Junior Doctors

Question 1

Negative effects of junior doctors striking

Answer 1

Fewer doctors present in A&E, meaning longer emergency wait times which can endanger patient safety.

Cancellation of clinic appointments and theatre lists due to understaffing.

Fewer doctors on the wards, meaning increased stress levels and possible errors (such as medication errors).

Deterioration of the doctor-patient relationship.

Question 2

Positive effects of strikes

Answer 2

An increase in doctor salary will mean doctors are less stressed and overwhelmed, leading to better patient care.

Improved working conditions will reduce emotional and physical pressure on medical professionals, leading to better patient outcomes.

Question 3

Ethical arguments against strikes

Answer 3

Doctors should follow the ethical principle of non-maleficence (do no harm), which is not followed when understaffing is a result of strike action.

Strike action affects the doctor-patient relationship as well as public perception of the profession.

Beneficence, or “doing good”, is not honoured by strike action as it is not morally good to delay a patient’s treatments/procedures when this is avoidable.

Strike action has cost the NHS over £1bn since the start of the year, which is money that could have been used for medical equipment.

The strikes are putting extra stress/pressure on the other members of the multidisciplinary team.

Question 4

Ethical arguments in favour of the strike

Answer 4

Doctors are human beings, and while they do a vocational job, this doesn’t mean they should accept poor working conditions.

Better pay and working conditions will improve the quality of life of doctors, making them better clinicians.

The literature shows that the mortality of patients either remains at the same level or decreases during strike action.

While some would argue that full walkouts are negligent, industrial action must be impactful to be effective.

UK doctors are leaving the NHS to work abroad for better conditions. If we continue to lose doctors at this rate, the understaffing crisis will get significantly worse meaning a much lower quality of care for patients.

Question 5

Key Economic Issues Related to Junior Doctor Strikes

Answer 5

The industrial action of the past year has cost the NHS over £1.5bn. The main reason for this is that the NHS is paying consultants to cover the shifts of junior doctors on strike days, which costs significantly more than paying the junior doctors to do their own jobs.

Question 6

Why Are Junior Doctors Striking In the UK?

Answer 6

The BMA is requesting full pay restoration of junior doctor salaries.

While inflation in the UK has made life more expensive, junior doctor salaries have remained static, meaning that while their pay has not been cut, their salary is not worth as much.

In order for junior doctors to receive full pay restoration they will need to receive a pay increase of 35%. Health Secretary Steven Barclay is currently radically opposed to such an increase, stating that the amount of money is just not available to be spent.

Question 7

Do Junior Doctors Get Paid When On Strike?

Answer 7

no, junior doctors do not get paid when on strike. However, it is unlikely that the industrial action will affect the pensions of the striking doctors.
The BMA encourages doctors to plan ahead and save money in order to cope with the financial strain of the industrial action. The BMA has begun to develop a “strike fund”; a scheme to provide financial aid to doctors during the strikes.
However, this scheme is still in its infancy and can only offer £50 per strike day only to doctors facing significant financial hardship.

Question 8

What Is The Junior Doctor Contract?

Answer 8

T he Junior Doctor Contract is the contract of employment for all NHS Junior Doctors, outlining pay scales and other details. The government tried to update the contract for 2016, with changes including:

Overhauling the system of pay and hours for Junior Doctors.
Protecting Junior Doctors from any unfair consequences that could come from whistleblowing.
Designating a member of staff for each hospital to ensure that Junior Doctors are working rotas that are manageable and safe for patients.

Question 9

The Controversy

Answer 9

The controversy around the Junior Doctor contract began in 2013 when the Department of Health shared its proposals. It said that the updates would make pay fairer and wanted to spread emergency and elective services across seven days a week – but Junior Doctors felt the contract was risking patient safety and was unfair to them.

Question 10

The Old Junior Doctor Contract

Answer 10

In the old contract, Junior Doctors were paid a standard rate for shifts where the hours fell between 7am and 7pm on Mondays to Fridays.

If a FY1 Doctor worked these standard hours, they would have earned a basic salary of £22,862. This basic salary would go up as the Doctor progressed through their training and their time served increased.

However, are also required to do on-call shifts outside of sociable hours. This earned an extra supplement known as banding, which could add an additional 40-50% to their basic salary.

Question 11

The Proposed Pay Changes

Answer 11

The proposed changes to the Junior Doctor contract increased basic salary but drastically reduced the supplements for on-call shifts outside of sociable hours – effectively meaning they were being paid less

Question 12

Safety Concerns

Answer 12

Junior Doctors were concerned that the contract would increase stress, tiredness and burnout among their peers, and that patient care would suffer as a result. The new rotas were designed for a seven-day NHS, but did not account for additional staff. The increase in antisocial hours was also not reflected in an increase in pay.

Question 13

How do junior doctors cope with stress in the workplace

Answer 13

Explain why Junior Doctors might experience stress during their work.
Discuss the many different types of stress encountered - for example, working antisocial hours, dealing with psychologically and mentally challenging situations, balancing career with personal life, studying for postgraduate exams, etc.

Examples - societies at the univeristy, work experience importance of exercise

alk about how you’ve seen or read about Doctors dealing with these stressful work situations, such as creating job lists, delegating tasks to different team members, and asking for help when they recognise a problem out of their expertise.

Consider how Doctors relax outside of the work environment, e.g. through sports, hobbies and socialising.
Acknowledge how important it is to talk about stressful situations, such as an emotionally difficult case at work, and to not bottle up emotions.
• If appropriate, link what you’ve seen with your own personal examples of managing stress.