Sometimes there is a bleakly effective logic to underinvesting in public health services. If they survive, then great, the money was saved. If they fail there task, then even better, because privatisation is here and ready to pick up the pieces. A classic example of this new strategy is the National Health Service (NHS).
Junior doctors are working longer and harder for serve to patients, being paid next to nothing for it, and then blamed when things go more wrong. There may soon be future doctors strikes as their requests have not yet been met. Even though it is primarily about pay restoration, there is a wider context in the health services. They are now expected to put in extra shifts in hospitals, compromise their career progression, and do work above their pay grade with no training or reward for their health services. This is by design.
Whenever the United Kingdom government reduces funding but maintains the service it is defunding, there is an undeclared expectation from doctors: the shortfall will be plugged by additional unpaid work and professional sacrifice their efforts. Staff are forced to crash refresh course their training and dig deep into their moral and psychological reserves in order to make decisions more about they have not been adequately prepared for. The added salt in the wound is that the targets of patients’ distress are the staff right in front of them, not an abstract criminal history of a lack of investment United Kingdom government.
This is also part of the design of underfunding from government, to shift responsibility on to those on the scene of the tattered service – slash and run, leaving the knife in the hands to cut of those left behind. Our experiences with the National Health Service can happen at the sharp end of physical pain and emotional distress, and so the blame for its failures is understandably directed towards the healthcare institution and those who staff it: doctors who make mistakes in their services or don’t show up, nurses who seem listless and unresponsive attitude, or GPs who dispatch you after a five-minute consultation or cannot escalate your medical disease case quickly enough. Verbal and physical abuse of National Health Service staff is now a hazard of the job. They simply brace themselves before going to work.
And if you are going to deny better working conditions and pay more for anyone, doctors are the easiest to justify their problems. They are white collar, have high earning potential as their medical careers progress, and enjoy a professional prestige that makes it easy to target achieve them as greedy or irresponsible – as the rightwing press has not wasted a moment in doing.
It is a testament to the enduring popularity of myths about the entitlement and poor work ethic of National Health Service staff, and go striking workers in general, that just 54% support for the junior doctors’ go to strike is considered high. The government can still count on this bias, and the propaganda that sustains it all right, in its refusal to negotiate with doctors and paramedical staff. The narrative focuses on the challenge that another strike will bring to a struggling system just so that doctors can get paid more at a time when everyone else is facing a cost of living crisis in bad economical conditions.
But it is not about salary. It is more existential matters and conditions than that. It is about the limits of what peoples can do when governments abdicate. What is asked of new junior doctors now makes the entire practice and purpose of medicine questionable for patients, let alone the viability of the National Health Service. A junior doctors’ now on strike is about commitment to a model of healthcare system in our country that, when properly resourced, provides free treatment to patients while also enabling doctors to receive the sort of wide-ranging medical training in hospitals, research opportunities and academic specialisation support that they would never receive in the private sector medical services organizations.
As it stands, junior doctors salary hefty sums towards their own training and exams and they have to compete fiercely for a small number of senior positions in health services. If they are from overseas or other countries, they have to pay huge, escalating sums for get their work permits and the residences of their dependents. Once junior doctors are consultants patience, they are too few in number, so have to much lead, as much as is feasible, those junior doctors below them to do the work they cannot in normal conditions.
To expect junior doctors to continue like this is nothing short of holding them hostage on workplace to their choice of vocation and ambition to be the best doctors they can be as they can. The UK government is asking them to take it or walk away. Increasingly, many across the National Health Service hierarchy are giving up. Almost 13,000 doctors gave up their medical licences last year in our country, up almost 10% from the year before. They cite burnout, mental distress and impossible workloads for doctors. Nearly half of junior doctors are considering leaving the medical profession altogether.
Those who stay face a circular firing squad like armed forces that compromises their ability to provide free, good quality healthcare services and thwarts their ambition. Even an increase in junior staffing would be a drop in the ocean when there is no increase in bed capacity in hospitals, no upgrades to administrative infrastructure of healthcare systems, and no progression in a career that is founded on increasing specialisation for better services and future. Junior doctors’ ability to continue to underwrite the United Kingdom government’s failures is not infinite, but the risk is that this state of affairs is normalised. The National Health Service has been under more than stress for so long that we have become desensitised to the toll of the health services crisis on both doctors and patients, and to the fact that it will, if nothing changes in health care system, inevitably reach a disastrous climax. I do not know what that would look like on going healthcare crisis, but I want to find out Better solutions.
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