[Closed] doctors on strike

That article is genius. I for one would be delighted if next time I need surgery it's done by a Territorial Doctor.

I wonder if the author even realised that he's simultaneously arguing for doctors to be classified as "essential" so that they can't strike, while arguing that doctors aren't essential and any random could do it?

From Facebook

People of England, and our Welsh and Scottish friends living on the borders who might use an English NHS hospital.

Good evening.

My name is Dr Philip Lee, I have been a doctor for nearly 14 years and I am a consultant doctor specialising in acute medicine and elderly care based in a London teaching hospital.

I'd firstly like to apologise for my photo intruding upon your timeline. But I appear in my uniform for a reason.

You see, I want to reassure you of something, and it's important that you trust me on this because the government that's suppose to reassure you have so far either said nothing, or spread panic inducing opinion through its apparatchik. And people trust doctors.

There is in all likelihood going to be an all out junior doctor strike in England a week next Tuesday. This will go on for two days with all junior doctors walking out between 8am and 5pm both days. This has never happened before in the UK, and all doctors in training who are not consultants will walk out.

Putting aside the reasons they're striking for a second, let me now say categorically, you and your friends and loved ones will continue to get world class emergency care those days.

If you come to the emergency department having been run over by a car, we'll be there waiting for you.

If you're already in hospital, you'll still be seen by a consultant or staff specialist if you need to. If you need an emergency operation, it will happen.

If your loved ones are in intensive care, doctors will see them as usual.

If you should have a sudden cardiac arrest in our hospital, my colleagues and I will do our very best to resuscitate you, stabilise you, and treat you just like any other day.

If your clinic or test appointment or operation has been rescheduled or delayed, I apologise. But these strikes are happening to ensure patients get the best and safest care, not a stretched out, underfunded, dangerous service.

The emergency service on those days will be no worse, if not better, than an average day. The Department of Health has said none of this.

You see as doctors, we have all sworn an oath to do no harm. Our junior colleagues will not have taken this action lightly, and they do so with a heavy heart but knowing that as consultants, and my staff grade and associate specialist colleagues, we're 100% behind them. Our support let them protest the changes to our NHS that is not safe for patient care.

I believe in the NHS, and I care for its future. That's why I'm providing #emergencycover.

On the 26th and 27th of April, if you're ill, please see your GP, or come to hospital. We will be there for you, just like everyday. And if you're not ill and walking or driving by, give my friends a honk, or a friendly word. These brave men and women need your support.

Oh and if you "like" this, please share as widely as possible to help spread the word!!

The statement above is disingenuous. The junior doctors are steadily eroding the sympathy of the general public, and the next strike will cause severe issues. Even the previous ones must have caused suffering in the sense of missed operations.

The fact 'hashtag emergency cover' is still available doesn't help the patients waiting for pain relieving operations, or that a whole tranche of consultant led activities will be deferred as a result?

I doubt many people disagree that doctors should be valued by the NHS, but deliberately removing emergency care has gone beyond what I think is acceptable behaviour. Really sad about this.

HAs the BMA set up a locum agency yet - ready for when all juniors refuse to sign their next contract ?

That'd be great

I fully support them.

It only looks bad because no one else dares challenge the government and its appalling decisions - the junior doctors are the only ones to stick the head above the parapet and say enough is enough....

They wouldn't strike if they didn't have to... besides, round here the majority spent their strike day last time volunteering in old peoles homes etc...they weren't having a day off...

The fact 'hashtag emergency cover' [b]is still available[/b]

but deliberately removing emergency care has gone beyond what I think is acceptable behaviour. Really sad about this.

See how they've got you thinking ?

I suspect that the group who are most "professionally" affected by these strikes is the senior docs. They provide the junior cover on strike days and then go off to make up the missed paperwork etc afterwards.
I work in the NHS and don't know a single consultant who doesn't support the strike.

Patients missing appointments or experiencing delays is a great shame and I agree it's about time this shit was sorted out. The difference is that "this shit" in my view is Mr Hunt.

I doubt many people disagree that doctors should be valued by the NHS, but deliberately removing emergency care has gone beyond what I think is acceptable behaviour. Really sad about this.

Good job that's never happened then.

Drac what are you on about?

Scaredypants you missed my point - consultants fill in for missing junior docs, hence their tasks get delayed which impacts patients? Am I missing something?

Either way not looking for an argument, the whole situation stinks and neither side are right. The people suffering as a result are the patients.

Drac what are you on about?

The emergency care hasn't been effected, you even said so yourself.

[i]I work in the NHS and don't know a single consultant who doesn't support the strike.[/i]

Why are the the public illogical with their views regards the strike.

The public trust the doctors with their professional decisions over their health, but then distrust the doctors professional decision regarding the strike (which is still related to the publics health) and instead choose to listen to the government who have far less 'real knowledge' of the situation.

I doubt many people disagree that doctors should be valued by the NHS, but deliberately removing emergency care has gone beyond what I think is acceptable behaviour.

But you do not mind when the Government do it? Recently problems have been escalating in the NHS.

An A&E unit has had to close due to government policy
http://www.bbc.co.uk/news/uk-england-lancashire-36042951

Oversees doctors are now being hurriedly brought in to fill gaps in GP Practices. The government over the last few years has reduced the number of training posts, and changed immigration rules that prevent oversees doctors working in many key roles in the NHS. Hospital doctors dont blame patients when they turn up at A&E because they cant get a GP appointment. They still treat them because they care.
http://www.telegraph.co.uk/news/2016/04/07/nhs-to-recruit-indian-doctors-to-plug-gaps-in-gp-services/

I know directly of a major Trauma Centre teaching hospital that is running with unsafe staffing levels. It is running on the goodwill of doctors coming in to do shifts post on call and rota'd days off. This is not safe for the doctors or patients.

I know of A&E's where the most senior doctor on shift has been a Surgeon Registrar as they can not get the correctly qualified doctors to do the job.

In all these cases doctors are going above and beyond to make sure the hospitals remain safe, where government policy is directly creating a situation where if doctors didn't step in, patients WOULD be at risk.

These are only the direct examples I have, they will not be the only ones through out England.

Remind me who's putting patients at risk again ? 🙄

Can't disagree with the above, just can't see the strike doing anything to help.

just can't see the strike doing anything to help.

whereas doing nothing, turning up to work and accepting a disastrous contract will help?...

It's got to becoming clear to you where the balance of blame lies?

i think you miss my point, turning up for work as you put it will help patients, which I thought was the job (sorry, vocation) of a doctor. A patient cares not where the blame lies if they desperately need an operation which has been delayed by a strike. The balance of blame is entirely subjective but don't be surprised by people not seeing the BMA as ideologically pure.

Government and profession have completely failed here, and the proposed strike is damaging to patients. The new contract, IMHO of course, is not a disaster for patients, just potentially financially damaging to doctors.

The new contract, IMHO of course, is not a disaster for patients, just potentially financially damaging to doctors.

Dr's working longer days, more hours in a week will have an effect on patients. That's why they are striking.

#groundhogday

That's one reason why they are striking. Also, just because you stated your argument previously doesn't mean it has been accepted. Using sarcastic hashtags doesn't help persuade either!

It's good to hear opposing opinions, and I suspect/guess/predict that you'll hear a lot more if the next strike goes ahead.

It's good to hear opposing opinions when they are based on facts and logic otherwise they are just like listening to a drunk babbling to himself in a corner

FTFY

just can't see the strike doing anything to help.

Why do you think striking used to be illegal if its ineffective?

That's a technique you often use I've noticed DrJ, I don't want to patronise you but it doesn't equate to debate or argument.

That's one reason why they are striking.

Not sure that what DrJ has put is constructive in any way...

Bainbrge - why shouldn't a doctor be paid a fair wage for doing a very hard, skilled job?

Mrs FD got an email recently offering her a private sector health related job £100k + 9-5. Way more than she will earn being a consultant.

It is not a race to the bottom

i think you miss my point, turning up for work as you put it will help patients, which I thought was the job (sorry, vocation) of a doctor.

Turning up for work now helps one patient here and now. The doctors have taken the longer view that not turning up to work will help more patients, not right now, but for the long term.

http://www.theguardian.com/society/2016/apr/17/pressure-mounts-on-jeremy-hunt-over-handling-of-junior-doctors-dispute
Apparently jezza wasn't imposing the contract after all, merely "introducing" it.

The man is an utter tool.

I'm not sure, but the difference between imposition and introduction sounds like semantics to me - junior docs renew contracts pretty often and if all that's on offer is the newly "introduced" variant, ....

The public trust the doctors with their professional decisions over their health, but then distrust the doctors professional decision regarding the strike

Given how discredited the BMA was over their "calculator" I am not at all sure the strike decision was taken on the basis of sound financial information. I can imagine Junior Doctors are not happy about the prospect of more weekend working

I don't trust a doctor anymore than any other professional, a doctor can make a mistake like anyone, they can make an error of judgement. There are 8,000 avoidable deaths every year (stat from health service peofessional quoted recently). Doctors disagree on diagnosis and treatment all the time.

+1. There is a worrying lack of accountability too, in my experience.

I'm not sure, but the difference between imposition and introduction sounds like semantics to me - junior docs renew contracts pretty often and if all that's on offer is the newly "introduced" variant, ....

Cut'n'paste from a Grauniad comment:

NHS trusts were going to refuse to use this new contract and retain the old one under their own mandates. *unt tried to force them by the whole 'I am going to impose this contract and fine any trust which doesn't implement it' strategy.

Now that he's saying he can't impose the contract it means the trusts may be able to choose to retain the old contract like they planned to.

I can imagine Junior Doctors are not happy about the prospect of more weekend working

Do you not understand anything about what this whole industrial action is about?

worrying lack of accountability too, in my experience.

What exactly do you mean by accountability ? I think all doctors would agree that they could get better at root cause analysis and become more like the aircraft industry. However see my previous post, how can you improve practice when you do not even have enough staff to do the minimum?

What exactly do you mean by accountability ?

Something along the lines of what they have in the US I suppose.

Now that he's saying he can't impose the contract it means the trusts may be able to choose to retain the old contract like they planned to.

So individual trusts are going to resist government pressure to adopt the new version ? Righto

I doubt it, but the point is that *unt was fibbing when he said he was going to "impose" the contracts.

Now attention can be turned to what arm-twisting is going to happen (already started, in fact) to make the "independent" trusts do what the govt tells them to.

See I am not even convinced the government knows what they want in terms of service, which only helps confirm that the doctor contract is a cost cutting exercise.

Current feedback from service users that I am aware of is that they do not want yo come to clinics Saturday or Sunday, they do want evening clinics.

It is also more the supports services that need to be more adaptable ie physio/diagnostics. These services are not run by, wholly dependant on doctors

Jambalaya, be careful not to assume that all deaths that are classed as avoidable are due to factors that could be attributed to mistakes or misjudgements by doctors. The definition of "avoidable deaths" is much more complex than that. And the word "potentially" should precede it

You'll see that deaths due to many different causes are automatically classed as avoidable because with timely medical intervention they could be.
Just picking one cause of avoidable mortality, dvt/pe, any deaths due to this are classed as avoidable even though someone might drop down dead in their sleep having never sought medical attention.
There are lots of reasons why we don't have the fabled "airline levels of safety", including the fact that we are dealing with human beings (both doctors and patients) that sometimes make poor decisions.

jambalaya - Member

Doctors disagree on diagnosis and treatment all the time.

Of course they do- that's because humans are complicated machines that you can't easily take apart, so diagnosis is generally based on imperfect information and there is often a wide range of suitable treatments.

Until you get an OBD2 socket in the back of your head and a big on/off switch, this'll remain the case.

I have know idea what an obd2 socket is but I get the gist of that completely. 😆

It's the "diagnostics port" in your car. You can buy cheap OBD2 tools on eBay, plug em into your car and get fault codes telling you what is wrong with it.

A human equivalent would be very useful (Star Trek style medical scanner perhaps?)

Doctors disagree on diagnosis and treatment all the time.

My experience is that in a lot of cases they don't use the available diagnostics and imaging techniques (most notably GPs). I've known too many people told the wrong information and have to suffer months of pain, when something as simple as an ultrasound or X-ray would have shown up the problem.

Techniques like these should be in GP surgeries, after all dentists can do x-rays then and there, private health care can likewise. The other advantage of all these modern techniques is they all record the data digitally, so you want a consultant elsewhere to look at the pics, then they can have them in the time it takes to send an email.

@grahamS
If only.
I'd have much more time for [s]golf[/s] mountain biking in that case.

something as simple as an ultrasound or X-ray would have shown up the problem. ...Techniques like these should be in GP surgeries

Really? There are roughly ten thousand GP practices in the UK. Who is going to pay for each one of those to have an ultra sound and x-ray machine? And for the specialist staff to operate them and interpret the results?

..after all dentists can do x-rays then and there, private health care can likewise

Dentists have very small specialist x-ray machine for taking images of your teeth. Not the considerably larger machines use in x-ray departments in hospitals.

Dentists and (other) private health care costs money. (and have the ability to punt people onto public NHS care when things go wrong).

Dragon - I get your point to some degree about having diagnostics in GP Practices, but this is very very expensive.

General Practitioners are generalists. They are not an expert in a particular field, so not always the best placed person to view an image/diagnostic outcome.

Trusts are looking at consultants doing out reach clinics, but that takes them away from the acute environment.

The fact is, if people want the NHS to expand its remit and do more, then it will costs more, and the government want it all at the moment for less money.

Of course when it all goes private you will be able to go and see your expert, and get your diagnosis quicker. Are you happy to pay for it?

Certainly in a new Private world doctors will be substantially better paid, yet they are oddly appear to be not wanting the change to a private system.

dragon, while better access to certain diagnostics can be helpful, it's not a panacea
One of the reasons that uk general practice is so cheap (£130/patient, 7.2% of NHS budget for 90% of contacts) is because we GPs are really rather excellent at dealing with uncertainty and using things like clinical judgement and time, with the advantage that we can see patients again and again to pick up changes.
We [i]could[/i] go down the route of over investigating everything but it would increase costs dramatically without necessarily improving outcomes (see: the USA)
It's also important to recognise the potential harm that can be done by over medicalising normal life and particularly self limiting illnesses.

Simple, charge for it, that's how it works with NHS dentists.

General Practitioners are generalists. They are not an expert in a particular field, so not always the best placed person to view an image/diagnostic outcome.

Agree, but as I noted all the kit now is computer based, so in a case where the GP can't decipher it, then they can email it on to an expert. Even if it took a week or two for an expert to look at it, for the patient that is still a lot quicker than waiting months for an appointment to even get a scan, then having to take a morning off to go to the hospital, try and find parking etc. etc.

so in a case where the GP can't decipher it,

i.e. every case since the GP is quite unlikely to also be a trained radiologist

they can email it on to an expert

Emailing confidential patient information? Nope.