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#studentviews: How can young doctors be discouraged from leaving the NHS?

With many junior doctors leaving the NHS workforce to pursue careers elsewhere, staff shortages look likely to worsen over the coming months. Short of meeting unions’ wage demands, improvements in working conditions could make some contribution to addressing this challenge.

Many trainee doctors leave the NHS after their initial two years of training. Some do so on a plane in search of better working conditions abroad.

Stopping this ‘brain drain’ should be a no-brainer for policy-makers. The migration of valuable workers has a negative effect on the nation’s productivity, limiting economic growth. The loss is twofold: with trained doctors fleeing or striking, ill workers in other sectors are stuck on hospital waiting lists, unable to work to the best of their ability or even at all.

The UK has seen major disruptions in the NHS, with doctors taking frequent industrial action. The total of rescheduled appointments and procedures over the eight months of strikes now stands at 839,327. The NHS waiting list has reached record length, directly affecting the labour market. According to the British Medical Association, the backlog now stands at 7.2 million people needing medical care. Data show that 20% of workers have had to reduce their working hours while awaiting treatment.

It is clear that something needs to change. Junior doctors deserve higher pay, with this group having seen an 8% fall in their real wages over the past 11 years. But are there simpler solutions to show doctors that they are appreciated? Something needs to be done to get them back into hospitals while wage disputes continue.

Many people are unaware just how difficult a day in the life of a junior doctor is – and how easily change could be implemented to reduce the challenges they face. After speaking to Peggy, a doctor who has recently finished her second year of foundation training, it is clear that she is utterly fed up. Peggy highlighted the experiences that made her job difficult, noting small things that leave her feeling ‘de-humanised’ at work.

It is important to think what anyone would want when working a 12-hour night shift. Basics should be hot food and a bed? These are not currently offered. Changing facilities and easy access to wards? Not available. Free parking? Instead, this costs staff members £26 per month.

Small things can go a long way. Peggy’s hospital management demonstrated that they were aware of this. When consultants were covering the junior doctors’ shifts due to strikes, all these amenities appeared to be available. There was suddenly an empty day ward that would be perfect for the consultants to rest their eyes on fresh linens. The consultants were provided with free food and more than adequate pay, with some being paid £200 an hour.

But when the junior doctors came back the next day, the ward was locked, and all the basic amenities were taken away. So, Peggy trudged back to the common room where she ate a cereal bar for her dinner and attempted to sleep in a chair, feeling truly disillusioned.

It will come as no surprise that Peggy doesn’t plan on staying as a junior doctor in the UK. Instead, she has a job waiting for her in Brisbane. And she won’t be migrating alone: 12 out of 14 of her university friends already have jobs lined up down under. They are moving for the simple reason of wellbeing. In Australia, they will have to work fewer hours (decreasing from 48 hours, plus unpaid overtime, to 38 hours per week).

This mass migration is what economists call brain drain: the emigration of highly skilled and educated individuals, such as doctors, from one country or region to another. Healthcare professionals are leaving England in search of better compensation and working conditions.

This phenomenon affects the economy in a range of ways. The government invests heavily in the training of doctors and nurses. By losing them to other countries, they never reap the rewards, furthering the negative impact on national productivity (a measure of how efficiently the population works, which is a key driver of economic growth).

A productive nation means creation and innovation occur every day, meaning higher wages and a better standard of living. In an economy rocked by the Covid-19 pandemic, growth is more important than ever.

So, things need to change. The main problem is a failure of management, causing widespread disillusionment, particularly among the younger members of the NHS workforce. There are major changes that need to be implemented in the allocation of shifts and wellbeing support. But before these reforms, it would be easy to make small changes that can make a big difference to staff wellbeing.

Providing junior doctors with spaces to rest, change and eat sound simple, but they could have a huge impact on staff retention. There could also be wider economic effects. Having a happier, more productive NHS will help to shorten waiting lists and make the whole country more productive, promoting post-pandemic economic growth.

Author: Beth Spooner
Editor’s note: This article is from the University of Bristol’s communicating economics class of 2023-24.
Picture by janecampbell21 on iStock
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