Sorry for imposing but EU see Bill, there are no Coincidences in Medicine

This post is really aimed at the non medical public. There is no point in reinventing the wheel. I came across a post on social media last night from my surgical consultant as a house officer. It summed up perfectly why not only the imposition but also the new junior doctor contract is unsafe for patients as well as doctors. More of that later.


Several of my non medical family and friends ask me what issues doctors have with the new changes. I try and tell them but feel there is a better way of putting it. Hopefully the post below explains it in a way that non medics can understand why we as a profession are united in preventing the imposition of this contract.


If you are non- medical and reading this, then take a moment to consider something.  A president is the leader of a country . The title “president” is sometimes used by extension for leaders of other groups, including corporate entities.  They are esteemed people, often experts in their field, who have been elected into office. They are highly regarded amongst their electorate and when they say something, people tend to listen and take notice. Now imagine if not one, but several, presidents all said the same thing. You’d think “Well they can’t all be wrong can they?”


That is exactly what has happened with the junior doctor contract. The majority, if not all, of the president’s of the  Medical, Surgical, Paediatric, Anaesthetic, Psychiatry and Emergency Medicine Royal Collages have come out and stated that this contract will lead to recruitment and retention difficulties in their specialities as well as leading to tired and overworked doctors, who will make mistakes. In the worst case scenario, these mistakes can lead to patients dying.

Not only that, Professor Don Berwick (an expert on patient safety, who David Cameron had asked to conduct a review into patient safety in 2013) has come out and said:

the NHS had a “demoralised” workforce and needed to find another way out of the “mess”.

Screen Shot 2016-02-24 at 19.43.01

I was at the tail end of working 100hr + weeks as a house officer. I wouldn’t want any junior doctor to go back to those days. I see the government are trying to push a working time directive (limitation) Bill which states that

the provisions in the EU Working Time Directive and the European Working Time Regulations 1998 shall not apply to  doctors and other health professionals

Another coincidence is that there will be a referendum on whether we leave the EU or not. If we do, the safeguards that the EWTD  put in place will disappear. That leaves NHS employers having the right to work doctors for more hours.

I have already noticed junior doctors morale declining particularly with the uncertainty of what will happen in August playing on their mind. Any way here’s the post I mentioned above:



well today the BMA announced three further emergency cover only strikes. Hardly surprising, but perhaps less severe than many of us thought. No full walk out. Yet.

No doubt they are keeping their powder dry, given the large hole the Gov has dug for itself since imposition. The BMA can always still escalate.

When he announced the imposition, that man said he had 20 senior Chief Exec signatories backing him on his actions.

From the day after almost all began publicly stating they had not signed up for imposition. I leave you to assess the implications of what he stated to be a fact.

We see the NHS facing its worst deficit (? Underfund) ever.

We see targets, for what they are worth, continually missed.

We see the BMA challenging the legality of the imposition. They would not do this without sound legal advice that the gov did not follow due process and the BMA have a case. Whoops!

We see a leaked document that says the data does not support the weekend effect to be due to reduced staffing. And we need thousands more doctors to produce a 7 day NHS.


Since even a neophyte doc takes 6 years to produce, and a consultant in my speciality a minimum of 16, that isn’t happening in this parliament.

We see a privately run service with allegedly poor outcomes.

We see ex gov advisors saying the gov should apologise to junior docs

We see all the Royal Medical Colleges condemning the imposition.

And along comes Europe.

Hunt said he wants, as far as junior docs are concerned, a cost neutral 7 day NHS or some such bollocks. Despite not clearly defining what this means.

The maths are so flawed my dog would laugh.

Clearly he can’t mean more docs doing elective weekends having been removed from weekdays. Because that is trying to make a 5 day elective service into 7. Leaving gaps in the week. The emergency service is already 7 days so he can’t mean that.

Which means There are only two ways.

More docs. But that has not been suggested and is not cost neutral.

Which leaves the same number of docs doing more hours for the same pay.


I am Not one for conspiracy theories. But the rushed imposition, referendum on EU and private members bill to exclude docs from the EWTD are amazingly fortunately juxtaposed in time.

We leave the EU or the bill goes through, there is no longer any legal limit on doctors hours, as far as I know.

Hey Presto. Potentially Back to the 100+ hour average weeks I did as a youngster.

Suddenly you have a cost neutral 7 day junior doctor NHS.

Albeit a very dangerous and unsustainable one.

To all junior docs: fight this tooth and nail. Our patients depend on it.

Thank you. That is all. For now.

Stuart Gould (General Surgery Consultant)


Imposition of a contract, EWTD BILL, EU Referendum…. Coincidence?

I hope this explains why the whole medical profession is against the government contracts and its not about money. Its about patient safety. Its about retaining and recruiting this country’s brightest and most talented individuals into a wonderful profession… the UK.



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