Contribution
As always, it is a pleasure to serve under your chairship, Mrs Barker. I thank the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for setting the scene incredibly well. We all appreciate his in-depth portrayal of the issues. I thank him for his 40 years, as I understand, of service to the NHS. It probably does not seem that long but, on paper and statistically, it clearly is.
The hon. Member has forgotten more than I will ever know about the procedures, as I speak from a layman’s point of view. I can, however, outline what young doctors have told me, which certainly bears repeating. They work through their F1 and F2 years in fight-or-flight response. They work unsociable hours without a support network. They make life and death decisions, then return home from that night or day on duty and wonder whether they made the right decision. They wonder whether they missed something and they worry about their patients.
Doctors are empathic with their patients, they are compassionate and they understand the issues incredibly well. They follow shift patterns that on paper look like a different week but, in reality, they are working 80 hours over seven days. Off days on call keep them on tenterhooks waiting to know if they will be called in to do more work, which they will respond to out of duty and compassion. They are scheduled to finish work at 8 o’clock and on a regular basis they only leave at 9.30 pm. They start work before 8 am and take their first break at 2.45 pm, and that is not a one-off on a busy day—every day is a busy day. It is almost like “Groundhog Day”—that film where the alarm goes off at 6 am, he gets up, he does all the things, he goes back to bed and the next day starts the same—but for doctors, it is life and death.
When I asked how they function on that lack of sleep and sustenance, one 23-year-old doctor told me:
“I keep sweets in my pocket and pray for guidance.”
It needs to be more than that. I carry sweets in my pocket because, as a diabetic, if I feel myself going down, I have a chew on one and it brings me back up again, but for them, it is to ensure their concentration. Christians always pray for guidance in everything they do. They need wisdom in all the work that they do.
When I asked that 23-year-old doctor what was next for her in life, what she wanted to specialise in and what her hopes were for the future, she said:
“I am so exhausted that I don’t think anything is next.”
The exhaustion takes over. The workload is overwhelming. Put simply, she is burnt out and feels unsupported and uncertain—not because she is not a confident person, but because the workload and all that she has done have overtaken her. That is replicated numerous times, in too many doctors for us to attribute it to personality. It is not her personality, because she is a lovely young lady; it is the current procedure.
I am very pleased to see the Minister in his place. He has empathy and understanding of what we need for our doctors. I am confident that his reply will encourage and hearten us. Hopefully, it will also help with the expectations on young doctors from families and with the paperwork—that has never been more onerous, yet there is no time for them to set aside to do it because they are overwhelmed by the workload in wards and A&E and surgical work supporting doctors. If their placement is in a smaller hospital, they do not have the support of house doctors or consultants during evening shifts, and the pressure is immense. I said earlier that it is overwhelming, and it is, to the extent that they sometimes just say to themselves, “My goodness me, how am I going to keep going?”
We all understand that medicine, by its very nature, is highly pressured and that skills are learned not only in books, but in practice. For the junior doctors I met back home, it is a physical practice—they learn by what happens in the ward. Home-grown students are not being retained, however, so changes to the system must take place, and take place soon. In his introduction, the hon. Member for Bury St Edmunds and Stowmarket referred to one doctor who went from Norwich to Belfast and another who went from Belfast to Norwich. It is unreal, and it seems idiotic—I use that word in a very gentle way—that that should take place.
Training a doctor in the UK costs the taxpayer roughly £230,000 to £327,000 per student from medical school through foundation training. That is a big sum of money, but we are training someone on whom we depend to be the best in a critical situation in hospital. Who of us, when we have a chat with our doctor and ask for their opinion, will not accept what the doctor tells us as gospel? We trust that we can depend on that doctor’s diagnosis of the disease, so that money must result in qualified, capable doctors and not just young people who could have made a difference if they had been given the support and reasonable working hours with reasonable pay to make all the on-calls and missed sleeping patterns worth it.