Ozva AdminQuit your job, leave the country, move to Australia. This may have once sounded like a hastily planned midlife crisis, but in 2023 these life plans are more representative of doctors across the country. Four in ten young doctors plan to leave the NHS as soon as they can find another job, according to a survey by the British Medical Association (BMA).
The survey asked more than 4,500 young doctors about their plans for the future. A third want to leave the country within the next year to work abroad, with Australia often being their number one destination. More than 80 per cent cited long-term pay cuts as the reason they wanted to leave the health service. A similar number referred to poor working conditions.
This follows a recent BMA survey of 3,819 young doctors in England, which found that 65 per cent of respondents have, over the past year, “actively researched” leaving their NHS jobs. Nearly 80 per cent of this cohort “often think about leaving the NHS”.
In a few weeks, the BMA will vote young doctors in England for industrial action. BMA Cymru has, in recent weeks, announced that young doctors in Wales are considering industrial action; while doctors in Scotland seek to vote for a strike in 2023. What would it take to prevent these strikes from continuing? Salary increases of 26 percent.
The health service would not be able to cope if so many doctors left the NHS to work abroad or in a different field of work, warned Professor Philip Banfield, BMA Council Chairman, in a New Year address to BMA members. . “We will not tolerate the chaos we face every day at work or acquiesce to those who seek to cut wages and reduce living standards.”
With clear routes out of the NHS to foreign health services, there has to be a certain level of commitment if we are to retain our medical workforce.
Asking for 26 percent is a hefty demand, especially when other public sector workers are on strike for much less, and their demands are still not being met. However, there is no question that doctors in the UK are not paid adequately for the hours they work. a recent BMA survey found that many have to cut back on food purchases and central heating while struggling to cover their own medical exams and student debt for insufficient wages. In Scotland, some junior doctors are paid a wage equivalent to £14 an hour, according to to Dr Chris Smith, Chairman of the BMA Scottish Committee for Young Doctors. In England, young doctors are believed to be paid even less than their Scottish counterparts, with many starting at around £29,000.
But sympathy for health workers is not universal. Health Secretary Steve Barclay has been accused of turning his back on striking staff, including nurses and ambulance drivers. Oliver Dowden told Laura Kuenssberg that the government was “determined” not to give in to nurses’ pay demands. Does the BMA think the government will really think differently if the doctors retire? Even shadow health secretary Wes Streeting accused the BMA of being ‘on another planet’, calling the union ‘hostile’ to the idea that patients should expect better standards from their doctors and health services.
Who will get away with it? After their first two years in the NHS, where they gain their full GMC record by working as base doctors, more and more doctors are simply deciding to pack their bags and move elsewhere. how i wrote recently, the UK provided Australia with 13 per cent of its GPs and 22 per cent of its specialists in 2011. There was a 17 per cent increase in the number of UK doctors working in Australia and New Zealand between 2014 and 2016. Today, the pattern continues, with disastrous effect across the UK. This afternoon, BMA Scotland Chairman Dr Iain Kennedy warned that the NHS in Scotland is in crisis, saying: “The workforce in the NHS in Scotland is simply too small.”
Australian cities like Melbourne, Brisbane and Sydney offer a more relaxed working environment, with better hours and better to pay. It’s not necessarily a simple move though, as visa applications and registration with Australian health authorities can slow down the process. Not to mention, the Australian government outlined plans to reduce the number of foreign doctors coming to work in primary care by 10 per cent in 2019, to ensure Australian-trained medical graduates have more opportunities. However, that has not deterred doctors from making plans to substitute or apply for specialized jobs abroad.
A junior doctor who was nearing the end of his basic program in the UK told me that they were planning to move to Australia. ‘He offers the opportunity to work abroad in a healthcare system that doesn’t fail and to work within a rotation that doesn’t depend on dumb hours. Even if I didn’t go to Australia, I wouldn’t work for the NHS. I would work as a substitute, to receive a better and fairer payment, by work shifts.
Another doctor nearing the end of his basic training said: “Going to Australia means more flexible working hours, a better work-life balance, better pay and ultimately a better lifestyle.” The UK system feels broken. Urgent and emergency services are overwhelmed, there is no hospital bed capacity and, ultimately, this leads to compromised patient care. When you work inside all of this and still face a real pay cut, the job here is no longer worth it.’
A Health Education England paper detailing ‘F2 destinations’, where junior doctors end up after finishing the second year of their basic programme, provides data to show this change in behaviour, from 2011 to 2019. It found that there has been ‘a steady decline in doctors intending to progress directly into UK specialist training, from 71.6% in 2011 to 34.9% in 2019. In 2011, 74% of F2 doctors planned to remain in the NHS; in 2019, this dropped to 57.4 percent. And while in 2011 only 0.1% of F2 doctors decided not to practice medicine, this number rose to 0.5% in 2019 who had chosen to leave the profession.
Is it true that being too harsh on the salary demands of young doctors can simply lead to a mass exodus? Quite possibly. But is a 26 percent pay increase really feasible right now? That is less certain. It is more likely that if serious salary negotiations are started, doctors will settle for a little less. A number told me that they would happily take 20 percent. But this still requires a significant move by the government. With young doctors in the UK feeling undervalued and stressed, and with clear routes from the NHS to overseas health services, there has to be some level of commitment if we are to retain our medical workforce.
Ozva Admin
