Today I March For You…

MarchPicWhat’s all the fuss about I hear you asking? Why did 20,000 doctors take to the streets of London on Saturday? Isn’t it all just about money? Is it because we don’t want to work weekends? Isn’t Jeremy Hunt promising us a 7 day NHS which can only be a good thing? Why aren’t doctors supporting that?

A lot has been said in the press over the past few weeks, and I feel compelled to offer my thoughts.

#SaveOurNHS

The NHS was founded in 1948. Its core principles are that it meets the needs of everyone, that it is free at the point of delivery and that it is based on clinical need regardless of a person’s ability to pay. Of course, a lot has changed since 1948… The UK population is growing year on year and so there are an ever increasing number of patients using the service. People are living longer, and their needs and demands on the system have become increasingly more complex. Advancements in technology mean we are diagnosing more diseases and much earlier, and treating them with more expensive drugs.

The Problem

Some argue that the NHS was never meant to offer the level of care that it does currently. It is no secret money is tight with many NHS trusts running at a loss. Over the past few years, since the change in the Health and Social Care Act in  2012 the NHS has undergone huge privatisation, with traditionally NHS contracts being offered to private companies. It is this fragmentation and privatisation of the NHS that worries doctors.

Why Attack Junior Doctors? What Have They Ever Done To Anyone?

Under the new contract, a normal working day will be from 7am-10pm Monday to Saturday. Currently junior doctors get a basic salary, around £23,000 in their first year of working, plus additional increments called banding depending on how many antisocial hours they work.  If the new contract goes ahead, it is likely junior doctors will take a pay cut of up to 30% for working the same, if not more hours. The government are also proposing to remove safeguards in place that exist to help prevent doctors working over their contracted hours by removing the financial penalties trusts have to pay.  It also penalizes doctors who want to carry out research, which is vital for finding new treatments and cures for cancer and other diseases.

Scotland and Wales are refusing to impose the new contract, and rightly so.

Why Does It Matter To Me?

Junior doctors need to be protected. They are ‘junior’ from the first day they qualify, up until the day before they become a consultant. This can take anywhere between 5-12 years, if not longer. They are not only our present, but our future. Your lives really are in their hands. Even if you are among the privileged few able to afford private health care, it is still your concern because even the most experienced of doctor, was still an NHS junior doctor at one time.

Isn’t It Still All About Money?

Most, myself included, view being a doctor as a huge privilege. We did not go in to this for money. Certainly, the level of debt, and hours we have to work wouldn’t make it worth our while if we were just doing it for the money. We fund all of our exams post qualification, we can miss Christmas’, our loved ones birthdays and sometimes even weddings because of the on-call rota, and we do it because we care about our patients.

But doctors also have families, bills and mortgages. If the contact is imposed, many simply won’t be able to afford to continue working as a doctor. A large number have already left seeking greener pastures abroad, with many others exploring their options. These are some of the brightest individuals the UK and it is a travesty they are being driven away. It isn’t about a 10% pay rise like the MP’s had, its about not giving them a 30% PAY CUT. So yes, maybe it is a little about the money, but I’m alright with that! But please remember, overall, what doctors are actually fighting for is patient safety #NotSafeNotFair.  We need a realistic service that works for everyone – not just the government.

I Want A 7 Day NHS?

There already is a 7 day NHS and doctors already work 24 hours a day, 7 days a week. We offer an on-call service at weekends, which means anyone that needs to see a doctor will be able to see one. Doctors are in full support of increased provisions at weekends, as long as they are properly staffed and properly funded. We aren’t entirely sure how this is going to happen safely within the time limits the Jeremy Hunt is proposing as there is already not enough money, hospital doctors and GPs to fully staff a 5 day service.

What Does It Mean For The Future?

Demoralised and devalued staff are not good for anyone. Under the new contract doctors will be spread even more thinly, working more hours and for less pay. Tired doctors make mistakes and it is our duty to protect them and ourselves.

The worry is that making the NHS unsafe in this way gives the government even more reason to further push private health care, by showing the public that it isn’t working in its current form. Don’t forget, private companies are already cherry picking the most lucrative NHS services, affording their shareholders huge profits.

Why All The Fuss?

If this continues doctors will leave the profession or move abroad. There won’t be enough doctors and other allied health professionals to staff the service and the NHS will become unsafe for patients. This means, in a few years sadly, you may have to pay to see your GP, pay for your life saving care and pay for all your medication. As will your grandparents and your children. As a doctor working in the private sector, I would likely get paid more, work less hours and have better working conditions. The 20,000 doctors who protested on Saturday are wholly aware of this, but they still marched for you! We need to protect them and our NHS.

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Staying Well: Stress… How it affects my body and how can I best manage it?

PriLakhani1Stress is a part of everyday life. A little bit of pressure can be a good thing to keep us motivated to get things done; too much however, and it can be a different story entirely. Stress is the feeling you get from being under too much mental or emotional pressure. Common causes include work, family, relationships, financial difficulties, unemployment and illness.

The stress response causes physical changes within our body as it releases hormones such as adrenaline and cortisol, triggering the ‘fight or flight’ response. This makes your heart beat faster, raises your blood pressure, makes you breathe faster and deeper so that you have an increase supply of oxygen, makes your muscles tighten up and causes a release of sugar into the bloodstream to give you a boost of energy.

All of this is excellent in the short term to help you up your game, but problems can arise when you are constantly stressed due to the continuous release of hormones. You can end up feeling tired all the time, not sleeping well, develop muscle aches and pains (usually back and neck) and suffer with headaches. You might also find that you have symptoms of acid reflux (heartburn) or get an upset stomach. Longer term, it can increase your risk of developing high blood pressure and heart disease.

You might notice that you keep getting ill, this is because cortisol and other hormones released over a continuous period of time can weaken your immune system. You also probably haven’t had enough time to rest. If you are feeling like this, listen to your body as it is trying to tell you something.

Being stressed can affect your mental health too. Emotionally you might find yourself withdrawing or feeling like you are walking around in a bit of a daze. Feeling like you are unable to cope is common, and you might even feel very anxious or depressed. It is important that you speak to your doctor if you are feeling like this, as they will be able to help.

The best way to deal with stress is to identify it early and make long term changes to the way you do things. Lets face it, you probably won’t be able to take away most of the things that make you stressed but you can ALWAYS deal with things in a better way.

First and foremost, try and avoid picking up (or returning to) bad habits like smoking, drinking excessive amounts of alcohol or using other recreational drugs. It might be tempting but it’s just not worth it, and in the long run you will end up feeling worse.

Exercise  – This might be difficult to fit in to your busy schedule, but try to get moving wherever and however you can. Exercise itself is known to relieve stress and it releases natural endorphins to make you feel more positive. It can help you to feel more focused, self confident and motivated and help improve your quality of sleep.

Eat well –  you are what you eat and it will affect how you feel. Try and avoid refined sugars, which are found in processed foods, as these can cause energy crashes that might leave you feeling unnecessarily tired and irritable. Opt instead for a handful of nuts, some dark chocolate or a banana. Avoid comfort eating – easier said than done I know! Try also cutting down your caffeine intake (although you might feel you need more of it) because it is a stimulant and can make your feeling of stress worse.

Take a step back and take control – When you can’t see the wood from the trees, stop for a moment and reassess. Make a list of what needs to be done and prioritise it in order of importance. Delegate where possible and set realistic goals. There’s no point in making yourself feel worse – so be true to yourself with what you can realistically achieve with the time that you have.

Work smarter not harder – keep this as your mantra – look at ways you can improve the way you do things to make you more efficient. Learn how to say ‘no’ tactfully – this may be difficult at first, but it will help to minimise situations where you agree to take on new roles or responsibilities when you already have too much to do and too little time to do it in.

Relax and / or Meditate – ok, it’s not for everyone, but whatever you want to call it, try and spend a few minutes a day reflecting inwards. This might be practicing a few breathing exercises or trying to focus your mind on clearing away any negative energy. Mindfulness really can help you a great deal in your day to day life.

Make time for your hobbies and friends – I really can’t stress this enough! Doing things that you enjoy will naturally make you feel better and offer a welcome distraction from everything else that might be going on. Just remember what I said about those bad habits – everything in moderation!

TALK ABOUT IT – a problem shared is definitely a problem halved. Talking to friends or family might be all you need to regroup and get going again. Sometimes though, you might feel totally overwhelmed or have found that talking to your support network hasn’t quite done the trick. Speak to your GP – they can help. They can offer support, and if needed, refer you for talking therapy such as cognitive behavioural therapy. This can help in identifying your stress triggers and give you techniques to deal with them in a better way. If needed, they can prescribe medication to help your symptoms.

Finally, remember life is short! Try and look on the bright side – stop worrying about the things you can’t control and focus on the positives, once you start looking, you will find them!