Sweating the assets

A friend of my family is due in hospital tomorrow, for a cataract operation. Had it been scheduled for today, the operation would have been cancelled, due to the junior doctors’ strike. I have mixed feelings about this. On the one hand, people do not fall ill to plan, and the risks associated with the lack of care available at weekends are surely unacceptable in a developed country like the U.K. Doctors’ protests about working at weekends only hold so much water when many other people work during those days, myself included, in many cases for lower pay and esteem than medics receive.

On the other hand, when one considers the hours already worked by junior doctors, they are one of the few professions to put even teachers in the shade. It equally cannot be right for patients to be treated by individuals so exhausted from long hours that they are barely rational. My family friend cannot afford to lose her sight as a result of errors made under such conditions.

It also not right that society should expect the cost of improved weekend care to be borne by those in the medical profession. As our great market society proclaims, if you want something, then you must be prepared to pay for it. Spending on healthcare in the U.K is lower as a share of national income than in many comparable countries; getting improvements on the cheap simply by worsening conditions for existing doctors is not acceptable.

Whether it be the demands for weekend working from medics, or the ever-increasing workloads of teachers and other public servants, the country needs to realise that it cannot have something for nothing, and attempting emotional blackmail is not the answer either. Those people often support society in ways far beyond the call of duty – and for none of the adulation or recompense received, for example, by certain recently-deceased pop stars.

I strongly support any drive to improve the quality if public services in the U.K., hopefully to the levels seen in many of our neighbours. I do my best, as do my colleagues, to deliver the best service we can under highly pressurised, under-resourced circumstances; we might be able to do better still if the constraints, particularly of time, were not so severe. But this cannot be done on a shoestring, relying on the sense of vocation of well-meaning individuals to pick up the tab, at the expense of their own lives and wellbeing and that of their families. This is something I am decreasingly willing to accept, and I support doctors in defending their own reasonable interests too.

In both medicine and education, this non-problem could be solved at a stroke – by recruiting more people to cover the extra work, in the process both reducing over-work (thus making it more possible to do the high-quality, considered work that society says it wants) – and reducing the disincentives for people to enter those professions in the first place.

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