‘We must be allowed to get on with our jobs’

Alexander Carpenter, a cardiology registrar in his fifth of 13 years working as a junior doctor, explains why he helped organise a recent march in Bristol.

I was one of the co-organisers of the recent protest march through Bristol city centre and a member of the Severn Junior Doctors pressure group. I’d like to explain why we marched and why doctors are gravely concerned at the moment.

This is not primarily about pay. In fact, most of my colleagues don’t even know exactly what they get paid, with changing rotas and often changing hospital trusts.

This is about safety. Most doctors know their own personal threshold for safe working. They know how to manage their time and how busy they can be, while still remaining a safe and effective clinician.

With real-terms cuts to the NHS over the past few years and a recruitment crisis in many specialties, many doctors already feel close to this threshold at the moment.

Nobody wants to feel rushed at work – so pressured or stretched that they can’t do a good job. But for doctors trying to help unwell patients, this is unsafe, leads to substandard care and is unacceptable.

The new junior doctor contract proposals make our working conditions unsafe in two main ways:

1) Removal of safeguards to prevent us working excessive and unsafe hours. At the moment, trusts are financially penalised if doctors regularly work excessive hours. This ensures adequate staffing levels and well-rested, safe doctors.

2) Changes to the way we are paid. We are paid primarily for the unsocial hours we work. Social or “plain time” hours are currently considered as 7am-7pm Mon-Fri.

The government wishes to extend these hours to 7am-10pm and include Saturday, 7am-10pm as so-called “social” hours, an increase from 60-90 hours. Any time worked outside these hours will also be paid at a lower rate.

So although we are promised a base salary rate increase of 15-20 per cent, as most of us work a large number of unsociable hours (with some of my colleagues in A&E departments working every other weekend), for most of us this means a 35-40 per cent real terms pay cut.

To give you an idea, the starting base salary for a junior doctor is just under £23,000. So we will work longer hours, at more antisocial times, for less pay. Bearing in mind this is after six years of university, with an average £45,000 debt for many medical students.

We are men and women with families and mortgages to pay.

Doctors feel privileged to serve the public who in general are extremely positive about their experiences with the NHS. But we feel extremely undervalued and undermined by the government. Above all, we are concerned.

Doctors do not want to be put in a situation, at work, where their practise becomes unsafe.

You wouldn’t ask a pilot, exhausted after a long-haul flight, to keep on flying. The pilot, knowing it was unsafe to do so, would refuse. And that is what we, as doctors, are doing. Refusing to do something we know is absolutely not safe.

This is not safe, and this is not right for the patients – current and future – of the NHS.