Dear Mr Tugendhat
I read with great concern your article in today’s Daily Telegraph. I note your conflict of interest, that you were in the army for several years, and so I’ll state mine at the start of my letter; I am a doctor, and have been fully qualified for 8 years, having been at medical school for 6 before then.
You stated in your article that it costs £500,000 to train a GP and £750,000 to train a hospital consultant. I would be grateful if you could furnish me, or better yet, publish for the public, your references for this claim. The BMA press release ‘How much does it cost to train a doctor in the United Kingdom’ states that the total training for a GP is £498, 489 and for a consultant £564, 112, but in addition to taking into account the cost for medical school placements (£151,792) it also seems to include the student loan payments of £57,433 (paid for by the individual) and accommodation costs (paid for by the individual). Does it include salary too?
I’ve had a look through your twitter feed. You seem like a reasonable man, and I’m sure a lot of this is a misunderstanding, but your misunderstanding seems to be part of a larger plan to discredit the doctors without whom the NHS would collapse. I can’t help but notice it comes at a time when your colleague Mr Hunt is attempting to negotiate a pay cut and there are widespread concerns about the longevity of the NHS.
You compare getting a medical education to receiving training in the army. True, skilled professionals are the outcome of both. However, in the army, university fees are paid, as is a bursary of £10,000 per year along with a lump sum upon graduation. After 8 years of qualification, I have only just finished repaying my student loan; given the increased loan repayments of £9000 per year plus living costs, there is slim chance of repaying the debt before retirement for the current cohort of graduates. Furthermore, the pay for newly qualified doctors in the military is inflated (regardless of hours worked) to the maximum pay available for junior doctors according to the banding process currently in place: yes, these people are required to remain in service for 4 years, but there is significant financial compensation for this, and significantly more than for non-military trainees.
Perhaps, rather than tarring us with the brush of ungrateful deserters, you should look instead at the reasons behind droves of medical and nursing professionals leaving the country.
As I said before, I have been qualified for 8 years, and am a haematology registrar. I am passionate about the NHS, and my reason for staying in the UK is the belief that healthcare should be free at the point of use, and members of the public should not be penalised for illness or injury. However, it has not been an easy decision to stay.
I have been kicked, bitten, sworn at. I have received needlestick injuries with the consequent worries of viral transmission, thankfully unfounded. I have laughed with patients, held their hands as they have learned devastating news, been party to the best and worst times of their lives. I wouldn’t trade that for the world, it is a great privilege, and I am good at my job.
It is a real kick in the metaphorical teeth, therefore, to have someone like you with limited experience of the NHS from the coal face turn around and question our dedication. We have been treated badly by the government. We are unsure of our future, how our job plans will work, what our salaries are, whether we will even be able to become consultants any more. We have been told countless times by the government and the media that we are lazy and greedy, and whilst that is not true, the public will believe that it is.
So why should people stay in the UK when they are treated like this?
There are a lot of reasons for people to leave. Travel broadens the mind, they say; I have learnt more moving around the UK than I would have staying in one place, and travelling abroad will improve skills of the doctors and nurses who do so – it’s your job not to stop them from doing this, but to ensure that they want to return.
People leave for other reasons too. Perhaps they are not happy, perhaps they are clinically depressed. Do you want someone who is desperately unhappy to be making life and death decisions on your behalf? More significantly, do you want someone who is clinically depressed taking their own life, as they have no way to pay the no doubt exorbitant fees demanded to leave the NHS. Please don’t tell me that people with psychiatric illnesses will be exempt from this: as a profession we have the second highest suicide rate; seeking professional help is rarely in our remit.
Other people leave to raise a family: are you taxing now the right to a family life?
Please Mr Tugendhat, get your facts straight before writing a damaging piece like this. We are tired, we are stressed, and we don’t have a government we can trust in any more. If you and your colleagues continue in this vein, you may well succeed in privatising the NHS. But I’m not sure you’ll have anyone to work in the British Health Service any more.
ST5 Haematology Registrar