Ruchi Dhir: The Impact of the Junior Doctor Contract

Busy enough with her own business and staff contracts, Ruchi Dhir never thought she would become preoccupied with the NHS Junior doctors contract. How wrong was she…

When her younger brother, an orthopaedic surgeon in London, became actively involved in speaking out about the dangers to the patient safety of the contract in 2016 and 2017 she couldn’t help but get involved. As a layperson, she had taken the level of care we receive in this country as a given.

Ruchi found her brother’s explanations of the dangers of the new contract, including removing whistleblowing protection, the impact on recruitment and retention of doctors and risks of privatisation too complicated to understand. This was before she applied her own experiences of getting medical attention abroad and the challenges encountered despite having full travel, medical and health insurance.

What does Ruchi Dhir think of the junior doctor’s contract?

The junior doctor’s contract dispute landed on her doorstep which meant she made an effort to understand it. There were primarily two main areas that concerned her:

The quality controls currently in place in the NHS would not necessarily be there after privatisation and affordability. Although she had been lucky enough to afford medical insurance so far with no guarantee for the rest of her life, privatising the NHS meant that it would no longer be universal and affordable to the majority of people.

Ruchi had also accompanied family and friends when they had been sick in Germany, Cuba, America, China and India. They were exposed to the emergency medical services there who were also thoroughly medically insured and witnessed how the quality of medical attention was not guaranteed.

Ruchi helped her brother prepare for interviews online and became actively involved supporting junior doctors who resisted the contract. She campaigned with doctors, leafleting and talking to members of the public sharing her experiences as a layperson and how it was possible to overlook the high-quality and efficiency of care we receive in this country when you haven’t experienced alternatives in other countries.

She found it hard to contribute to the conversation and respond to people’s questions and concerns, so she drew from her own experiences of medicine abroad:

Medicine in India

In 2011 when her maternal grandmother was admitted to hospital in India, she flew out to India with her family to spend what she thought would be the last few weeks of her grandmother’s life with her. In India, despite it having an image in the West of a third world country, Indian hospitals have extensive facilities and doctors and nurses are of a high calibre. However, many of the best hospitals are extensively privately run, and medicine is very much a business

While her family were willing to spend what it took to treat her grandmother, Ruchi observed that, at a very stressful time for them, the care her grandmother received was highly dependent on money received at the hospital.

The impression she received was that, even with enough money and insurance, when medicine became a business, patient care came second. And, it seemed, so long as the doctors and nurses worked to please the hospital owners, some of their practices were overlooked.

Medicine in America

In America when her mother suffered an abscess in her mouth, the family were quoted around 1000USD for a dentist to attend to her at the hotel. This was with travel insurance. Although her brother was qualified to know what his mother needed, the doctor would not accept his advice on prescription. Again, it was a tightly run business.

Medicine in China

In China, when her sister contracted pneumonia, although she had full medical and travel insurance, there was the fear in every hospital attended of trust and that the best care or options were being given to her sister. It was again a task of speaking to as many people as possible who she could trust to ask for recommendations of hospitals or doctors who were reliable and trustworthy and going by those recommendations. It made no difference as to how good the medical or travel insurance taken out was; she was still at the mercy of the medical system in whichever country she travelled or stayed.

Conclusion

And so, when the junior doctor’s contract began to be debated fiercely in the media, it was from her experience of medical systems and access to medical systems abroad that she gained greater empathy and understanding for their arguments. It was, as she saw it, a tremendous privilege and comfort that, in the UK, medicine was still not entirely viewed as a business by the doctors, nurses and institutions tasked with care for the wider public. The boon of free healthcare, available to all regardless of wealth or social status is also something that Ruchi felt should be treasured.

It was clear that access to care and medical attention from trained doctors and nurses with good intentions for the patient was not a given. It was part of the medical culture of this country which needed to be understood and protected. It appeared lost on the many voices on talk shows and represented in the media who seemed to have no experience of requiring medical attention abroad and the risks that were often involved even when fully insured. There was an attitude cultivated amongst medically trained people in this country, due to widespread access to the NHS for all people, that they were there to serve and do the best for their patients. Ruchi Dhir could see that this was something that would die out if people didn’t fight to protect it.

So just keeping informed by talking to doctors instead of relying on social media gave Ruchi Dhir insight which raised her awareness and, in turn, helped her raise awareness amongst friends and family.

Even recently amidst Storm Emma and the Beast from the East, NHS workers would forsake leave and time off and sleep overnight in hospitals or work extended hours to provide care for people at such a critical time. This has become something of a norm for medically trained people in this country.

It is the genuine and sincere motivation of these highly skilled people that are unique to this country and should not be lost chasing an idea of mass privatisation which often requires the people who work to lose their humanitarian connection to the people they are serving.