Reena Aggarwal on the politicisation of junior doctors

reena_aggarwalThe term junior doctor has entered into vernacular. We have become a news story with media, politicians, and satirists all using it as subject matter. Last year little was known about junior doctors and it would have seemed very unlikely that the medical fraternity would have routinely filled headline news as they do now.

I have a confession. A year ago, I would have been ambivalent, indeed indifferent about the BMA. I’ve been a paid up member for nine years, but I have rarely engaged with it other than occasionally reading The BMJ. The BMA represents four types of doctors—general practitioners, junior doctors, associate specialists, and consultants, as well as medical students. It holds a split identity between being a professional association and trade union. For me, the former role has always prevailed and I had never considered the potential power of being in a union. But how times change—on Saturday I even attended the BMA junior doctor conference for the first time to listen to the great and good from the BMA, alongside 300 junior doctors from across the country.

The conference was probably the best attended junior doctor conference for years and exuded optimism, kinship, and a sense of purpose amongst junior doctors. As a doctor who has been an active grass roots campaigner against the junior contract, I had been curious to understand how did 54,000 junior doctors, the workhorses of the NHS, the rank and file of medicine, the ones who rarely complain about their working conditions, their continuous exams, their inability to plan their lives due to often terrible administrative organisation become so engaged in a political discourse that has led to the first junior doctor strikes in 40 years, and an unprecedented emergency walk out?

The conference opened by asking whether the event was the highlight of the medical and political calendar. I am not sure—but it was most definitely a significant moment in what has become an increasingly bitter, tense, and difficult junior contract dispute. The dispute overlays much of the discourse with remonstrations of junior doctors being portrayed in the “harshest possible spotlight” where their motives and vocation have been questioned vociferously by the government and media. The vilification of doctors and rhetoric used against us in this adversity has brought both the BMA and grass roots leaders to the fore, uniting the medical profession in a way I had not thought possible.

Two Royal College Presidents—Jane Dacre (Royal College of Physicians) and Neena Modi (Royal college of Paediatrics and Child Health)—were keynote speakers. They were unanimous in their congratulations of junior doctors on their unity and commitment in attacking the government’s rhetoric which has made the junior contract dispute about Saturday pay, as opposed to ensuring an evidence based NHS service which is not discriminatory and ensures a sustainable workforce for the future. Their inspiring speeches asked junior doctors to remain united in the face of a potential negotiated settlement, to remain in the NHS, and to work together to build a stronger NHS, working in collaboration with the government. Much was said about the seven day NHS, recruitment and retention crises, and how to ensure a work/life balance to ensure that the junior doctors of today will be motivated, valued, and supported to become the leaders of tomorrow in the NHS.

The role of the conference is to democratically build policy to support junior doctors and provide a voice in the BMA. Junior doctors did not just want to discuss terms and conditions of a junior contract—they were there to ensure the tenets of our health service are secured—universal healthcare, free at the point of use, tax payer funded, and evidence based. They want to ensure that patient safety is at the heart of every policy decision. It was my first “union” conference and I saw it as an environment for junior doctors to allow the BMA to lobby on their behalf to ensure a safe, protected, and effective working environment. The issues that agitate and exercise junior doctors on the shop floor were discussed which allows for change.

The most striking thing for me has been the politicisation of junior doctors—they have not become radicalised—they are vitalised. There was unanimous agreement against imposition of the junior contract, however despite uncertainty, a mood of hope prevails. A ray of light has been shone with the pause in the dispute and negotiations resuming with genuine willingness on both sides of the table. A negotiated settlement has always been the goal of junior doctors. We wait with bated breath for news from the negotiating room. Compromise has to be reached on both sides of the table, and I, for one, am very optimistic. Any negotiated agreement will be put to a referendum of members as they ultimately have to decide if the contract is acceptable. The BMA will have conducted their role of negotiating and lobbying on our behalf. A resolution seems within grasp and I hope that when talks do conclude that progress will have been made.

This past year, I have become even more proud to be a doctor and part of the BMA as we have stood united against an unsafe and unworkable junior contract. The BMA spoke for its members and we in turn have stood with them. We have experienced tough times in the profession but I am reminded of the words of CS Lewis “experience that most brutal of teachers, but you learn; my god you learn”. In the past months, I think junior doctors will tell you they have learned much about the interface between politics and health, their ability to unify, and ultimately the importance of fighting for a junior contract that provides safe and effective care.

Reena Aggarwal is a specialist registrar in Obstetrics and Gynaecology. Twitter @drraggarwal

Competing interests: None declared.