22 November 2023

To save the NHS, the Chancellor should pay doctors properly

A fair-pay deal would stop the strikes and prevent doctors from leaving the profession.

In April 2004, our son, Henry, was born, before his due date. Even though my wife and I are doctors, like so many parents, there was nervousness and trepidation at being wholly responsible for such a tiny vulnerable human being. He didn’t seem right a few days later – he had a temperature, and it was maternal instinct as well as medical knowledge that took us back to our local hospital. Henry got a lot worse, collapsed and arrested the following morning. The cardiac arrest call went out, people came running; Henry was not expected to survive. He was whisked across the Paediatric Intensive Care Unit at Alder Hey Children’s Hospital in Liverpool and all my wife, my six-year-old daughter, and I could do was follow, numb with fear.

Those dark days subsequently defined the way I looked at medicine – and at life. I was already a consultant obstetrician dealing with life and death on maternity wards when Henry arrived, used to swinging into “emergency” mode, and I’ve carried on doing that ever since.

Yet now, with the austerity politics of the past 13 years, I’ve found myself working in systems where the skills, expertise, and enthusiasm – of all clinicians, not just senior doctors like me – have been all but extinguished. Year after year of sub-inflationary pay awards across the board, unmanageable workloads and staff shortages have led many experienced doctors to reduce hours or leave the profession. New doctors now face vastly inflated student debt of up to £100,000, a minimum of five years of university, and postgraduate training that sees doctors shuffled like a deck of cards, dealt out around the country in a lottery over which they have little influence.

Doctors are some of our brightest brains, and they are intelligent enough to see that the offer in UK PLC is falling way short of expectations – Australia and New Zealand seem much more attractive, and in Northern Ireland, doctors head south across the border where they can get much higher pay and better conditions.

The British Medical Association (BMA) has paused industrial action to talk. The new Health Secretary, Victoria Atkins, must surely know the cost of retaining our expertise is less than what it would take to resolve these disputes. There is an opportunity here to invest in the long-term security of the medical workforce. It would be an unnecessary and entirely preventable tragedy to take any of these disputes across what promises to be a difficult winter for the NHS, and into the spring.

In today’s Autumn Statement, the Chancellor Jeremy Hunt can do a lot to help doctors feel valued, and to materially increase the chance of getting us back to doing what we love the most – treating patients.

There is a small window now for the Chancellor to act meaningfully, to listen. The BMA has long called on the government to ensure safe staffing levels across the NHS, but it has failed to take the action needed to do so. It is ironic that the government is now focusing on minimum staffing levels as a reason to curtail strike action and “protect the lives of the public”. Protecting the NHS and having a workforce fit for purpose is at the heart of why healthcare workers are striking.

Oh, and Henry is currently at university, the only one of us not affected by his early weeks struggling to survive on this planet. He wants to be an academic and finds himself increasingly drawn to medicine as a possible career. If we want to retain our doctors, now is the time to act, before it’s too late. The cost of medical expertise is worth every penny to a country that will spend so much more without it.