'Patients deserve better'

Unite’s consultative ballot on industrial action over NHS pay in England closes on September 30. Each day this week, we’ll hear from a different member from our Unite health sector who explains why it’s so important to have your say on pay.

When Doctors in Unite (DiU) chair and London GP Jackie Applebee learned that she and her colleagues would be given another well below inflation wage increase this year, she was furious.

“Furious, but I can’t say I was a bit surprised,” she told UniteLive.

This would not be, after all, the first time doctors and their colleagues across the NHS have been dealt a slap in the face in terms of pay. Pay cuts and freezes in the health service have become a relentless feature of their jobs since as far back as 2008.

“When you take into account pay erosion over the last 15 years, we’ve actually suffered a 30 to 40 per cent cut in real-terms pay over that time,” Applebee said.

For her, this year’s 4.5 per cent offer to doctors is especially galling after they and other health workers were clapped every Thursday evening during the pandemic for their heroic efforts in combatting Covid-19.

“Politicians all came out and clapped for us and now they deliver a kick in the teeth like this,” she said.

Although the public clapping sessions have long stopped, the pandemic that first spurred them on is nowhere near finished.

“We’ve got an enormous amount of staff off sick from both Covid and long Covid,” Jackie explained. “Even before the pandemic we were dealing with huge GP shortages. In 2016, we were promised 5000 more GPs, and seven years later we actually have around 700 fewer. So we’re going into tackling the backlog created by the pandemic with our forces substantially depleted.”

This has meant that GPs’ jobs have never been more stressful, just as helping desperate patients has never been more difficult. Jackie told of how the huge backlog in care has meant that she and her colleagues are left inundated with extra work that has hampered their ability to carry out their normal duties.

“At the beginning of my day I look over the list of requests from patients and so many of them are queries from patients about hospital treatment – wondering why haven’t they heard from the hospital,” Jackie explained.

She recounted how one of her patients has been waiting for a knee replacement for an entire year.

“I don’t know how much longer he’s going to have to wait for,” she said. “He’s really struggling to walk. And it’s made him really depressed. So he’ll come and see me to talk about both his depression and how much pain he’s in. I’ll have to treat both his mental health and prescribe him painkillers. This type of work is taking up all our appointments.”

Jackie noted that younger GPs are especially struggling with the cost of living.

“Many of them have a significant amount of student debt that they’re having to pay off at the same time as they’re facing rising mortgage and rent payments, as well as skyrocketing energy bills,” she said. “I’m lucky that I’m toward the end of my career; I’ve paid off my mortgage and I went to university for free essentially – this is not the case for a significant proportion of younger GPs who I fear will simply leave the NHS at a time when they’ve never been more needed.”

Indeed, Jackie’s fears are already coming to pass, with a survey published in April showing one in six GPs under the age of 50 are planning to leave the NHS within the next five years. Overall, a third of GPs reported wanting to quit or retire within the next five years, with 61 per cent of doctors over the age of 50 saying they intend to leave. In this sense, what NHS workers on the front line are crying out for is not just more pay for its own sake but to ensure a future for a health service that is now on its knees.

Jackie warned that if an adequate pay settlement in addition to more funding for the NHS was not on the horizon, then general practice “is going to completely disappear as we know it”.

“General practice is already becoming transactional, and we’re going to lose all continuity of care because we simply don’t have enough GPs to do the work,” she said. “We’re going to have new models of care forced on us – and that’s not fair to patients or staff.”

She urged the government to listen to NHS staff on the front line.

“I call on the government to truly value general practice and to value the wider NHS. Pay us properly so that our pay keeps up with inflation at the very least,” she said. “We love our jobs, and we want to look after patients but NHS staff simply cannot do that when we’re burnt out, exhausted and can’t pay our bills. Patients deserve better.”

If you’re a Unite member working in the health sector in England, it’s not too late to vote in the consultative ballot on industrial action over NHS pay. You will have already received either an email notification or letter with a QR code to vote online. If you haven’t received either of these, you should speak to your rep in the first instance, or email [email protected] 

By Hajera Blagg