{"id":35750,"date":"2015-12-02T16:51:34","date_gmt":"2015-12-02T15:51:34","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=35750"},"modified":"2015-12-04T12:32:33","modified_gmt":"2015-12-04T11:32:33","slug":"jessamy-bagenal-junior-doctors-what-are-we-fighting-for","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/12\/02\/jessamy-bagenal-junior-doctors-what-are-we-fighting-for\/","title":{"rendered":"Jessamy Bagenal: Junior doctors\u2014What are we fighting for?"},"content":{"rendered":"<p><strong>So what?<\/strong><\/p>\n<p>There has been a huge increase in the number of junior doctors who have joined <a href=\"http:\/\/bma.org.uk\/\">the BMA<\/a> since June when Jeremy Hunt began new tactics with NHS staff. Repeated inflammatory and insulting statements like &#8220;<a href=\"http:\/\/www.bbc.co.uk\/programmes\/b061t8sw\">when you turn medicine into a Monday to Friday profession<\/a>&#8221; have enraged doctors to an unprecedented state. The strike action has been suspended whilst talks continue. Some are angry and a previously united front has fractionated. But, even if, in some alternate universe the government agreed with all the BMA\u2019s terms for a new contract would it matter?<!--more--><\/p>\n<p><strong>Political awareness<br \/>\n<\/strong><br \/>\nJunior doctors have become more politically aware, realising too late the importance of changes made in the Health and Social Care Act in 2012. A \u00a32 billion deficit, three years of expensive reforms, and <a href=\"http:\/\/www.bmj.com\/content\/351\/bmj.h6250\">overall reductions in mean earnings<\/a> has resulted in such dissatisfaction and government mistrust that NHS staff are for the first time united. At the weekend the nurse I worked with in A&amp;E wore an &#8220;I support junior doctors&#8221; badge. NHS staff feel a sense of community. Something that although common to previous generations has fragmented with the introduction of increasing shift patterns and financial pressures. They have joined in what can only be described as a fight; taking arms through social media and recognising the power of public opinion. The continual undermining force of negative media and savvy politicians seems to have reached a critical mass, NHS staff suddenly standing up for their own professionalism and refusing to be mere employees of a government body and their political agenda.<\/p>\n<p><strong>Mixed messages<br \/>\n<\/strong><br \/>\nBut the reasons are unclear. When 20,000 people took to the streets in London in protest many of the signs read &#8220;Save our NHS,&#8221; &#8220;Protect our Doctors: Protect our NHS&#8221; &#8220;We already work seven days a week.&#8221; And songs re-written and sung to famous tunes like &#8220;It\u2019s not about the money&#8221; all have similar mixed messages. This has for many people become more about the future of the NHS rather than terms and conditions in a contract. The BMA has stayed &#8220;on message&#8221; but even their well organised and branded paraphernalia &#8220;Junior Doctors\u2019 contract, It\u2019s everyone\u2019s fight&#8221; seems to suggest we are fighting for more than a contract. This &#8220;fight&#8221; has been managed well with focused press coverage, and rising stars that have highlighted the issues that the NHS is facing to the public.<\/p>\n<p><strong>Seven Day Working<br \/>\n<\/strong><br \/>\nOf course the junior doctor contract changes started because the DDRB was commissioned to come up with a cost neutral pay envelope that would allow seven day working. The government is so convinced in the need for a routine seven day NHS, a notion of such expense and unknown benefit that NHS staff no longer trust the government with its management.<\/p>\n<p><strong>What now\u2014will there be a Christmas number one NHS staff song?<br \/>\n<\/strong><br \/>\nAlthough times have been hard for NHS staff, their loyalty to the concept of free healthcare and the NHS as an institution is deep rooted and emotional. For many who voted &#8220;yes&#8221; to industrial action it was because they felt there was nothing else to do\u2014a last resort. The importance of the result of contract negotiations must not be underestimated. It will have ripple effects for all NHS staff, for the future of recruitment and research, and shape the future of NHS staff professionalism.<\/p>\n<p>But now we\u2019ve drawn our only card, what will happen when a resolution is made? The demoralisation of a workforce and the crisis the NHS faces will not go away, but will staff continue to be united? I cried watching the two NHS staff choir songs; the first &#8220;<a href=\"http:\/\/www.bbc.co.uk\/news\/health-34961773\">A Bridge over you<\/a>&#8221; a mash up of Simon and Garfunkel\u2019s Bridge over troubled water and Coldplay\u2019s &#8220;Fix you.&#8221; The second, a more uplifting but equally moving song, &#8220;Yours&#8221; with lyrics like &#8220;The NHS needs saving and they\u2019re not listening but we\u2019ve got something to say.&#8221; Will a movement to protect a failing NHS continue? Or will the business of people\u2019s everyday jobs, lack of immediate threat to our livelihoods, and knocks from shrewd political moves make us go back under the covers? I do hope not.<\/p>\n<p><em><strong>Jessamy<\/strong> <strong>Bagenal\u00a0<\/strong>is a general surgical registrar in North West Thames and currently undertaking a National Medical Directors Clinical Fellow scheme. She is based at <\/em>The BMJ<em> as an editorial registrar.<\/em><\/p>\n<p><strong>Competing interests:<\/strong> None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>So what? There has been a huge increase in the number of junior doctors who have joined the BMA since June when Jeremy Hunt began new tactics with NHS staff. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/12\/02\/jessamy-bagenal-junior-doctors-what-are-we-fighting-for\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[165,236],"tags":[],"class_list":["post-35750","post","type-post","status-publish","format-standard","hentry","category-junior-doctors","category-nhs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jessamy Bagenal: Junior doctors\u2014What are we fighting for? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/12\/02\/jessamy-bagenal-junior-doctors-what-are-we-fighting-for\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Jessamy Bagenal: Junior doctors\u2014What are we fighting for? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"So what? 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