The NHS, a lesson in politics: part III

NHS, a lesson in politics part three

In a continuation of my series here is the third part of the installment. This time I’m focusing on the Doctors current strategy.

Some background

I am not a doctor. I never have, and will never be. I like having spare time. Also, whilst we are at it, you medics only ever talk about fucking medicine. I thought engineers were bad, but jeez, have you guys tried baking? Oh wait, overtime….

However I’ve spent the last 10 years immersed in the world of NHS. I’ve been through OSCEs, I’ve made you dinner after your first day as a surgical F1, I’ve helped you with the selection for specialist training, I’ve felt your pain doing old age psych in the arse end of rural incestville. I’ve been there every step of the way, I’m not about to let all that effort go to waste. What I say comes from the heart, and is not sugar coated.

A fly on the wall

I’ve been involved in some of the bigger initiatives to help get your message out. Its really quite frustrating trying to get it through your collective skulls that this situation isn’t going to be sorted out by writing blog posts starting with “I call on x to….”.

Its even more baffling that the most vocal of you appear to be unable to google basic employment law (more on that later).

There is the relentless bashing of the BMA. Yes its not doing what its supposed to, but that’s because you, yes you, don’t go to the meetings. There are two halves to the BMA, the national and local. There is a small amount you can do on the national level, however there is massive scope for you and your peers to dominate the local stage (by local I mean trust/hospital).

A union at work

I work for a media company that has recently been sold to a large corporation. As soon as the news broke, the local Union reps (there are many) started putting posters up, and organised an open meeting.

Lots of people turned up, much was said, and crucially someone from the union was dispatched to talk to the boss.

Roll on a few months and the details of things like pensions were being ironed out. Because the company I work for is old enough to have a Final Salary pension scheme, there was some controversy about how it was being forcibly moved to a less gold plated scheme. (also it transpires that the rest of us were being dropped into limbo to serve the needs of the old owners, possibly costing more that 7% of our total pension pot)

Cue a company wide email, Hundreds of posters advertising an open meeting. Three hours later, a partial climb down was signalled. All before the meeting was scheduled to take place.

Why did that work?

Because people generally turn up to union meetings. They actually participate. In those meetings, they hash out an official line and elect someone to beat it into the face of the nearest HR/management type. The implicit agreement is that if you ignore the union, shit goes south pretty fast.

20% of us turned up to one meeting

In this meeting, the chairman laid out the problems with the current proposals, brought in the union lawyer, and discussed the results of the actuary that the union had hired.

We then voted on a statement that would be issued to the collected big cheeses. That statement said something along the lines of “do what you fucking promised, or we’ll piss on your dreams of a profitable company”

It the end it took ~50 minutes to do that.

Contrast that to the NHS, where The government can run roughshod over the BMA because they know that A) Doctors grumble, and nothing else. B) Doctors blame the BMA for being shit, and don’t do anything to change it.

“Oh the BMA is expensive”

You guys are still bitching about the monthly £30 BMA subs. WHICH YOU CAN CLAIM BACK AGAINST FUCKING TAX. (something we out here in pleb land can’t). If you really honestly think that £30 a month (well nothing because you can CLAIM AGAINST FUCKING TAX) isn’t it worth it, to avoid either rage quitting or a 30% wage cut? You already have to fill in self assessment to claim back your GMC, royal college of x and all your exam fees right?

face palm please tell me you know about that right?

Why do none of you know your legal rights?

Putting aside the union business for a moment, another pet peeve is not knowing your employment rights. In an attempt to rectify that here is a non-exhaustive breakdown:

There is a website called which allows you to log your NHS overtime. Why in living fuck are you not taking your trust to court for breaches of employment law? Remember, 10 minutes longer on a 13 hour shift is ILLEGAL. Not a little bit illegal, ILLEGAL. Rota’s hours of 48 a week on average means that any overtime is ILLEGAL, unless you get time off in lieu.

I’ve heard the excuse “oh but the trust said it only counts if 96% of blah blah blah” NO. WRONG. Your contract is with the trust, no one else is in the way. If you are working illegal shifts because of staff shortages, its still illegal. Make no mistake, if you fuckup and you are ten minutes past clock off time, they will drop you in the shit for breaching contract.

Next steps: “Operation big fuckoff legal stick”.

First, you’re going to swallow your pride and fucking join the BMA.

Then you are going to find your hospital rep, and make your self known to them. You will offer them help. You will help put up posters. You will attend meetings. You will encourage other people to come to meetings.

You will guide the BMA, you will make sure that they source a competent talking head that is the single source of doctor truth. Someone who is succinct that can be wheeled out to tackle the “hunt effect” More importantly someone who can actually make a point in 15 words, not 15 paragraphs.

You will insist the BMA hires a media department that can actually spell.

You will point out that there are lots of cheap ex-labour spin doctors about.

You will ask the BMA to sue the Health secretary for slander

You will, as a local chapter start to log the hours that you and your colleagues do. You will note down, as a group, any breaches in safety, Staffing issues, issues with hours, etc. You will get it all signed off by a third party.

After a few weeks, you will arrange a meeting with the head of trust. You will present the evidence and demand real action. If quantitative action is not forth coming, you will, as a group draw on the legal resources the BMA provides to force the trust to comply. You will tell the head of trust this. You will smile as you breathe deep the sweet smell of loose bowels. There is much more to industrial action than striking. Accidentally filling in paper work at the wrong time so it appears that all targets have been missed for that day. Calling mandatory meetings during teaching, repeatedly. Be creative. Be obstinate, channel your inner radiographer.

There is no need to wait.

It seems like a lot of you are waiting for the BMA to do things for you. I see a lot of people saying “Hurry up and ballot” and the like. WRONG. YOU ARE THE BMA. IF YOU ARE PASSIVE, SO IS THE BMA. The only way you are going to succeed is by playing an active part in the only organisation that is legally representing you. If the BMA is not doing what you require, its down to you to change it.

Failure to heed the above advice will result in a right royal bum fucking from Mr Hunt. You’ll also get a slap round the back of the head from me, for fucking up the NHS under your watch.

So, Stop your twittering, store up your anger, and use the legal tools at your disposal. Gather evidence, verify, present. Destroy. Do it now. NOW.

#SUPPLEMENTAL: The GMC requires you to make a fuss:

The GMC are very clear on the quality of care:

  1. You must promote and encourage a culture that allows all staff to raise concerns openly and safely.1, 11
  2. You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised.

    a. If a patient is not receiving basic care to meet their needs, you must immediately tell someone who is in a position to act straight away.
    b. If patients are at risk because of inadequate premises, equipment* or other resources, policies or systems, you should put the matter right if that is possible. You must raise your concern in line with our guidance11 and your workplace policy. You should also make a record of the steps you have taken.
    c. If you have concerns that a colleague may not be fit to practise and may be putting patients at risk, you must ask for advice from a colleague, your defence body or us. If you are still concerned you must report this, in line with our guidance and your workplace policy, and make a record of the steps you have taken.11, 12

  3. You must offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, your competence and the availability of other options for care.
  4. Whether or not you have vulnerable† adults or children and young people as patients, you should consider their needs and welfare and offer them help if you think their rights have been abused or denied.13,14

Not only is it your moral, but also professional duty to act on unsafe working practices.

  • Over worked doctors are unsafe doctors.
  • Doctors doing over time are unsafe doctors.
  • Hungry doctors are unsafe doctors.
  • Trust cutting back on equipment is unsafe

Your job as a supportive peer, is to help those doctors log their illegal hours, and put a stop to unsafe practices.

Next time

Next time I’ll discuss ways in which you can effectively use advertising to undermine the government.