A YEAR or so ago, junior doctors took to the streets of Glasgow to protest against the way that changes to medical training were being implemented. It was intended that these changes, which would apply across the UK, would streamline medical trainin
g, reducing the number of years spent "marking time" as junior doctors while waiting for an opportunity to progress to a consultant post.
But the implementation of these changes was badly thought out and resulted in chaos for juniors caught up in the transition from the old system to the new one. Computer systems failed and job offers were limited, leaving junior doctors uncertain about their future and of their opportunity to train in the NHS.
One year on we are still unsure as to the future structure of medical training. Even though the application process this year is vastly improved many doctors still face uncertainty about their future careers in medicine. At the same time, additional service pressures are taking their toll on doctors' morale. A recent survey of junior doctors across the UK found that three in ten junior doctors are working on understaffed rotas and many reported being pressured to work extra hours, without pay, to help fill these gaps.
Junior doctors are also facing increased financial pressures, with this year's pay rise below the rate of inflation. Juniors have been particularly angered because of the pay review body's refusal to compensate for the loss of free accommodation on hospital premises for first-year junior doctors. For some, this amounts to an effective pay cut of up to 20 per cent.
In addition to this, doctors training in Scotland are facing even greater financial pressure as NHS boards continue to employ trainees on short-term contracts. The implications of these short-term contracts are significant, since they affect eligibility for relocation, removal and travel expenses, as well as mortgage applications and rental agreements.
Next year the NHS will face its greatest pressure yet as the European Working Time Directive comes into full force for all junior doctors. In August 2009, working hours will be limited to no more than 48 hours – at the moment most juniors are working around 56 hours per week.
Recent reports of under-staffing at the Edinburgh Royal Infirmary illustrate the importance of having a system that can deal with unpredictability. The Hospital at Night Scheme is one way of planning to deliver a service with fewer junior doctors.
All of the issues that I have highlighted are serious in their own right, but together they are having a damaging effect on the morale of junior doctors across the country. Unless we resolve them, juniors will be enticed away from the NHS to countries where there is greater opportunity and a more certain future. Every doctor we lose from the NHS represents at least £250,000 of the taxpayers' money being wasted.
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Dr Alan Robertson is chair of the BMA's Scottish Junior Doctors Committee The full article contains 517 words and appears in Edinburgh Evening News newspaper.
