Maria Vittoria Capanna remembers the terror of her first shift as a junior doctor in a London hospital.
“It was like, ‘right go’ and suddenly I was on call. I cried in a little broom cupboard as the registrar was off sick and they hadn’t taught me how to bleep anyone. We all laugh about it, but it’s really not funny at all if a patient gets very sick or something goes wrong.”
While years of experience have made her shifts a slightly less frightening experience, the sense that junior doctors should “grit their teeth and bare it” in times of mental distress has endured.
It is a feeling shared by tens of thousands of junior doctors in the British Medical Association (BMA) who have voted for strike action in the past six weeks – the largest mandate in the union’s 190-year history. Nurses, paramedics and physiotherapists are also involved in ongoing industrial action.
Maria, a local BMA representative, says the strikes represent a “pivotal” moment for the NHS.
“For me and my colleagues, pay is the tangible thing you can strike about but the issues are so much larger and have been drawn out for so long.
“You feel like you are just a number and as if your feelings and wellbeing don’t matter. The slow erosion of what it means to be a doctor and how you’re valued in society and the workplace have made many of us feel disillusioned.”
This sense of frustration around the wellbeing of junior doctors began early on in her career, she says.
“The ‘feel free to cope’ approach is really traumatic for so many of us. I love my job but I look at how bosses in other professions take their employees out for lunch to thank them, or even just say ‘well done’ at the right time, whereas I feel like I give 100 per cent and all I get back is more work and more problems.
“You watch your colleagues crumble and think, how long can I accommodate this broken system without breaking down myself?”
The BMA have demanded a pay rise of 26 per cent which they claim is needed to restore years of pay erosion. Ministers have branded the demand “unrealistic and unaffordable”, though other health unions with double-digit pay demands - such as the Royal College of Nursing (RCN) – have indicated they would be willing to settle for a lower figure.
Training to be a doctor does not come cheap. Six years of medical school accrues student debt of well over £50,000 and there are additional mandatory costs, such as Royal College exams, licence to practise fees and even hospital car parking.
A Foundation Year 1 doctor earns just over £29,000 per year, rising to £34,000 a year later and up to £53,000 during specialist training.
You watch your colleagues crumble and think, how long can I accommodate this broken system without breaking down myself?
With inflation running at 10.1 per cent, Maria says that many junior doctors have been forced to pick up extra locum shifts to pay bills. But in London, locum pay rates have been capped – leaving medics putting in extra hours for what Maria calls “insulting” pay.
“It leaves you torn between getting more money if you need it but at the cost of burnout by doing extra work. The pay is terrible so it is a tricky situation, but a lot of people end up doing these shifts out of desperation.
“People might say that ‘greedy doctors just want more money’ but it’s not that at all. We just want to be compensated for inflation, it’s not a massive ask.”
The strike comes amid unpredented pressure on the NHS, with record waits for treatment in A&E during the winter and over 7.2 million people on the waiting list.
Maria says that the Covid-19 pandemic pushed many junior doctors over the edge.
“These problems existed a long time before the pandemic but, afterwards, the lack of human consideration for doctors was absurd. We were struggling to get masks and PPE…. How can you treat your workers like that and not expect them to be angry? It’s baffling.”
Civil servants will meet with the BMA on Wednesday afternoon to discuss forthcoming strike action. While officials are currently locked in talks with the Royal College of Nursing (RCN) over a possible pay deal, it is not clear if this will impact the BMA’s dispute.
With no obvious resolution in sight in the near future, Maria says many junior doctors are reluctantly bracing for months of industrial action.
“I don’t want to go on strike, I like my clinic and my job. But at some point there has to be a line – the NHS can’t run on good will forever.”
