. I’ve had days where I’ve been on the ward looking after 25 people with one other F1, doing at least four people’s work, not taking a lunchbreak, staying late. I’m a hard worker, but you need the correct recognition for what you’re doing.’
She questions the logic in employing people in roles such as ‘wellness lead’ when the basics needed to do the job are not provided. ‘They put in wellness rooms we never have the time to visit because we’re too busy,’ explains Dr Gurr.
‘It’s a lack of understanding of what we need. Our wellbeing is having a chair, an office, a computer. ‘Wellness is adequate staffing which means I’m not leaving two hours late every evening and can take a half-hour lunchbreak. Not putting on a ballet show we don’t have time to attend.’
Our wellbeing is having a chair, an office and a computer
Dr Gurr
While junior doctors are set to ballot over industrial action in a dispute over pay this January, Dr Gurr speaks for many doctors when she says poor working conditions are the primary cause for concern.
She says: ‘The issue is the sacrifice we put in and how rubbish our lives are comparative to the pay.’
Dr Gurr notes how FY1 and FY2 are ‘the years you are meant to be supported’ and supervised. Her reality? ‘I found myself on my very first job doing my rounds with little to no supervision or senior support. The responsibility and amount of work doesn’t seem fair compared to what I was being paid.’
She notes how some friends rely on locum shifts ‘just to get by’ and how ‘every junior doctor I know who lives in London picks up extra shifts’ to meet the higher cost of living in the capital.
‘I picked up a few locum shifts because I felt I had to because my department was struggling,’ adds Dr Gurr. ‘I can’t fathom how my friends pick up extra shifts to survive because I don’t have the mental or physical capacity to work more than I already do.’
In some cases those locum shifts have been unpaid for months, says Dr Gurr. ‘My friend who gets by on her locums still hasn’t been paid after 13 months. She’s owed more than £1,000 – and needs it. It took me seven months to get paid for mine.
‘In most other jobs, if you worked extra there would be something in place to ensure you get paid. If we didn’t keep logs of locum shifts we work they would go unpaid. You shouldn’t have to spend so much time chasing your pay.’
Dr Gurr considers what her life might have been if she chose a different career ‘basically every day’. Her partner is an accountant and ‘his pay, compared to mine, is obscene’. She points out his 18% pay progression in the last year alone, while junior doctor salaries have eroded in real terms by more than a quarter since 2008.
And it’s not just accountants earning significantly more money than junior doctors. ‘The difference between our pay and some of friends working in grad schemes for companies like Amazon is crazy,’ she adds. ‘It might sound obnoxious, but I got the grades to do almost anything and I had a lot of other interests I could have pursued.’
She recalls she had ‘reservations’ as a first-year medical student but after a brief stint switching to aerospace engineering returned to medicine because she was lead to believe it’s ‘a rewarding and well-respected career, which I thought then was decently paid.’ And, crucially, because ‘I wanted to help people’.
As the first person in her family to go to university, she notes how she was supported and encouraged into medicine over chemistry because it would be a rewarding career – not because of earnings potential.
By comparison, ‘A girl in my flat was in the same position but had doctor parents who said being a doctor wasn’t worth it, and she chose chemistry. Had I been in her position I might have made a different decision.’ On placement, she recalls ‘a disillusioned registrar’ telling her to “leave now”.
I’m a hard worker but you need recognition for what you are doing
Dr Gurr
Dr Gurr hopes to specialise in public health as her career progresses but before that, she hopes – like many – to take a year out of the NHS to work overseas, with her eyes set on New Zealand.
She’s been researching the differences between UK and New Zealand working conditions and notes how in New Zealand staff are paid extra if colleagues are off sick to recognise their extra workload – and on-call relief workers are there to step in when they are understaffed.
‘None of my close [medical] friends are staying [in the NHS] next year,’ she says. ‘The majority are planning on either working in a different country or locuming so they can have a life outside work.’
She thinks the ongoing exodus is driven by poor treatment of healthcare workers in the UK compared to other countries. ‘There have only been one or two days over the past few years where I’ve really enjoyed the day because we had enough staff,’ says Dr Gurr. ‘If that was the day-to-day, then I’d love this job. But it’s not’.
‘I’m at a very real risk of not continuing to be a doctor if that doesn’t change. And that’s really sad.’
