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Sir, Junior doctors have been pushed to the limit this year by an unfair recruitment process. Their job security is vanishing, their debts are rising and their take-home pay is falling. Given all this, you might expect the Government to pay a bit more attention to their working conditions. It is surprising, therefore, that the Health Secretary has admitted to being “unaware” that first-year medical graduates lost their entitlement to free accommodation in July — a change that followed amendments to the Medical Act.
While such accommodation was generally of a poor standard, it was one of the benefits of working as a junior doctor. The Department of Health has always argued against an increase in first-year junior doctors’ pay on the basis that they received subsidised accommodation. There is now no excuse for them to keep their basic pay down, and an uplift to reflect rental costs — on average £400 per month — is now essential.
Ram Moorthy
Chairman, BMA Junior Doctors Committee
Ian Noble
Chairman, BMA Medical Students Committee
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I second Alan Smiths' comment on moving upon graduation. I cannot wait to leave purely because there is only so much someone can be squeezed until they explode. I want to be a doctor, what I do not want to be is an NHS minion shackled at my neck.
Harish, Manchester,
The notable comment by the pharmacist above whereby pharmacists are unable to get accommodation does not take into account that many juniors work on average 50% more hours than any other NHS speciality on a WEEKLY basis and yet are receiving massive pay cuts due to local trusts being able to fudge the hours that doctors work. Sooner or later the only response from junior doctors will be the end of all the good will extra duties that they perform and that their response will be to work to rule - that means that they will only turn up and leave at prescribed times (very much like pharmacists and other NHS specialities doe). The trainining of such doctors will suffer as a result and the UK population of tomorrow will be treated by incompetent consultants who are not even fit for purpose
James Nash, Liverpool, UK
Victoria,
It is true we are still in training.
But if (heaven forbid) you were hit by a car outside a district general hospital at night and needed surgery then the accident and emergency doctor who would assess and look after you would be a "junior", the surgical doctors who assessed you if your injuries were serious would be a "junior" the anaesthetist who put you to sleep would likely be an experienced "trainee" and the surgeon who operated on you also. In fact you may not see a single consulant until morning.
Without junior doctors the health service in this country would be utterly incapable of functioning.
Dr Benjamin Patterson, London,
To keep the best you have to pay for it, i guess thats why the brightest juniors are actually going abroad, for me thats the U.S.
Alan Smith, London,
Please note that other junior healthcare professionals in NHS hospitals do not get accommodation paid for. All of whom are paid less than junior doctors (especially nurses), work unsocial hours/on-call, carry student debt, and whose salaries in comparison to doctors, do not rise as exponentially.
Consider junior hospital pharmacists like myself, who in addition to paying for hospital or private accommodation:
-are the only healthcare profession not to receive an NHS bursary during undergraduate study
-owe £20K in student loans
-pay over £500 in fees & indemnity insurance
-initially earn around £10K less than newly qualified colleagues in community
-undertake further post-graduate study for 3 years to progress to better paid posts in the hospital sector - funding for which is increasingly coming from their own pockets, due to NHS spending cuts.
Surely bringing junior doctors living costs in line with those of other junior healthcare professionals in NHS hospitals is fair?
Sarah Colfer, Leicester,
For the information of the general public: a 'junior' doctor is a doctor who is still training to be a consultant. Some people seem to think a junior doctor is still a student, (s)he isn't, those are called 'medical students'. For example, I am still a junior doctor yet I am 35, qualified in 1997 and so have 10 years clinical experience, and am not due to become a consultant until I am 37. Compare that to GPs for example, many of whom finish training after 4 years.
1st Year Doctors ('JHOs' or 'F1s') typically get sent (with no choice) from one hospital to another every 3 or 4 months, often up to 100 miles away. It is virtually impossible to rent accommodation for 3 month leases, that is why hospitals were always obliged to provide accomodation. Also the reason why labour persistently refused to increase JHO basic wages, since they got free accommodation...
Adrian Mc Elholm, Omagh, N Ireland
Could the authors please enlighten us as to the actions of their respective committees during the consultation period on these changes to the Medical Act? It seems the BMA WERE consulted on this and OKed it - complicity they seem to have conveniently forgotten about. A recent response from Alan Johnson MP to Stephen O'Brien MP reads, in part:
"...the Department consulted extensively on the changes to the Medical Act between 1 October 2005 and 31 January 2006. The Consultation Document contained a draft of the Order which contained the repeal of Sections 10-13 and their replacement by section 10A which removed the requirement for doctors to be present on site. THE BMA RESPONDED TO THAT CONSULTATION AND DID NOT RAISE ANY OBJECTION TO THE REMOVAL OF THE REQUIREMENT FOR RESIDENCY. There was further opportunity for comment and debate on these changes when the legislation was considered by both Houses of Parliament last summer and no objections were raised"
Palmate Breech, Trivet Hull, GB
We may be junior doctors, however we still do a large volume of work, and whilst we are supervised, we make a lot of management decisions on our own, and often are the first to see ill patients in the hospital setting.
We work hard, and care about our patients and standards of care, i think it reasonable for us to expect the government to treat us with some respect for our job and the work we do, which simply isnt happening
Karyn, Glasgow,
nurses have their tuition fees paid by the NHS and get a yearly NHS grant for all their 3 years at university. They earn £19.500 as graduates for their first post. Doctors spend six tough years at university, no help with tuition fees or any grants but for one year, year 5. They then graduate with a huge debt of around £40,000 and the three years lost income they would have earned had they done nursing instead. They then earn £22,500, out of which they have to pay for their own accommodation, their debt and their own futher development training courses which is also no longer paid for by the DoH in the majority of cases.
I can't understand why should anyone endure the tough study of medicine and lose around £120,000 by the time they graduate only to also find that they would be lucky to even get a job at the end and face a wasted career as they can work nowhere else but for the NHS who 'commissioned' them in the first place only to discard and/or humiliate them on graduation?!
Sam, London, UK
I don't know what to say, doesn't surprise me anymore. Surely Labour have to realise that no Junior Doctors will be voting for Labour in the next election. That's minimum 30,000 votes lost. Serves them right.
Betty Wood, Bristol,
They Are Junior doctors. They are still in training and working under supervision. At least, as patients, we all hope they are being supervised by their Consultants, who are training and mentoring them !!!
Otherwise, God help us !!!!
Victoria Foster
ex-patient
victoria foster, maidstone, UK
They might be treated more fairly if we stop calling them "junior". These are fully qualified doctors in the 30s, many with families and mortgages. Call them "doctors"!
Rosemary Roberts, Germany,
Well done on getting this published and brought to the attention of people. Sadly i doubt we're going to get much change. The fact is that doctors, and more so junior doctors, represent but a tiny fraction of the electorate.
The public have traditionally had very little sympathy for doctors and the general misconception will be that they are rich and can easily afford their own accommodation anyway with a lot to spare - something we know is not trye of junior doctors, most of whom graduate with huge amounts of debt. This wil suit the government's agenda just fine.
Abhishek, Leeds,