Adam Kay, a former Doctor, publishes an open letter to the Secretary of State for Health calling for him to walk a mile in the shoes of a junior doctor.
In his new book, ‘This is Going to Hurt: Secret Diaries of a Junior Doctor,’ the former obstetrics and gynaecology doctor writes candidly about his experiences as a junior doctor and the effect working in medicine has on both his personal and professional life.
In the open letter to The Secretary of State for Health, he said;
“Roger Fisher was a professor of law at Harvard University, who suggested back in 1981 that they should implant the American nuclear codes in the heart of a volunteer. If the President wanted to press the big red button and kill hundreds of thousands of innocent people, then first he’d have to take a butcher’s knife and dig it out of the volunteer’s chest himself; so that he realizes what death actually means first-hand, and understands the implications of his actions. Because the President would never press the button if he had to do that.
“Similarly, you and your successor and their successors for ever more should have to work some shifts alongside junior doctors. Not the thing you already do, where a chief executive shows you round a brand-new ward that’s gleaming like a space station. No: palliate a cancer patient; watch a trauma victim have their leg amputated; deliver a dead baby. Because I defy any human being, even you, to know what the job really entails and question a single doctor’s motivation. If you knew, you would be applauding them, you’d be proud of them, you’d be humbled by them, and you’d be eternally grateful for everything they do.
“The way you treat junior doctors demonstrably doesn’t work. I strongly suggest you seek a second opinion.
‘Student nurses graduate with £54k of debt, shouldn’t we pay them a wage instead?’
The Government claims students are “supernumerary” and “not contracted to provide nursing care”.
Student nurses are the unseen workforce and vital to patient care.
While I am pleased for the thousands of students who will soon be starting their journey to become a registered nurse, it comes with a stark reminder.
In November 2015, ministers announced the NHS Student Bursary and tuition fee payment would be cut in a plan to increase the number of available student places.
Suffice to say, this hasn’t worked.
Instead, we have seen a consistent decline in the number of student nurses qualifying. Official figures from the Universities and Colleges Admissions Service (UCAS) show an overall decline in applications of 8% since 2015.
There is no debate that nurses need to be degree-level educated – but are student loans the best way to fill an ever-widing gap in our workforce?
The unseen workforce.
Student nurses are the unseen workforce and are sometimes vital to the delivery of safe, compassionate, person-centered care.
Completing over two-thousand hours of hand-on, direct clinical practice over three years – is it fair to ask them to accumulate up to £54,582 (plus 6.3% annual interest) of debt?
With a starting salary of £24,214, this is a debt the majority of nurses will never pay off.
The Government claims that because student nurses are “supernumerary” and “not contracted to provide nursing care” they need to be treated like all other higher education students.
While is it true that the Nursing and Midwifery Council (NMC) mandates that student nurses are considered ‘supernumerary’ – how realistic is this expectation? We hear stories of student nurses, trainee nursing associates and healthcare support workers being used to fill nurse staffing gaps on an almost daily basis.
A self-perpetuating cycle.
With an estimated 40,000 unfilled nursing vacancies in the NHS alone, health and social care services in England are stuck in a self-perpetuating cycle.
Chronic under-investment in services has led to an increased demand on staff and subsequently affected recruitment and retention rates. Universities then fail to recruit enough nurses to meet the current demand and so the cycle continues.
The Royal College of Nursing has called on the Government to invest at least £1b per year into nursing education and come up with a long-term plan after its plan to increase numbers has failed to work.
Matching the proposed apprentice wage while student nurses are on placement would go some way towards alleviating the financial burden the government has placed on student nurses.
A fresh start?
I’m excited and I’m nervous. I qualified as a nurse just 15 months ago. I left a career in IT of “quite a few years” – I decided I needed a fresh start.
Now I’m sat on a train heading to my first ever RCN Congress. I’m a voting delegate and will be honoured to carry that responsibility for my branch.
I’m also excited to finally be meeting people that I’ve solely (or mostly) only ever connected with online.
Finally, I’m looking forward to the various debates and resolutions. Listening to the speakers will further inform my views and I might even share a thought or two myself – fortunately speaking in public does not generally worry me (I’ll be the one with the ukulele).
A brief glance back to this time last year when certain “irregularities” were noticed by some members around the pay deal and communications regarding it.
The train of events that followed uncovered a number of poor practices regarding transparency and accountability and our current council were elected to address these.
I also mentioned I am nervous.
Recently, it has become clear that further “irregularities” have occurred – and questions will be asked.
Tomorrow morning is the Royal College of Nursing’s Annual General Meeting – an opportunity for members to ask questions. An opportunity for the council to demonstrate its commitment to openness, transparency, and accountability. An opportunity for a fresh start.
I genuinely hope the answers to the questions I raise are clear and dispel the concerns many of us have.
And if they don’t? Well, that’s why I’m nervous.
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