As junior doctors in England take to the picket line on Friday morning, thousands of them will have been in their roles since only last week after finishing medical school. Now in their first year of foundation training, they will be ending their working week by hanging up their stethoscopes and picking up a placard.
The strike is the fifth round of industrial action organised by the British Medical Association (BMA) and is scheduled to run for four full days from 7am amid the bitter dispute with the government over pay.
Going on strike so soon into a new role is intimidating. Omolara Akinnawonu, a first-year junior doctor in eastern England, describes a fear of backlash among many new starters in this “extraordinary” situation. “It’s difficult, so early in your career, having only worked seven days, to be thinking of going on strike. In the first couple of weeks you’re trying to make a good impression on your team, and being labelled as a ‘striker’ can be difficult.”
Financial anxieties also weigh on many of the new starters, who will not receive their first paychecks until the end of August. “You haven’t received an NHS bursary or maintenance loan since April, so you’re digging into your overdraft more than you’d like to,” Akinnawonu says. “The first paycheck is just covering the debt you’ve incurred over the past couple of months; it’s not actually something you can live off. We sort of graduated at the back foot and to arrive finally as a doctor, to not receive a fair salary is not fair.”
A first-year junior doctor in southern England, who did not want to be named, agreed that it was a difficult time to start in the role: “You want to create a good reputation for yourself, you really want that first paycheck, you want to help patients, and your union is telling you to go on the picket line.”
She has more than £100,000 in student debt, and will receive the basic hourly pay rate for junior doctors of £14.09. To minimise expenses, she has been cutting her own hair and buying clothes from charity shops. “You would have thought a doctor with two degrees could have her hair done, but it’s a long slog until you get your first paycheck.”
“Rent has gone up, the cost of living has gone up, and pay has not gone up,” she adds. “It’s a really difficult time for unions to ask us to strike. I 100% support it and will be striking, even though I will struggle [financially]. It’s more important I do this for my future colleagues, to ensure they get better pay.”
The government, accepting the recommendations of the Review Body on Doctors’ and Dentists’ Remuneration, announced a final offer last month of a 6% pay increase for doctors, but stated that departments must use their existing budgets to fund the pay rises. The BMA rejected the offer, with the chair of the union’s council, Prof Philip Banfield, saying it failed to address “a decade’s worth of sub-inflation pay awards”.
On 26 July, the BMA junior doctors’ committee announced the new strike action, from 11 August to 15 August.
Many first-year doctors witnessed the strikes this year while in their final year of medical school. Tom, a first-year doctor working in oncology in West Yorkshire, was hoping that industrial action would end before he started working. He describes feelings of guilt for going on strike so soon into his career. “It’s hard making a decision which does impact on patients’ care. We see a lot of the suffering first-hand now.
“A lot of people have already been let down by long waiting times, and it makes it difficult to make a decision which would contribute more to this, although that’s just as much the government’s responsibility as it is ours.”
Akinnawonu says she feels “daunted” yet “hopeful” about the strike. “This new generation of junior doctors are going to inject new momentum into the movement, and bring fresh energy. We’ve not been touched yet by burnout, and we’re not in the same headspace as many of our colleagues. We now have the responsibility to take up the mantle and strike hard for a 35% pay restoration.”