Forty-three years ago I was a junior doctor halfway through my pre-registration year. It was one of the most difficult times of my life. After qualifying in medicine in Manchester in 1972, like all doctors I had to spend my first year under close supervision by senior colleagues, until I was deemed safe enough to be released on the public.
My second pre-registration job, which started in February 1973, was on a busy surgical ward in the Manchester Victoria Memorial Jewish Hospital. The meant working a one in two rota shared with a young Indian doctor. I started work at 8.30 a.m. six days a week, and when I wasn’t on call I was rarely home before seven. I was so tired and exhausted that I could barely muster the strength to talk with Stella, my long-suffering wife, who at the time was heavily pregnant with our first child. When I was on call I had to sleep in the hospital so that I was available to respond to urgent problems on the ward or in casualty. Most nights I was fortunate to snatch two or three hours sleep. The rota also involved being on call in the hospital every other weekend.
Stella and I hardly saw each other during the latter stages of her pregnancy. Sometimes she came over to spend the night with me in the narrow hospital bed, not an easy task when you’re heavily pregnant. Maria, the lovely Spanish cleaner who was responsible for the doctors’ mess, used to put a cushion on a chair placed strategically beside the bed for Stella’s ‘bump’ if she knew she was staying. Otherwise we would have seen little of each other. At home I was so exhausted I was unable to offer her much love and support through the last three months of her first pregnancy. I bitterly regret that to this day.
When she went into labour I was at work and she had to find her own way to St. Mary’s Hospital, because she didn’t drive. I was on call the evening she gave birth, and through the kindness of a Pakistani surgical registrar who covered for me; I managed to dash over to St. Mary’s just in time to hold Stella’s hand in the last half hour of labour. There was no paternity leave, so when she returned home with our new daughter I carried on working one in two as before. Worse was to come.
In June my consultant told me that the Indian doctor with whom I shared the rota would be leaving at the end of the month. She had saved up all her annual leave and there was no locum cover available. This meant that I was the only junior doctor covering the surgical ward for four weeks, during which time I had to stay in hospital on call. July 1973 was hell; cooped up in hospital, unable to leave, hardly able to see Stella and the new baby I so desperately wanted to hold and love, chronically sleep deprived. I can remember very little of it now, but I have vague recollections of a dazed young doctor, eyelids heavy, struggling not to make mistakes (I pretty sure I made many), and yearning to be with his family.
Things have changed a great deal for the better since then. The old Victorian Jewish Hospital and the 1960s brutalist St. Mary’s have both been flattened in the name of progress that has also brought about important changes in the culture of the NHS. These days everyone recognizes that junior doctors have a right to a family life. Working conditions have changed to reflect this. Some years ago I was responsible for the training of junior psychiatrists in Bradford, when the European Working Time Directive came into effect. This was implemented because of the evidence that tired and overworked staff experience stress, depression and illness, and are more likely to make serious errors at work. In medicine errors can be a matter of life and death. The working time directive placed a cap on the number of hours junior doctors could work each week by putting them on shifts. Other changes increased the amount of maternity leave and introduced paternity leave.
Jeremy Hunt’s new contract threatens all this. If implemented, it would stretch junior doctors so thinly that there could be no safeguards for patient safety. It would also push the clock back 40 years to the days when junior doctors were exploited.
Strangely enough in 1973 I didn’t see my one in two rota as exploitation. Why was that? I entered medicine accepting that there would be consequences for my family life. But Stella, a staff nurse, and I were both committed to the NHS. We believed in it, and even more important we knew that our political leaders felt the same way. But today, Hunt wants to demolish the NHS. Nothing he says will convince the majority of the 58,000 junior doctors that he loves the NHS and really values their sacrifices. No wonder, then, that they are on strike, and that’s why I was so immensely proud to join them marching from Manchester Royal Infirmary to Albert Square on 26th April 2016.