I'm a doctor working in England and we're on strike for the first time in 40 years. AMA

What band are junior doctors on? As an electrical engineer for the NHS who's tasks involve keeping a hospital running at all costs and seeing wages drop under a conservative government..I worry alot for the future of our beloved NHS. I personally think Cameron is running it into the ground (so to speak) so that more ppl will agree to privatise in the future. See you on the picket line!!!

Doctors are on a separate contract, we're not on Agenda for Change. A brand new junior doctor starts on £22,636 plus their antisocial hours pay, which can be up to an additional 50% depending on how many antisocial hours they do.

Fuck, that's it? That's actually disgraceful that's barely a live-able wage in London.

There is additional pay for NHS workers in London - www.nhsemployers.org/your-workforce/pay-and-reward/pay/pay-in-high-cost-areas

Are you considering relocating to a different country to practice medicine?

I am. Scotland, Wales and Northern Ireland currently have no plans to impose a contract.

Do you feel the NHS may be both more effective and more reasonable on it's staff if it were run by a doctor, rather than an individual with a solely political background?

I do. I fully support Norman Lamb's recent proposal of a cross party independent NHS governing body. I imagine it would be a bit like the Bank of England, but for healthcare matters.

Thanks for doing the AMA. How engaged and organized do you feel the Junior Doctors are towards this entire effort? Has this really mobilized your community?

It has, all junior doctors and many consultants and GPs are concerned about the contract.

IF 98% of the doctors dont sign the contract wont that have the same effect?

It would, but it'd also leave hospitals without any doctors. Today's strike action is to protect future patients and future doctors.

what does the picket line look like now?

http://imgur.com/KMUYJAj

What would you say to one of your patients who is missing their appointment today?

I would say, I'm sorry your outpatient appointment has been re-scheduled so that senior clinicians can cover the inpatient wards. I'm on strike today to protect future patients and future doctors.

The current system isn't perfect, but neither is the contract proposed by the Government.

I used to work in the NHS as IT. We were trying really hard to move paperless (they still are from what I hear) but all the health staff kept ignoring us or resisting us at every step. I thought the health care professionals would be happy that all the relevant people could have all the information they need at the touch of a button. What are your thoughts on this?

A lot of trusts are using shared resources such as Lorenzo.

I've used Lorenzo, I'm not a big fan. Felt very clunky.

Why do you think junior doctors have mobilised so quickly and easily in comparison to nurses and admin staff who have had similar or often far worse changes imposed on them? It is simply that these changes have been doled out on a trust by trust basis so it's more difficult to organise resistance or is there another problem. Similarly why have junior doctors not raised concerns about the problems faced by their fellow works in other professions in the NHS?

I don't think this has been quick, the contract negotiations have been going on for a couple of years.

It probably helps that there is only one major doctor union. I think it is also the result of years of slow chipping away at our collective good will and tolerance.

Junior doctors are very supportive of our colleagues. I am disgusted that the government want to remove the student nurse bursary which is so important for so many student nurses.

Hi

Thanks for doing this AMA! I can also see your in Norfolk and Suffolk, easy Anglia represent!

I have full respect and I back you guys 100% with this strike. A friend of mine is a junior doc and from her explanations (and some stuff I have read online), this is fully justified and I would do exactly the same were I to be facing your predicament.

A couple of questions...

Firstly, is this likely to have an ramifications for you personally? I work in telecoms and we are also looking at possible strike action regarding some policies. However I know that if I were to strike I would also be seen as 'intolerant' and therefore likely to lose my job. Is this something any of you guys are facing or are the general medical population happy to back you on this?

Secondly I have been an outpatient for mental health services for some time. The problems you have explained in another comment regarding privatisation of the services I have experienced first hand. And honestly it is awful. Long live the NHS! What I really want to know here is how you feel about the privatisation, do you feel it is better for patients overall? Or are there many like me that are trying to muddle through life as we are dropped by people that can help us as we are 'too much of a problem' to deal with? This doesn't strike me as an effective model, it's as though they wait for the worst of us to top ourselves so we are less of a burden.

Again thanks for this AMA and sorry for the wall of text!

I am not a lawyer (and this doesn't count as legal advice etc etc) but if you undertook legal strike action in the UK it is not lawful for your employer to discipline you for it. I'm taking part in lawful strike action and have the full support of the BMA legal team should anything untoward happen.

I am very disappointed by the privatisation of NHS services. The Health and Social Care bill was/is terrible and has caused many problems. I do not believe the patient can be he priority when a company is trying to make a profit.

As you say, this is the first time in 40 years that junior doctors have gone on strike. Have you spoken to any more senior consultants who were junior doctors during that time to get their view on the proposed changes? What kind of solidarity are you finding from the older guard so to speak, who have completed all their training long ago and earned their full pay?

EDIT : yes I'm playing devil's advocate. I'm just keen to see what your answers would be

Consultants are some of the most supportive people. One of our A&E consultants visited the picket line on her day off and another brought us snacks.

Consultants know that their jobs would be a lot harder without good quality junior doctors working for them.

We are the consultants of the future.

The government have no plans to recruit extra doctors so I can only assume they intend to spread us out thinner.

Can you go into a bit more detail concerning this?

The government keep saying that to provide a "truly 7-day NHS" a new junior doctor contract is required. The government have never defined what they mean by that statement. The NHS is currently provides urgent and emergency care 7-days a week.

We currently only have the staff to cover urgent and emergency care at weekends. If you want more services provided, you need more staff.

If the government want more staff working at weekends (which, I must say, would be nice to have) then they need more total staff.

If more staff are not recruited (and retained) then staff will be taken off weekday shifts in order to cover the weekend.

An American here - referring to this section of your post:

In a ballot of more than 37,000 junior doctors, 98% voted in favour of strike action.

Does this mean that junior doctors are unionized in the UK? Are Doctors unionized as well? How does this work in the UK?

All doctors in the UK can be members of the British Medical Association (BMA). The BMA is the largest medical Union in the UK and negotiates our employment contracts at a national level. They also settle local disputes and give advice on working conditions.

On average, how many hours a week do you work? I'm a US resident and work approx 60-80 depending on the week. No extra pay on weekends or overnight shifts. On average, we get paid ~$50-60k USD per year, but haven't heard any rumblings about striking.

I do anywhere between 48 and 56 hours a week on average. 1 week in 6 I am rostered to work 87.5 hours.

I earn around £40,000, which after tax and other deductions is about £2,000 a month.

We're not striking for a pay rise. We are striking to show how strongly we feel about the unsafe, unfair contract proposed by the government.

How will this be affecting medical care for emergency purposes?

It's not. Emergency and urgent care was unaffected by today's strike action.

As someone who admires a lot of the work of trade unions across the world (in particular rights for medical staff) what is your thoughts on the tube strikes London will be having over the proposal of a night service, and what do you think of state ownership of assets in Britain?

We have an odd situation in the UK where organisations are state funded but owned by private companies.

Many ambulance crews are employed by G4S. Paediatric health is being run by Virgin Health and many Mental Health services are run by private companies. Profit making companies trying to make money out of patients worries me.

Not trying to be antagonistic, just curious, but would you ever strike in solidarity with paramedical staff and nurses if you thought that their employers were compromising patient safety?

I would support their strike but it is not legal to join another groups strike.

Do you like tea?

I don't actually! I'm more of a coffee drinker.

I work at a Students' Union and we are standing shoulder to shoulder with you and all of our medical students. Hold your heads high and keep fighting regardless of what the media is saying. Good luck.

To ask a question... What do you think Average Joe can do to support you other than writing to our MP?

Edit: I've also been on the picket line outside of our local hospital and nurses and midwives are standing with you too. It's important to remember the terrible deal that student nurses are getting too as a result of Jeremy Hunt. #BursariesorBust

Sitting down and talking to your MP can be very productive.

You're right, the removal of the nursing student bursary is disgusting.

<I have no idea how the new system will work

Yet you still oppose it? Are all the protesters ignorant of what they are protesting.

You've truncated the quote. I oppose the proposed contract because the government have not explained it fully and want me to trust them that everything will be alright. I don't trust them.

I am behind junior doctors, but just to play devils advocate, what is your response to the statement that lots of professions have to work overtime nowadays without any extra money, why should you be any different?

It's not overtime, it's hours we have to work. The proposed contract would reduce my pay by roughly 15%.

Hello JonJH! Your post has been removed because you have not provided adequate proof within a reasonable amount of time. Please see the /r/IAmA sidebar for posting guidelines. Thank you!

That's a shame, can it be re-instated if I provide more evidence?

Yes.

Please review our guidelines on what counts as proof

Here I am, on the picket line, with my badge http://imgur.com/9aTcUPH

Would you mind editing that in to the description please :)

Have done!

What do you think of Hugh Laurie, can you pull random diagnosis from little to no facts about the patient?

I like Hugh Laurie, but House has very little to do with actual medicine.

One of the things junior doctors have complained about is that, in future, instead of fining hospitals money if they ask junior doctors to work too long, they will use other means to regulate working hours. Given that a) any fines have to come out of money which should be used for patient care b) hospitals and NHS trusts generally don't have to balance their budgets anyway and c) those hospitals which are most stretched are most likely to overwork doctors, but least likely to be able to afford fines, isn't that an argument to take money away from patients to protect the working hours of junior doctors?

Currently if a hospital is found to be overworking doctors, the hospital has to pay the doctors for their time. That is the current fine. It is being used for patient care. It is being used to pay for doctors who care for patients.

Under the proposed contract the hospital would still pay a fine, but instead of going to the doctors who were made to work additional hours it would go to a "Guardian". This guardian would be appointed by the hospital and decide how the fine money is spent.

As a fellow jr doctor (resident- in the US), don't you feel like a sudden strike is kind of irresponsible? There is a profound difference between a company striking and a public health care worker strike...

Did you reasonably exhaust all other options? Sounds like this whole contract thing is still in the works at this point?

Emergency and urgent care is being provided by junior doctors today. Consultants are in work as normal. Some elective operations and outpatient clinics have been re-scheduled.

Our emergency departments and oncall teams are fully staffed today. The hospital has better staffing today than it did on Sunday.

This was not a sudden strike, the negotiations have been going on for over a year. The ballot for industrial action was roughly 2 months ago and the first set of strikes were called off to allow for further negotiations to continue.

You really think it is efficient? I support your cause but we need a serious rethink about how the Nhs could be made more efficient, and no I don't just mean getting rid of some of the bureaucracy and chucking a bunch of middle management on the scrap heap, although that would be a start.

Compared to other healthcare systems, I think it is efficient

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I hope that this strike will mean the government listen to our concerns about the lack of proper safeguards to protect patients from overworked, tired doctors.

Does this action take a direct effect on immediate workloads? with doctors striking, are the patients suffering ? and if so, how can you justify patients suffering while you strike in order to get patients in the future applicable safe not over worked care teams ?

Elective operations and outpatient appointments have been re-scheduled. Emergency services are fully staffed and unaffected by this strike. Senior doctors are covering the wards.

Every effort has been made to minimise harm to patients. I feel the proposed contract would be more harmful to patients than today's strike.

Doctors have been going on strike a lot in the past few year, have these strikes been all about working conditions, or are there other complaints?

This is the first strike by junior doctors in England for 40 years. So I'm not sure which strikes you are talking about.

Firstly, I respect the NHS, and consider it a fantastic organisation.

However, hearing doctors complain about how much they earn has left a bad taste in my mouth. A fully qualified doctor in the UK is in the top 5% of earners. See consultant pay, and compare with percentile income before tax in the uk.

As for complaints about long hours, you should only be working a average of 48 hours a week. The new pay deal will not remove this safeguard.

Compared to all other health workers, carers and other hospital staff you have a fantastic deal. How can you justify striking?

I am on strike today because I do not trust the safeguards the government is proposing. I am on strike because I do not want my pay to go down.

That sucks dude. I fee for you. Whilst you are here, help me out.

My back has been in pain the last two months. The lower part of my back. I have tried sleeping on my side, on my back, on the floor, on a different mattress. Any idea why this could be?

Also my left knee hurts from the outside when I try and apply pressure on it. Could this be damage to the ligaments?

Reddit guidelines expressly prohibit comments giving medical advice.

If you are concerned, please see your healthcare provider.

Was the NHS a bad idea after all?

No.

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Emergency services are covered. Oncall services are covered. Elective operations and outpatient appointments have been re-scheduled.

Senior doctors are covering the wards. Adequate cover has been provided. Hospitals are better staffed today than they were on Sunday.