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Junior Doctors

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19 October 2015
Doctors Rally On Saturday, thousands of people across the country joined together to protest about proposed changes to Junior Doctor contracts.

I spoke at the rally in central London. You can read my comments here. You can also read my write up of the time I spent with a junior doctor below (this article originally appeared on commentisfree on Saturday 17 October):

"Hello, I'm Heidi. I'm one of the local MPs". That's how I decided to introduce myself to a man I met on Wednesday morning. 

Jack - let's call him Jack - was a patient at Lewisham Hospital. It was 7.45am. He was sat in a chair next to his hospital bed. Jack looked expectant, nervous and a bit tired. 

"What? Heidi Alexander?" he said. 

"Yes. That's me" 

"I've seen you on the telly." 

As I perched on a window ledge and listened to the conversation between Jack and the night shift junior doctor, I wondered whether I should have introduced myself as the Shadow Secretary of State for Health. 

It was too late by then and anyhow, it didn't matter. 

Jack has recently suffered his second stroke. He had been transferred the night before from another London hospital to a rehab ward at Lewisham. Jack really wanted to go home. You could see it in his face. 

For the next ten minutes, I sat quietly, listening to the questions and answers that went back and forth between doctor and patient. I watched Jack try to get up and walk from his bed to the end of the next one. "It's alright doctor I did this much better yesterday" he said. His gait was “ataxic” the doctor told me later.  

I watched as various simple checks were carried out to assess Jack's neurological functions - Jack was asked to repeat words, to confirm light finger touches to his limbs, to use his neck and face muscles to resist slight pressure. I listened as Jack said he wanted to get back home to his two cats and I listened as the doctor explained to Jack that he would not be going home immediately: more checks were the order of the day, the doctors needed to feel confident that he was ready and that it had to be safe. 

This may be the bread and butter of a junior doctor's work but for me, it was the single most important thing I had seen and heard in the four weeks of being Labour's new Shadow Secretary of State for Health. To glimpse the intricacies of the patient doctor relationship was humbling and powerful. All the reports, all the advice of eminent medics and health professionals, could not have taught me as much about the NHS as that deeply human, deeply caring, deeply professional exchange - superficially simple, but only possible due to the years of knowledge and skills built up by the junior doctor. 

Jack was just one of the patients we saw on our rounds that morning. Whilst it was the start of the day for me, it was the end of an eleven hour night shift for the junior doctor I was shadowing. We checked a leukemia patient's platelet levels, we did a handover with the day shift consultant of two elderly women who had been admitted the night before - one from a fall, one because a neighbour had found her outside disorientated. We talked through the other patients on the 8 wards for which the junior doctor was responsible overnight. We talked about his 60 hour week and the pressure of doing a lumbar puncture at 1am. He told me about the "crash" that had happened the night before and his hope that the patient might survive the resuscitation exercise performed by him and his colleagues. 

I was blown away by his skills, knowledge, professionalism and humanity. He told me his work was his calling. I didn't ask him how old he was but I suspect he was in his late twenties or early thirties. He already works nights, he already works weekends and for the last two years he has worked on Christmas Day - how is right that he could end up worse off as a result of a new contract? Why on earth should anyone want to remove the safeguards which prevent hospitals from making doctors work excessive and punishing hours? It might be the junior doctor contract today, but what and who will it be tomorrow? Perhaps the healthcare assistant, who told me she was working a 13 hour shift and will take home about £1300 a month?

I shadowed a junior doctor on Wednesday because I wanted an insight into the NHS frontline. I've had the terse exchange with Jeremy Hunt over the despatch box. I've read the letters between the Department of Health and the BMA. But I needed to see it with my own eyes and understand the reality of the job junior doctors do and the challenges of providing care in a busy acute hospital.

As I left Lewisham Hospital at 10am and headed into Westminster, I wondered whether I could have been a junior doctor had my life taken a different course. I thought about how I would feel if the Government was failing to provide clarity or reassurance on issues I thought would compromise standards of care. 

Junior doctors are the backbone of our hospitals and they should be fairly remunerated for the work they do. Tired junior doctors are bad for patients. We can't go back to the old days of worn out staff, too exhausted to do their jobs. The Government has to compromise - they need to listen and to demonstrate they are prepared to negotiate in good faith. When I speak at the rally of junior doctors on Saturday in central London, I know that I will be on the right side. On the side of doctors, on the side of patients and on the side of the NHS.


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