Survey of Junior Doctor Parents Show More Than 50% Considering Leaving NHS England

jdcchildMore than 1000 junior doctor parents have spoken up voicing grave concerns about the new contract, set to be imposed this August. In an online survey conducted in April 2016, 99.4% consider the contract will have a detrimental effect on their family life and less than 5% of respondents plan to continue their career as it currently is. 93% consider the proposed contract will have a detrimental effect on their relationship with spouse or partner. More than 25% are considering leaving the profession altogether, with a further 26% considering a move to another country.

“There are around 54,000 junior doctors. A junior doctor is anyone graduated from medical school up to consultant or GP level. Most are of child rearing ages and many have children. When doctor recruitment is already in crisis and only 5% of junior doctor parents plan to continue as is, imposition of this contract could throw the entire doctor workforce into disarray,” states survey creator, Dr Sethina Watson, junior doctor and mother of four. “This contract threatens both lives of medic children and, with a potentially reduced workforce, the lives of patients too.”

The survey asked a range of questions on current level of training, current and potential childcare and whether or not they envisaged continuing their current career should the contract be imposed. The survey identifies extreme difficulties in finding childcare, 93% state that finding childcare with the new contract will be more difficult. The governments equality analysis of the Junior Doctor contract openly states that it disadvantages women but that this ‘indirect adverse effect on women is a proportionate means of achieving a legitimate aim’. The equality analysis suggests that some women may find it easier to arrange informal, unpaid childcare in the evenings and weekends. The survey results showed that nearly 60% of respondents do not have access to such childcare. Of those who do, 86% believe it will be unreliable for ensuring attendance at work. There may be a surge in doctors requesting part-time working, which can still entail up to 55 hours per week.

Of particular concern are the doctor and doctor couples that comprise nearly 40% of those who responded. “I cannot imagine how it would be tolerable if the frequency of our weekend working were to increase; I could easily imagine this causing marital and family breakdown,” said one married male doctor.

Jeremy Hunt’s rush to impose the contract threatens to create a potential time bomb that could explode as early as August as thousands of junior doctor parents struggle to find childcare or quit their jobs. The legacy could harm generations of children and lead to a loss of thousands of years of medical training from the workforce.

Survey Results Summary:

  • 1060 Respondents
  • 84% aged 30-44
  • 82% female
  • 84% married/civil partnership
  • 38% have doctor partner/spouse
  • 38% full time employment, 41% less-than-full-time
  • 39% caring for one, 39% caring for two
  • 59% use nursery and 58% spouse for additional childcare
  • 34% ST 5+
  • Of those choosing to stay in medicine 58% will stay in speciality
  • 40% spend between 20-39% of net household income on childcare
  • 58% do not have access to unpaid informal childcare, those who do 86% say not robust or reliable enough for work
  • If contract comes in 48% plan to use partner for childcare, 48% don’t know what they will do (you could have more than one answer for combination arrangements)
  • 75% expect to pay for this additional childcare
  • 93% said that finding more childcare would be more difficult
  • 4.6% will continue their career as it currently is
  • Those considering other options 87% cite impact on children, 79% impact on spouse, 53% cannot afford further childcare, 77% emotional strain and stress as key factors
  • 74% state the proposed contract will definitely have a detrimental impact on their relationship with spouse/partner (19% state probably)
  • 93% state it will definitely have a detrimental effect on family life and 6% say it probably will

Complete survey findings are available JDCchildcaresurvey2016.

Survey conducted by Dr Sethina Watson, Anaesthetics Trainee, mother of four and former founder of MomMD.com. Follow me on Twitter @morefluids.

For a short link to this survey use http://wp.me/p3pm8R-bk

Featured in The Guardian – Junior doctors: ‘over half could quit NHS England over Hunt’s contract’ and Hospitals braced for walkout as Hunt says doctors’ strike must be defeated.

For more information on the survey and permission to use findings, please contact me below

Being a Junior Doctor & Parenting a Child with Cystic Fibrosis

Last week junior doctors staged another strike in opposition to the proposed enforcement of Hunt’s Junior Contract. A contract which most doctors believe will endanger patient lives and destroy the NHS. On the eve on the third strike, while my daughter recovered from anaesthetic I wrote the following piece.

“My husband and I are both junior doctors. Unfortunately, we cannot join the picket line this time.

We aren’t there because we are in hospital with this little one.

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Smiling despite low oxygen saturation and high fever.

Our three year old daughter has cystic fibrosis. She’s not been well recently and she’s in for a general anaesthetic, bronchoscopy, fixed intravenous line and two-week course of heavy duty antibiotics. The NHS is so vital for her care and future. We have no doubt that she will be well cared for the next two strike days.
The junior doctor fight is for every patient and every person working in the NHS. Doctors looking after her (and everyone else) should be well rested, motivated and valued. She starts nursery soon, we’d like to see her and our other children at weekends. We already work many weekends away from them. CF shows us that life is precious; it is too short.

Doctors involved in her care over the next two weeks will be many; junior doctors, respiratory consultants, anaesthetists, radiologists and microbiologists. But also ward nurses, recovery nurses, operating department practicioners, specialist nurses, student nurses, ward clerks, pharmacists, pharmacy technicians, porters, health care assistants, domestics, dieticians, psychologists, physiotherapists, radiographers, play specialists and more. Behind the scenes are lab technicians, estates workers, IT staff, medical secretaries, central sterile services team, theatre managers, ward managers, volunteers, security staff and a huge long list of others.

We all work together for our patients. We make something pretty amazing. To think that adding just junior doctors to the ward at the weekend is all that is needed ignores the rest of that amazing team.

When times are tough, we remember this phrase, ‘Dum Spiro Spero’. It means while I breathe I hope. Perhaps one day there will be be a cure for CF. We try to remain hopeful about the junior doctor ‘fight’ too.

Junior doctors are standing up for the future of the NHS. Let’s all stand together. Good luck, we’ve got our badges and banners on the ward ready for tomorrow. She says a big thank you for everyone looking after her.

Mr Hunt, I request that you engage with us and take our concerns seriously.”

Since then, she has been recuperating in hospital and faces further treatments prior to discharge home. The contract in short, may mean many doctors simply cannot afford to work in the NHS, whether financially or emotionally. Minty’s story was featured in The Independent and on Doctors of the NHS.

As always, fundraising for the CF Trust is a goal. Minty’s Godfather and family friend aim to cycle from London to Paris to raise money. Find out more about Magical Minty Cycling Team on Facebook or donate here.

To understand more about the Junior Doctor contract this recent Facebook post is an excellent summary. 

We weren’t expecting you, but you are here now. Cystic Fibrosis – The Diagnosis

In medical school, the cystic fibrosis lecture was memorable. The lecturer, I do wish I could remember his name because I want to thank you for the hope he instilled, was passionate. He conveyed his excitement about the new drugs in development for CF, raved about the possibilities of gene therapy and said ‘there will be a cure one day’. It was like a performance, an uplifting speech, much of which went over my head as he talked about delta F 508, CFTR and so on. Interesting, I thought, but that will never apply to me as we don’t have the CF gene in our family. For sure we don’t; I’d have bet £1 million that we didn’t. Especially as I’m half Ghanaian. No way. That’s the thing, you imagine that these things always happen to other people. That’s what my doctor husband thought too when he sat through the same lecture one year earlier.

Our daughter’s life had a brief 3 week period of no known CF. We received cards and gifts, fell in love with her and celebrated her welcome into our life. She will be my last baby and she took quite a journey to get here. We were thrilled to meet her.

Here she is!

Here she is!

It’s always on the power of hindsight you look back and see hints of things to come. The newborn heel prick was memorable as she was reluctant to give her blood. The midwife came another day to try again. I nearly said ‘don’t bother’ as those things won’t apply to her. The test took longer than usual to come back. Odd I thought, I think they are repeating it. Still, I thought nothing of it. Some three weeks later while feeding in the middle of the night I thought, ‘it’s still not back I better just give a call’.

Didn’t need to because at 9am one Tuesday morning a worried sounding health visitor called to say we needed to go to the children’s hospital at 2pm that day. She sounded like she didn’t want me to ask her any questions. Panic ensued and I Googled the name of the person we were to see. Palpitations set in as I saw that she was the CF specialist nurse. My husband tried to reassure me saying it was probably nothing and that the blood tests were going to be repeated.

Now, I often tell patients to use the Internet with caution as there is a lot of misinformation out there. Googling positive CF newborn screening I found such misinformation. Confident that this was a big mistake and that the test would be repeated we went down, I nearly told my husband not to come. As a doctor, I had no idea that the heelprick test could be diagnostic. Merely a screening tool for other tests I believed. There she was a lovely healthy baby with nothing wrong with her.

As we arrived at the hospital I knew something wasn’t right. We were ushered into a room quickly, taken out of the waiting room. I felt this to be a bad news room. When the specialist nurse and consultant walked in carrying and large folder with our baby’s name on I thought, this isn’t good. This isn’t good at all. Why was the consultant there, what did he want?

They began by asking how the pregnancy went and how she was doing. “Fine, OK, she was just breech that’s all,” I said. From then on he explained how the test had shown the 99.5th percentile for the enzyme produced in CF patients. The blood sample had already been sent all over to labs here and there. Long story short, two genes were found. “That means that she has a positive diagnosis of cystic fibrosis,” he said.

Stunned.

Terrified.

Devastated.

Shocked.

I looked down at my baby. It was like I had been told she was dying. That’s what it felt like, looking back on it now. I was shaking so badly I thought I would drop her. My dear 3 week old baby, what life does she has ahead of her I thought. Tears ran down my face as I looked at hers, so innocent and so new. How was this tiny baby going to live her life like this I grieved. “Is there any chance that its a mistake?” I asked. I knew it wasn’t but just had to be sure. I was simply unprepared, not that you could be, for the diagnosis. I would pull myself together for a few minutes then burst into tears again. My two year old tore road the waiting room as if nothing had happened. We asked questions, we absorbed answers, though probably only a fraction of what was said. It seemed completely surreal. This couldn’t possibly be my child. My husband looked pale, in shock and spoke quietly. He felt the need to be strong, matter-of-fact, optimistic to support my postpartum collapse.

I felt that her future had been re-written. I felt that she was facing an unknown world. I wondered if we were up for the job for looking after her. I remembered patients I had cared for on a respiratory ward and I remembered the battles these patients had faced, the antibiotics, their life in hospital, their lines, their life. I remembered the lady I helped prepare the papers for her lung transplant. All of this flashed before me. In a moment, I imagined quitting my job, my child being ill, my family and a trillion other worries all at once. Our family’s future was also re-written. It was too much to take in.

This is where the consultant said, “you must not change any of your hopes and dreams for her or for you all.” “You must live a normal life.” Lots more was said about her going to university, school and travelling the world. I realised by the end of the two hours we spent there that we did need to carry on as normal. She needed us to be strong for her, to be her rocks of support, her advocates and love her unconditionally.

Coming to terms with the diagnosis and quest for information I found it hard as words like, life threatening, fatal, lung transplant and so on stood out. I chose not to read information that told me her life expectancy is 41. I know now that those diagnosed through screening can do very well because we catch it early.  We are now around 3 months into prophylactic antibiotics, Creon, daily physiotherapy and the amazing multi-disciplinary care team support we have for her. This is where I truly understand and appreciate how each individual contributes synergistically to brilliant care. I shall not go into details as every patient has their own care plan and experience of this journey. What I will say is that now, more than ever, I know we must be grateful for the NHS and the service it provides.

Reactions from family and friends were unpredictable. That was very hard. All I can say is call people, communicate even if you don’t know what to say. We experienced a sad sense of abandonment which will stay with us forever. If you don’t know what to say, say just that “I don’t know what to say”. Cards and gifts stopped and her birth stopped being celebrated. Some even said “I bought a present for her but I feel that I shouldn’t send it now”. Please do. It has taught me that no matter what every child’s life must be celebrated and welcomed. Each child has taken a difficult journey to get here. That said, support has been great. It’s brought many family members closer together. Our family unit of six seems stronger than ever. I’m extremely grateful for my rekindled relationship with my youngest brother, who has been outstanding. Thank you to him and to you all.

If you would like to know more about what cystic fibrosis is please look at the CF Trust website. If you have a few spare pennies or pounds (not that many of us do these days) please consider a donation to the charity. In America? Try the Cystic Fibrosis Foundation.

I am hoping that in her lifetime we shall find a cure. I believe her future, though uncertain, looks bright. But there’s much to be done.

My daughter and I

My daughter and I