The Sunday Telegraph - Sunday
Junior doctors are tomorrow’s high earners. Less stroppiness, please
I was at dinner recently with an NHS consultant in her 50s, a specialist in brain cancer. She had the quiet but switched-on air and permanent bags under her eyes that characterise late-career hospital doctors. This one had three children to boot, and worked full-time. And overtime.
But like most physicians, she had taken the Hippocratic Oath and gone into medicine to save lives, not to make money. Indeed, over pudding, the soft-spoken consultant said that what upsets her now is the new intake of doctors who are, on occasion, not only lazy, entitled and obsessed with “fairness” and pay but unsackable to boot. A minority of doctors use their work to play at politics, to come over all Arthur Scargill, not to push themselves to the limit to serve patients and gain experience that will help them up the ladder into better paid, more interesting work.
Last week’s junior doctors’ strike – the worst NHS strike in history – encapsulates what the consultant was talking about. Yes, they’re labouring within a system that’s in worse shape than ever before. And yes, they are paid relatively little for their labours. But the unease – for observers and patients alike – isn’t about whether they should be paid more, per se, but about the shift in attitude from a paradigm of hellishly hard work and manic commitment under backbreaking conditions to one of complaint, self-aggrandisement, and the desire to disrupt. From a sense of responsibility to patients to one of selfishness and performativity. From hard work to playing politics. This is a simplification, of course, but when you take a look at the picket lines, full of upper-middle-class Lefties yelling for more money, it takes amazing discipline to see it any other way.
And the junior doctors could not have chosen a less appetising, or unsurprising, front man than Dr Rob Laurenson, co-chairman of the British Medical Association’s junior doctors committee. He has the bad judgment one might expect of a union militant who is also a director in his family’s multimillion pound investment firm: bunking off last week’s strikes to attend a friend’s wedding. He simpered that he was sorry that the reporting of his decision to take the week off has “been able to compromise my character in your eyes… I hope you can forgive me.”
But he has a more iron-fisted core. “I have created and facilitated the creation of every single hospital strike WhatsApp group which we are using to gain and share an incredible amount of intelligence,” he wrote in a message. He also said: “I am determined and committed to doctors and winning.” Meanwhile, the tens of thousands of elderly and infirm who have had care suspended or appointments and operations cancelled as a result of the excitement on the picket line don’t get much of a look in.
It’s not that there are no grounds for striking for better pay in the case of rank exploitation. And even in cases where that exploitation doesn’t exist, we simply tend to accept it, either out of class guilt or class solidarity. The past year has seen what feels like non-stop disruption on the railways and Tube, in schools, libraries, and among ambulance drivers and nurses – with barely a squawk from us. But junior doctors, many of whom come from privileged backgrounds – in 2016 less than five per cent of doctors were working class – have lucrative prospects.
Unlike ambulance drivers and nurses, junior doctors are heading for top salaries, with many consultants (fairly) splitting their time with private work. They’ve chosen a career in a famously and necessarily hierarchical system that richly rewards the best, who only get there through hard graft, done for reasons that must be other than financial gain. That the junior docs are fresh out of their degrees and angered about their payscales isn’t grounds for being sympathetic; we all know that if you want to earn the big bucks straight out of the gate you must choose another option favoured by the well-to-do such as banking or consultancy. The doctors’ demand – including £82 per hour for overnight shifts at weekends, or £656 for an eight-hour overnight shift – is not modest.
Yes, life is expensive now, and life in London particularly so. Everyone needs enough to live, and the current typical salary of a junior doctor at £37,000 a year, while low for the kind of work being done and the training required, is still a good deal higher than most of their patients’. And if they are serious about changing the system so that there is more money for them, which would be good for everyone, then they should be using their power to push for decentralisation, more public-private partnership, and a total overhaul of the current NHS structure. But, given that to these young activists the centralised nature of the health
It looks like they want to burden the NHS to an even more parlous breaking point
service remains sacrosanct, the cost to patients of the strikes is not justified. Indeed, it looks awfully like the placard-wielding junior docs really want to burden the NHS to an even more parlous breaking point, not create any real and positive change.
Britain faces a crisis in healthcare, with an urgent need for more doctors. Their numbers are dwindling; it’s clear that something needs to change or we won’t get nearly enough people applying for medical training
– and then staying in Blighty to practise. But what the strikes show is how in this brave new world of Lefty activism, it’s the money that counts not – as in days of yore – the calling.