We are stoics, not radicals, Prime Minister

Dear Prime Minister,

As a junior doctor, I’ve been spat upon, assaulted, drenched in blood and doused in excrement. There isn’t a bodily fluid with which I’m not intimately acquainted, nor an expletive I haven’t heard. I’ve faced patients who are psychotic, seething with rage, deranged with pain, blind with grief or sometimes simply blind drunk.

Yet none of this has ever provoked a fraction of the frustration that now consumes me.

Today, imposition has been met with escalation. We are all — patients, doctors, Government and NHS — standing on the brink of a precipice. If ever there was a time for you and your ministers in the Department of Health to cease posturing and start talking, now, prime minister, is that time.

No dispute is so toxic, so intractable, that words cannot defuse it. You owe your electorate your words.

For while you’ve been standing mute on the sidelines, the men you chose to appoint as your custodians of the NHS have used language so incendiary, so offensive, your silence on this matter is incomprehensible. Health secretary Jeremy Hunt promotes the branding of junior doctors as ‘militants’, while the health minister Ben Gummer, chose this week to describe us as ‘radicals’. You, prime minister, are an Eton and Oxford-educated man: I do not expect the nuances of language to be lost on you. The insinuations of your appointees, in a post-9/11 world, could not clearer. Your turning a blind eye to their smearing of young doctors is the antithesis of leadership.

And you wonder why we feel driven to an inescapable escalation of industrial action? Have you never been struck by the gross inappropriateness of your ministers linguistically linking doctors to terrorists?

We are not, I assure you, the enemy. We chose our careers in medicine to help, not harm people. The marshal imagery your appointees so relish diminishes you as much as it does them, and the time to rein them in is long overdue.

Perhaps the deepest irony in this sorry debacle is how very much doctors and Government agree on. No one is more strongly committed to a genuinely seven-day NHS than us, the junior doctors on the frontline of delivering services at weekends. Your problem, prime minister, is not our intransigence. It is your flat refusal to fund your manifesto soundbite. So deep runs your commitment to patient safety at weekends, you aim to achieve it entirely ‘cost-neutrally’, without one single extra pound of expenditure. To those of us who practise evidence-based medicine, I’m afraid that looks like sophistry.

Your fundamental problem, after last year’s unanticipated majority in Commons, is that your soundbite has turned to bite its own creator’s hands. You actually have to deliver. If ‘radical’ means standing up for our patients against the nonsense that seven days can be delivered for the price of five, then you face 54,000 of us. The cheaper your shots — the more lurid your language — the greater real doctors’ resolve to stand firm against spin doctors.

Perhaps I may I make a ‘radical’ suggestion? Instead of condoning more fire and brimstone from your renegade appointees in the DoH, put a temporary brake on imposition.

You want a seven-day NHS, we want a seven-day NHS. All you need to end this — to stop at a stroke next month’s industrial action — is to flesh out your soundbite with evidence, so that contract negotiations can recommence from a new, meaningful starting point that reflects the funding and staffing required from rhetoric into safely staffed reality. Is that really so very militant?

Prime minister, it’s time to get real about a seven-day NHS. There is almost nothing junior doctors want more than to avoid next month’s strike. But the long-term threat to our patients of an uncosted, unstaffed, seven-day scam makes it impossible for us not to take action.

If you understood the realities of the NHS frontline, you would know that junior doctors are stoics, not radicals. To echo the words of president of the Royal College of Physicians Professor Jane Dacre, the escalation of our industrial action is junior doctors’ stoical, imperturbable expression of truth to power. Please listen and please let’s talk.

Originally published by the BMA, 23.03.16



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