British Orthopaedic Trainees Association (BOTA) President MUSTAFA RASHID urges consultants to actively show support for junior doctors amid signs of a growing retention crisis.
Junior doctors are very concerned about what the new doctors in training contract will mean for them and their families. They are upset that despite several years of negotiations with BMA, which failed to reach a resolution, a worse and radical new contract will now be imposed on them from August 2016. Junior doctors are in support of the BMA’s position to withdraw from the sham negotiations they were invited to, and continue to be in favour of honest, meaningful, negotiations without pre-requisites.
Junior doctors are rightly more concerned about the impact of removing safeguards to excessive working hours on patient safety. Many feel that the removal of the current system of financial disincentives for hospitals forcing junior doctors to work excessive and unsafe hours will lead to tired, exhausted junior doctors that make mistakes. Whilst although the new contract will not include a 70-plus hour work week in black and white, in the context of increasing demand on the NHS, and a lack of financial penalty for hospitals, junior doctors are fearful that the hours they work will inevitably escalate to meet this demand.
In our position statements, BOTA has highlighted the current medical recruitment and retention crisis being experienced by the NHS. This is not exclusive to surgery, which has always been regarded as a desirable career path, but is prevalent amongst all medical specialities. The current working environment provided for junior doctors is not sustainable and has led to a concerning trend among the most disenchanted and disillusioned cohort of junior doctors, the foundation trainees.
The GMC Foundation Training Programme Destination Survey results have demonstrated a year-on-year decline in these doctors continuing into any training programme in the NHS. In 2011, 71 per cent of foundation doctors — those in their first two years of their postgraduate medical careers — continued into any specialty training programme. In 2012, this figure dropped to 64 per cent, and again to 61 per cent in 2013.
In 2014, the GMC survey reported that only 58.5 per cent of foundation doctors progressed into any training programme in the NHS.
Of the 41.5 per cent who chose not to continue their careers in the NHS, only 24 per cent did so to work abroad – most of whom, we can argue, may return. But what has happened to the other 76 per cent?
What have we done to those junior doctors who, only very recently, passionately decided to follow a path of becoming a doctor, only to choose not to continue their career in the NHS after two years of clinical practice?
More importantly, what message our we sending them if we then impose a new contract that will worsen the working conditions in which they work in, and reduce the amount the system values them even further?
The HCSA and its members have a unique perspective and an opportunity to help in this very challenging situation that junior doctors find themselves in.
In some specialties, and in some parts of the UK, the consultant body has pledged their support for the junior doctors’ cause. When this has occurred it has alleviated concerns held by junior doctors about what impact fighting this cause will have on their daily working lives.
Unfortunately, although many consultants and departments have spoken out in favour of junior doctors, and some even on a personal level, some are still not aware of the issues entirely, and others have remained impartial.
We would encourage all HCSA members to speak to their junior doctors on a personal level, and make them aware that they have their full support during these challenging times.
• Mustafa Rashid is President of the British Orthopaedic Trainees Association, which represents the views and opinions of Orthopaedic Surgical Trainees in the UK. More information on BOTA’s position relating to the junior doctors’ contract are available at www.bota.org.uk under the Position Statements category of the News section.