An Open Letter to the Secretary of State for Health

Dear Sir

As a Consultant Cardiothoracic Surgeon some of my peers may feel that my wading into the Junior Contract row is inappropriate, and that maybe, just maybe I should leave the Junior Doctors to fight their own battles; which, I might add, they are doing ably; fighting a fair fight, garnering public sympathy and, as ever, putting the safety of patients first.

That said I am nothing if not forthright with my views and given my current role as a Clinical Lead in a busy and over stretched Emergency Department, and the very obvious truth that I too was a Junior Doctor once, I feel absolutely compelled to put pen to paper.

The Junior Contract issue, is, of course, one of great complexity. As someone who has worked at Board level, I understand budgets, I understand the need for accountability and I appreciate that from time to time, costs have to be cut, but my question to you is this. When does the need to balance the books come at the cost of human lives?

Because, if we take this issue at face value, cut away the spin and the Moet Medic smears, the preservation of human life is the real crux of the issue. At least it is for those of us on the front line.

Junior Doctors have always worked long hours. That is not being disputed by anyone, least of all this Senior Doctor who remembers the exhaustion and fleeting moments of sleep caught in on call rooms only too well, but the new measures are draconian and are going to result in our Junior colleagues, our bright stars, our Consultants of tomorrow burning out before they have even really got started.

These Doctors might be mere numbers to you; a drain on the economy; leeches who are more interested in the salary that they will be bringing home than the vocation they have chosen to undertake, but I work alongside them every day, and I can't stress enough that those sweeping statements could not be further from the truth.

These are people who care deeply about the patients in their care and who still, in the face of increasing pressure and the threat of the new contract over their heads, quite simply could not give anymore.

You forget, that whilst they are battling you, they are also dealing with life and death situations on a day to day basis. I know from personal experience that every patient who walks, limps or is wheeled through our doors leaves an indelible mark on at least one if not all of us. I have been there; I have cradled the body of a 17 year old girl who died in my arms following a stabbing within the walls of my department, I have cried silent tears for the pensioner who presented with signs of physical abuse inflicted in their care home, I have held sobbing relative after sobbing relative in the moments after they have discovered their loved ones have not made it. You no doubt think that we get used to it, go home at night and sip Moet from our well stocked champagne fridge and move on? Let me tell you something, we do not.

Because we care; We want to give our patients all we have. Our Junior Doctors want to give their patients all they have. How are they meant to do that when they are running on empty?

Just last week, I watched a talented, caring Registrar (for they too are Junior Doctors – you do not always make that particularly clear in your spin) teeter on the brink; a brink your budget cuts had pushed him to. This is a Junior Doctor who could not care more, who could not give more, but had through significant understaffing, the pressures that the four hour target brings and general bad luck, missed something. He got it wrong.

Was it his fault? No. It could not have been less his fault. He was doing his job, juggling patients, trying to be all things to everybody, and doing it whilst clutching a can of Red Bull because he was exhausted. Because he was doubting himself.

And you want to make it worse?!

I was as delighted as anyone when the second strike was averted and you went back to the table with the union. An ongoing dialogue is good. That said though, if talks collapse again and if further strike action is needed, I will support my Juniors Doctors 100%, even if - in a worst case scenario - it takes the form of a full walk out and their absence brings our department to it's knees. To do anything less would be doing our patients both present and future a disservice, and as I have already stressed so many times, putting them at risk.

I am one voice, but I fear for an NHS where the Junior Contract sets the precedent. I am also a voice of experience, knowledge and understanding.

My name is Constance Beauchamp. I was a Junior Doctor.

Thank you for your attention.

Yours sincerely

Mrs C Beauchamp, MBBS, MS, FRCS (CTh) FETCS

Clinical Lead, Holby City Hospital Emergency Department