My family and I won’t survive the junior doctor contract financially or personally – I’m giving up
Anonymous, for The Guardian
My juniors tell me I’m an inspiration. They tell me that the only reason they have hope is because they can see through me that it is possible – to be a woman, have children and a career in the NHS. They tell me I’m the only reason they think they can keep going. The comments from my recent appraisal included “outstanding” and “one of the best I have ever worked with”.
I’m nearly 40 years old and I have a six-year medical degree, a BSc, an MD and membership of the Royal College of Surgeons. I also have two children, debts which make me sick with worry each month, a marriage which is likely over and a good going stomach ulcer.
I work part-time but that involves a 100-mile round trip, three-hour commute and being away from my children for 48 hours every week because I can’t afford to live close enough to the hospital. I work 60 hours a week in order to make my part-time arrangement work.
I can’t afford to attend the conferences and courses I need to in order to make consultant. I can’t afford the last exam I need to do. I can’t afford my General Medical Council fees, my medical defence insurance or my membership of the Royal College of Surgeons that I worked so hard to earn. I can’t afford the petrol to drive to work each day.
This year I have been screamed at, spat at and kicked. I have physically removed excrement from someone who needed that help. I have cut off people’s legs. I have told people that the most important person in the world to them is dying. I have told people that they are dying. I have told a woman her child may not survive. I have not eaten or drunk anything over a 13-hour period more times than I can remember. This year, once a week, I have woken up on the floor cold, jittery, anxious, hungry and traumatised by the things I have seen and the things I have had to do.
This year I have been so pressured and overstretched. I have several times run to theatre to do an operation to find my patient is already asleep, with me having never met or assessed them. I have had to choose which elderly sick patient I want to stay on an A&E trolley all night because there are no beds.
I have been told “no” by a theatre manager when I’ve said that we need to cancel our elective surgeries because I have seven sick patients who have been waiting two to three days for emergency surgery and I’m afraid for their safety. I’ve been told we have to move a dying patient in the middle of the night because otherwise the hospital will be fined.
This year my children have been inconsolable asking why I have to look after other people and why can’t I just look after them? This year every few weeks I have not seen my children for five days straight even though we all live in the same house. This year, I have asked neighbours, friends and someone I skyped for only 20 minutes to look after my precious children.
I have been doing this for 12 years.
This year, for the first time since I was 13 years old, I have decided I can’t do it anymore. As I write this, there are tears streaming down my face because all I ever wanted to do was be a doctor and help other people. But I just can’t do it anymore. Especially when I don’t think I’m helping anyone the way I want to.
The junior doctor contract is supposed to be “cost neutral” but for someone who works part time, it means I will likely never see my salary improve. It means I could not have afforded to have either of my children. It means the female doctors who look up to me so much, will have to choose children or their careers. It will mean hospitals can make me work as many Saturdays as they like which is the only time I have left with my children – my husband has long given up on me.
It means a 30% pay cut for me from next August and anyone else who works in an emergency specialty.
It’s not cost neutral. It is at such a cost that it is now too high a price to pay. My family and I won’t survive this contract – financially or personally.
It’s time to put my children first.
So I’m sorry to all those who have supported me. I’m sorry to all those juniors who look up to me and to whom I give hope. I’m sorry to the British public for giving up on you.
I just can’t look into the future and face this any more.
If you’re affected by the issues raised in this article, help and support is available from Support 4 Doctors. If you’re based in the UK, the Samaritans can be contacted on 116 123.
National Health Care. Britain is a sample of things to come for USA. Bravely out of character for PW to publish (of course you think its just a money issue).
When my dad was a kid in the thirty’s and forty’s and you needed a doctor you went and paid the bill yourself. Doctors were affordable because they were doing what they loved doing and they did not have to jump through ten thousand hoops to do what they were naturally gifted to do. Same can be said of teachers. Excess government involvement always fucks everything up.
My apologies to those who believe otherwise. This is my opinion.
This is not the 30s or 40s. This is 2015, and until recently (so I understand) you had people actually dying from preventable diseases because they couldn’t afford the insurance. If the US is likely to get a public health service modelled on what ours once was, then I’m sincerely happy for everyone who might formerly have been denied essential treatment.
Meanwhile the UK government is slowly creating a non-welfare, or rather workfare, state in the image of yours. This has already caused thousands of deaths, mainly disabled people who were mistakenly told they were fit for work.
IMO it’s no good looking back to some halcyon era (if such there ever was) while human beings – living in the most advanced and wealthy nations that have ever existed – are losing their lives needlessly, just because they happen to be poor. Capitalism only gives you freedom if you can pay for it.
Not all government policies are created alike — I’m sorry yours has suffered from austerity thinking and unrestrained capitalism, Amy … something we’re trying to grow out of ourselves. With any luck, we’ll eventually figure out that taking care of one another will only make us all stronger.
I knew I would get blowback but honestly what I get from this article is someone who is doing what the system requires and is being completely destroyed in the process. Her gift for helping people is completely repressed by the system.
Just like in public schools today being a gifted teacher is not honored because gifted teachers know how to teach and often that irritates top down managers who are beholden to their higher ups to enforce directive’s and who could care less about teacher student relationships. There was one truly gifted teacher in my high school experience who changed my life and she quite just a few years after I had moved on because she just wasn’t allowed to do her job anymore.
Some other less gifted – but better at following orders – took her place. That is what we witness today in medicine. If you aren’t gifted at following the directives of the top down geniuses (who know everything) then you probably hate your job. And hey – hating your job is one of the main requirements for any system advantage.
Good doctors, good teachers, good police officers are all becoming extinct. But hey we still have a few to kill off before we are through. Just need a little more money thrown at it.
I can only hand over to Harry Smith:
Wonderful Harry Smith – thanks Amy.
Yes. Such a moving video, and heart-breaking piece. While it’s true that excess government involvement fucks everything up, as Cowboyiam says, in a civilised world, everyone should have access to proper health care and education, not just the privileged. For the many of us who have grown up in relatively privileged circumstances, it’s hard to imagine what it’s like to grow up in extreme poverty, or having to flee our beloved families and homelands in search of a better life. As Jude so beautifully says, “With any luck, we’ll eventually figure out that taking care of one another will only make us all stronger.”