Hospital care is being jeopardised every single day, with patients lucky to be seen within 12 hours, junior doctors have said as they walked out on the first day of a 96-hour strike.
Thousands of junior doctors in England walked out from 7am this morning, causing “unparalleled disruption” across hospitals, according to the medical director of NHS England, Stephen Powis, with about a quarter of a million appointments and operations cancelled.
The British Medical Association (BMA), which represents the junior doctors, is demanding a 35 per cent pay rise, claiming their current salaries represent a 26 per cent real-terms cut over the past 15 years.
On Tuesday hundreds of junior doctors marched from Trafalgar Square past Downing Street and the Houses of Parliament, cheering and chanting “Claps don’t pay the bills”.
Shivam Sharma, 27, who works on a geriatrics ward in a Birmingham hospital, told i that as a junior doctor “you’re constantly fighting fires”. “I just finished three nights in a row, three 12-and-a-half-hour shifts over the bank holiday Friday, Saturday, Sunday. It was very hectic. So many patients coming in…. The hospital is very stretched: you have understaffed wards, fewer nurses, fewer doctors, and we need to really tackle the retention recruitment crisis currently.”
He said: “You used to be seen within four hours in A&E. Now you’re lucky to be seen within 12. We have seven million people on the waiting list. Things have to change. They can’t carry on like this. So over winter we had 500 excess deaths. That’s a jumbo jet of people. So if we continue in this current trajectory, things are going to get worse with patients and doctors. I think people need to realise that doctors are the solution, not the problem.
“You’re constantly fighting fires and you just don’t get enough time to spend with patients. You don’t get enough time to properly talk to them and connect with them. Everything is rushed and stressed and ultimately that does affect patient care. And you see these patients who are getting nursing in corridors and you think, ‘Where’s the dignity here?’ Things have to change.”
Patient care was being jeopardised “every day”, he added. “You been put in a system that’s set up to fail. As I’ve said, there’s patients who I’m having to treat in waiting rooms, so I can’t even get a cubicle for them. I can’t even get a corridor space for them. I’m having to assess them and treat them literally in like some weird, small dingy room and I’ve literally fought for just to get and that’s not the right way. That’s not how it should be and that’s after the patient waiting for seven, eight hours and as I said even 12 hours. These patients are often quite unwell and sometimes can have time critical conditions like a stroke or a heart attack. So patients in this country deserve better and if the government won’t fight for patients then we will.”
During the strike, most non-urgent care has been cancelled as hospitals prioritise emergency cover.
The BMA has said that during the strike there will be a “safety net” in place, with hospitals able to flag any concerns over junior doctor cover four times a day.
However, Steve Barclay, the Health and Social Care Secretary, has called the strike action “extremely disappointing” and accused the union of “deliberately” putting patients at “greater risk” by refusing to provide exemptions.
The junior doctors’ committee has refused any national exemptions and obviously that puts patients at greater risk but we’re working very hard to mitigate those impacts.”
Tal Ellenbogen, 28, a junior doctor working in general surgery in Leicester, said: “In recent shifts, I’ve seen that patients are coming in having waited 10, 12, 14 hours in A&E. They come in in agonising pain and they get up to the ward and they’re having to wait again to be seen. Because there’s just not enough doctors on the ground to see them in a timely fashion.
“I start every consultation with an apology, an apology those patients deserve but that it’s heartbreaking to have to give over and over again.
“They could be coming in with abdominal pain, tummy pain where they could have a burst appendix, they could come in where they’ve had a blockage in their bowel and there’s a risk of it perforating and them having to have some bowel taken out. When I’ve worked in orthopaedics that could be someone in a car crash. It could be someone who has broken their leg in a football match. There’s a range of different issues depending on your department. And sadly in so many of these we’re now not giving patients the care they need.”
“Patients in pain should not be expected to wait that long, but it’s far longer than it used to be. The NHS used to used to have standards, for example, at A&E where 95 per cent of patients should be seen, treated or admitted or discharged. That standard was then dropped by the government to 76 per cent quietly and we’re failing to even meet that standard. We used to talk about winter pressures now we just call them NHS pressures because it’s constant. What used to be an awful winter’s week back 10 years ago is now a fairly decent summer’s week.
An intensive care doctor at Medway Maritime Hospital in Kent who wished to remain anonymous told i that many patients were waiting a year for life-changing operations and many patients were waiting all day to be admitted to the intensive care unit.
“Our unit is pretty much always full. Often patients are waiting a very long time to be able to be admitted to intensive care or the HDU (high dependency unit) which is really tough for patients to be in A&E for a really really really long time. It’s not infrequent that there’s someone in A&E for 24 hours on some days,” the anaesthetist, 32, told i.
“The levels of burnout and a hangover from covid means that junior doctors are very tired in the short term, but also long term.
“Services have changed. We still got a lot of a Covid backlog in operations. We’re working weekends and longer days, Doing lots of extra overtime because of a backlog of cases and patients waiting for care which is horrible to hear about. Patients are waiting for a year for life changing operations. We want the NHS to provide really good care. And I think a lot of it is about not having enough staff. The poor nurses working to the bone and it’s hard for us to see them go through that. And also a lot of junior doctors are just struggling a lot.
A medical trainee, 28, at a south London hospital said: “I think our profession is being eroded. And we are not an unskilled profession. It’s not taking anything away from people that are in unskilled labour. We are among the most highly trained profession and our remuneration should be should match that. If you don’t pay people properly, and don’t treat your staff well, they’re not going to stay in the profession. And that’s going to just reduce the quality of healthcare. People are going to leave the workforce which we’ve seen over the past decades, and eventually it’s going to undermine the entire NHS if you can’t attract competitive staff.
“What is shocking is the how busy the NHS is getting because of decades of erosion to services and cutbacks has left the population more unhealthy and it’s making our hospitals busier.
“The general health of the UK is suffering because of all the cuts in the NHS that have happened over the last decade under the Tory government and it’s starting to really cause a lot of troubles in that our day jobs now are becoming so difficult. We’re just firefighting, we’re just dealing with crises constantly. And it’s no way to promote health and to create a healthier society. It means that we can’t actually do our jobs.
“So it means you come on to a shift in the morning if you’re working in a&e and there’ll be a wait of eight hours and people waiting there the whole night to be seen by a doctor. Those people are suffering and they can’t get seen.
“No one has started treating them the entire time they’ve been waiting in that hospital. no one started in the investigations or because there’s not enough staff. And it’s demoralising to see people in that state.”
Ayesha Shafaq, 33, chair of the BMA West Midlands junior doctor committee, who works in Stoke on Trent as a GP trainee, said: “If NHS were a patient, it would be requiring ventilation at the moment. The NHS is in a dire condition right now. And in fact, it has been so way before pandemic even hit.”