This is a fight we cannot afford to lose

From Mmc

Original Article


This is a fight we cannot afford to lose

By Sarah McMahon, a junior doctor Last Updated: 2:36am GMT 19/03/2007

Some 12,000 people took part in Saturday's march through central London. That represents more than one in three junior doctors in Britain. Consider that another one in three or four of us was working or asleep between nightshifts, and that most doctors have not been on a march before, and you will understand the scale of our anger. The disastrous overhaul of the way in which junior doctors are selected and trained to become consultants is the most serious threat to the patient care and the health service that we have witnessed, and the ramifications are frightening in scope.

Junior medics and surgeons carried banners, chatted and caught up with old friends. Placards were heartfelt: "Our training, your health care, their mistake" and "Don't dumb down doctors". I met people I hadn't seen since medical school, doctors I had worked with in A&E, and friends who have been locked away in hospitals all around the country. Everywhere, the stories were the same: no interviews offered, or one perhaps - in Wales. One friend from university summed up her feelings after being informed, by a computer program, that she had not been successful. "You just think, all those years, all those degrees..."

The mood overall was one of determination: this is a fight that is too important - to us and to our patients - to contemplate losing. We are protesting against an ill-conceived, centralised attack on the integrity and quality of the medical profession. As a leaked Department of Health memo revealed at the beginning of the year, medical unemployment is seen by the Government as useful to create a downward pressure on wages. In the context of New Labour's ideological commitment to introducing market principles and corporate provision into the NHS, this makes sense. In the context of providing safe, high quality health care to Britain's patients, it does not. Excellent physicians and surgeons are not readily replaceable. They have to be trained well, for a long time and to exacting requirements. I started at medical school in the year that Tony Blair took office.

Ten years ago, my colleagues and I were among the brightest and most idealistic school leavers in the country; for the past four, we have worked tirelessly in dreadful conditions. For those of you unfortunate enough to have required our services, we are the doctors who treat you in casualty in the middle of the night, carry the crash bleeps, thrombolyse you when you have a heart attack, resuscitate you, and treat your life-threatening injuries after a car accident. We routinely work for longer than our contracted hours because medicine is a vocation rather than a job and to leave on time would be dangerous. This is the situation, with full medical employment. A deliberate attempt to destabilise the profession, in the hope that it will lessen our power to insist on working to clinical priorities, rather than political and commercial ones, is what the Americans would call a deal-breaker. As we walked toward Russell Square past the British Medical Association, I was reminded of the London bombs 18 months ago during which my friends and I worked treating the injured. How quickly people forget.

This Government knows the price of everything and the value of nothing. A downgraded, under-trained, biddable medical workforce might be a cheaper way to meet flashy paper targets, but if we don't put a stop to this, every one of us will know the true cost.

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