Thousands of doctors say they will leave the NHS if contract changes go ahead

Nearly 60% of junior doctors say they would no longer practice medicine in England if new contracts are pushed through, according to an opinion poll of thousands of junior doctors across the country.


The poll reveals for the first time the true scale of concern amongst junior doctors. More than 2,600 (42%) said they would leave the country to work elsewhere if the government pushed through with contracts as they currently stand while 929 (15%) said they would change career completely.


Only a quarter of all those polled said they would accept the contracts and continue working.


The same poll revealed 97% of respondents were in favour of industrial action, with around two thirds favouring a full walkout strike and the majority opting to stay out for up to a week.


Shadow health minister Heidi Alexander said: “If junior doctors left the NHS in these numbers it would have a devastating effect on patient care.


“It is particularly concerning that specialities, such as emergency medicine, which are already struggling to recruit, could face further shortages, exacerbating the pressure in A&E departments.


“Jeremy Hunt must now withdraw his threat of an imposed contract and make clear he’s prepared to compromise. If he refuses to back down, and continues to ignore the serious concerns of doctors, then it will be patients who suffer.”


Junior doctors are concerned about plans to change what are considered sociable hours for work- extending the definition from 7am-7pm Mon-Fri (60 hours) to 7am-10pm Monday to Saturday (90 hours). If imposed the changes could acute emergency specialties like A&E, surgery, obstetrics & gynaecology, paediatrics – which often involve long hours in late evening and weekends – will lose the supplement they currently receive for working “out of hours” and effectively see their hours increase and their pay cut.


The new contracts would also remove important safeguards that currently work to prevent doctors working excessively long hours for long periods at a time.


By removing the current fines imposed on hospitals that overwork doctors, some junior doctors worry they may be pressured to work dangerously long shifts in the future.


The survey shows that doctors starting out before specialising are the most likely to leave the country, quickly followed by emergency medicine trainees and those specialising in surgery.


The proposed changes have lead some to consider leaving the country in search of better working conditions.


Dr Roshana Mehdian, who works as a trauma and orthopaedic registrar, told the Daily Express: “I am surrounded by people daily that already have their plans in place to go abroad. In my last job three out of ten of the team were planning to move to New Zealand of Australia.”


If all the evidence says it is unsafe to have tired, overworked and overstretched doctors, then what on earth does the government think it is doing? If you had a pilot that flew five days a week but the airline decided it wanted a seven day flight service, you wouldn’t then say ’it’s ok for you to do seven days a week of flying’ because that would be dangerous. You would hire more pilots. This is the same thing,” she added.


Last week it was revealed that, since it was announced that the new contracts would be forced through, the General Medical Council has had at least 4,000 requests for the certificate needed by doctors to work abroad.


If junior doctors follow through on their threats, it could leave some parts of the NHS system particularly weak.


Just 10% of those training in emergency medicine said they would continue in their posts, with a third saying they would quit and work as locum doctors and 47% saying they would move abroad.


A fifth of all those specialising in Obstetrics and Gynaecology said they would consider changing their careers completely.


Dr Eleanor Rayner Specialist Trainee in Obstetrics and Gynaecology working in South West. She explained this month she will average a 60 hour working week and will take home the equivalent of £10 an hour after tax.


“I help to save the lives of mothers and babies during difficult labour and dedicate my life to ensuring I am the best doctor I can be to help keep them safe and healthy while I am on shift,” she said.


“Hardworking individuals should be rewarded, not punished with pay cuts. I cannot imagine working more hours than I already do, especially not for less money,” she added.


Dr Johann Malawana, BMA junior doctor committee chair, said:  “These findings paint a very worrying picture. They echo the outpouring of anger from junior doctors in recent weeks and show just how let down they feel by the government’s proposals. If even a small proportion of junior doctors choose to vote with their feet it would be a disaster for the NHS, coming at a time when we need more doctors, not fewer to meet rising demand on services.


“It is vital for patients, junior doctors and the NHS as a whole that we agree a safe and fair contract that values the important contribution junior doctors make to the health service.”


The number that participated in the poll is equivalent to 12% of all junior doctors in England.


Jeremy Hunt said it is “utterly irresponsible” to suggest he is trying to introduce “unsafe” longer working hours and pay cuts, and he called on doctors to work with ministers to deliver seven-day services.

“We are not asking junior doctors to work longer hours – that wouldn’t be safe,” he told the Conservative Party Conference in Manchester.

“But we do want to support the many doctors who do work weekends with properly staffed shifts, safe working hours and 7 day diagnostic services so that patients are not put at risk.”


A version of this story was published in The Daily Telegraph on 7 October 2015.


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