Monday, November 20News For London

With changes to contracts, junior doctors are threatening to leave the UK, but what is the consensus?

As Jeremy Hunt imposes new contracts of employment onto junior doctors, there is talk of many of them leaving the NHS to work overseas. Westminster World investigates the benefits and drawbacks of such a decision.

Breathing heavily and slowly, as if through a straw, Josephine doubles over on the bed, fighting for her final few breaths.

Uncomfortable and terrified, the 76 year-old squeezes her daughter’s hand as she desperately tries to draw oxygen in through her mask.

A young man stands at the bedside, hand on her shoulder, tears rolling off his chiselled jaw. Jack is a junior doctor. It’s 4am and Josephine’s bed is one of more than 60 he is responsible for tonight, along with just one other doctor.

Josephine’s chronic lung disease has stiffened her lungs and filling them with oxygen is becoming impossible. Jack has tried to make her as comfortable as possible.

Five nurses on other wards have bleeped his pager, asking him to assess other patients. He has been awake for 19 hours and he can’t formulate a clear thought or plan.

This is the NHS Jack remembers: stressful, stretched and broken. An uncountable number of sleepless nights and one mental breakdown later, Jack packed his bags and went to work as a radiologist in Australia.

Infographic created by Charlotte Staley. data taken from the Financial Times and Business Insider Australia (2016)
Infographic created by Charlotte Staley. data taken from the Financial Times and Business Insider Australia (2016)

Jack now earns almost triple what he would be earning in the UK, and tells me his cost-of-living is less than half of that when he was in London. He says he is far more relaxed, optimistic and the happiest he can ever remember being.

But at what cost to the British taxpayer?

According to the BMA, it costs the taxpayer a quarter of a million pounds to train an NHS doctor, and the number of NHS doctors applying to work abroad surged by 1,000 percent on the day that Jeremy Hunt imposed the news contracts.

But despite these rising figures, the BMA found that, of these applicants, as many as 30 per cent will not end up leaving and the fact remains that the overwhelming majority of UK doctors are choosing to remain in the NHS.

Infographic created by Charlotte Staley. Data from BMJ Careers Sept 2015 (30,000 doctors surveyed)

Infographic created by Charlotte Staley. Data from BMJ Careers Sept 2015 (30,000 doctors surveyed)
Infographic created by Charlotte Staley. Data from BMJ Careers Sept 2015 (30,000 doctors surveyed)

Dr Lucy Beale is 26. After completing her mandatory training in the UK she looked into a life overseas. “The work load just keeps on increasing,” she told Westminster World. “It’s very stressful, and my work life balance is certainly not what I’d hoped. But at the end of the day I love the NHS. I love my patients and I love my job. I trained as a doctor to help those in need, not to make money and have a big swimming pool in the sun.”

Dr Owen Alexander and his wife Helen, a nurse, left the UK in 2008 to work in a hospital in the US. “We were paid a lot more money, yes. But money isn’t everything to us. The culture is completely different and the private culture of medicine in America compromises good care and medical ethics, from what we’ve seen.” Since returning in 2014, Owen and Helen say they’re much happier back in the UK.

So for those still applying to leave, how easy is it to work as a doctor overseas?

Dr Tom Leach is the founder of almostadoctor.com, a popular advice website, app and blog used by millions of medical students and junior doctors. Speaking to Westminster World, Dr. Leach explained: “It really depends on which country you’re applying to. America and New Zealand are relatively easy. Applications take less than a year and the NHS training is regarded very highly out there.”

“America is another story. You have to sit a very expensive, very difficult set of examinations and there’s no guarantee of a job once you pass them. Those offering junior doctor level jobs tend to favour American-trained graduates.”

“Most European countries fall somewhere in the centre of this scale.”

The trend of doctors applying to work abroad en masse has been seen before. With an average, fully trained, senior doctor in Italy earning as little as half what the equivilent doctor would earn in the UK, for many years it has been common to save up and sit the American medical examinations, and yet still, the majority of Italian doctors remain in Italy and work for the

Yet with British medical schools still receiving more than 10 applicants per place, perhaps filling the medical schools, and subsequently the junior doctor workforce, with those happy to work for less money would provide a more economical service and cut government spending on healthcare.

 

Subeditor: David Gregg