Blog Action Day 2008. Dr Poverty

Medical Establishment
A Direct Cause of Poverty in Junior Doctors

I believe I have hated poverty since I was a child. This social class structure that money creates has irritated me. Life for me has always been difficult and I have no idea why. Social Class and breeding is of course the key to social success.

I believe I seemed to have climbed the ladder then subsequently challenged it. There are themes during my blogs where I find it important to challenge the upper classes. I wasn't your average rich person's child who went to all the best schools and mixed with all the richest people. My father was disabled for many years and I worked bloody hard through school and medical school. Mentally, this is probably why I have always been frugal and actually need relatively little.

There is one interesting issue you learn out of poverty - that is, you never give up. It increases your stamina to work faster and harder than many people. The second issue is this, when everything is taken away from you, you don't feel loss as much as everyone else. The other good thing about experiencing poverty as a doctor is that the social management of patients' requirements becomes considerably easier.

So yes, I know what it is like to sleep at Fitzroy Square under the stars overnight in the dead of winter as a medical student because my grant was too late. I know what it is like to shiver in the cold and I know what it is like to have no food for many days. I also know what it is like to hide your torn clothes strategically under your winter coat. When you have experienced poverty of that sort, you are simply grateful for the basics of humanity. I went to medical school in London and often when I return there, it gives me the haunting memories of the endless poverty I experienced. While I struggled with basics, my richer colleagues were out at parties and buying their makeup at Oxford Street. The shocking issue about University College London is that the tutors never understood poverty. I found it tiresome to explain my plight to a doctor who sat opposite me looking down on me while wearing a Saville Row suit. In the end, I just suffered it until I qualified. After qualification a different kind of poverty begins, the poverty caused by the payment of your loans by the blood and sweat of oncalls.

The medical profession really is about social class, about upbringing and about the acceptance of the elite. It also causes the destruction of those who do not have the etiquette or the style to wallow in the niceties that drives high medical society. These difference also exist when doctors manage patients and results in communication problems.

Those who have been born with a silver spoon in their mouth -or in [BMJ Editor] Fiona Godlee's case - "a golden spoon", find it difficult to understand what real people want or need. Poverty becomes a "intellectual debate".

To people like her, intellectual debate and social acceptance is the done thing. It is the sort of pointless debate/discussion people have at the dinner table with a rather clipped accent over a bottle of wine while smoking large panama cigars. The sneering arrogance of looking down on others who have fallen down the social ladder [ or their perception of a fall from social grace] and the belief that they are somehow better than all of us because they have all the social graces. In the end, the elite of the medical profession and those who are stupid enough to join it wallow in control and power. "Money is apparently power", said one GMC committee member a few years ago. There is a misconceived idea that if you don't have money or class, you are somehow intellectually inferior. I find this class issue is often the case when dealing with lawyers. The I have often been of the view that - anyone can read a law book.

To a certain extent, this is the reason the Deaneries or the General Medical Council fail to accept random expletives from the working class Dr Scott Jnr. Essentially, this is all about social class, the " done thing", the way one is supposed to behave in an establishment world. If your face doesn't fit, you essentially can't join the club.

On a slightly different aspect of medical poverty - The public often have a fluffy view that doctors never suffer or ought not to suffer. To them - being a doctor = being rich. The two do not necessarily come together.

I wanted to highlight a serious problem in the NHS. The Mori Poll [ listed on the Royal Medical Benevolent Fund] website cited as follows

MORI Social Research Institute has conducted a survey for us among a representative sample of working doctors. This produced a range of interesting findings. For instance:

• Half of the doctors interviewed knew a colleague who had experienced problems significant enough for them to be off work for six months or longer.

• Managing aspects of the Work/Life Balance emerged as the most common problem they saw doctors facing

• There was a high level of interest in the Fund developing information, advice and support services.

• This interest was particularly high among younger doctors and female doctors.

In 2006, there was the exposure of foreign doctors promised the earth from the NHS. They ended up in poverty.

"Standing in the courtyard of the Sri Mahalakshmi Hindu temple in east London, a dozen jobless doctors are eating dhal, rice and potatoes off paper plates.

Wrapped against the cold in anoraks and sweaters, they come here each evening when the temple serves free food. They eat in the gloom before slipping away to damp, squalid lodgings where many sleep three to a room"

Thankyou Dr Edwin Borman :)

Unknown to many people, Temples serve great food and I love eating there on Sundays.

Express India Reported as follows

"A large number of overseas doctors, mostly from India, who had flocked to Britain in response to the UK National Health Services' global appeal for more staff, are facing unemployment, poverty and discrimination, a report said today"

While the system was mistreating foreign doctors. It continued to treat the home grown doctors badly. The Modernising Medical Careers scandal placed doctors in debt, poverty and many suffered mental health problems.

See the following study :-

"Despite these limitations, it is evident from this survey that a number of former SHO rotational trainees were disadvantaged by MTAS/MMC, that their views of the process are negative, and that they experienced high levels of psychological distress during and shortly after the application process. However, it is reassuring that a number of the problem areas highlighted by this study were also identified by the MMC inquiry's interim report, and that Professor Tooke's recommendations are similar to those of doctors who responded to the survey"

The Stirrer describes at least one suicide.

Those who know about the MMC and the impact on finances may like to post here anonymously. My apologies in advance of being naive on these issues but I have never been sent the true figures on poverty, unemployment or debt in those that are victims of the MMC.

In April 2008, we see that debt is crippling junior doctors.

A recent survey by the British Medical Association revealed 91% of those surveyed had a student loan, more than half had an overdraft and two thirds had at least one credit card.

The BMA medical students committee report also warns that if the government decides to lift the cap on university tuition fees in 2010 then the average medical debt could almost triple to over £57,000.

And there we have it. Catastrophe in the medical profession.

So any doctor or member of the public reading this should donate any amount to the Royal Medical Benevolent Fund who do a sterling job of looking after doctors. Apart from choosing Elizabeth Paice [the master of causing unemployment] as one of their members, the rest of their decision making is very supportive. Many doctors find it an embarrassment to admit they are in financial difficulty and often hide away, develop serious mental health problems and resort to self harm or suicide. It is important to spare a thought for any of your colleagues who may well be in need.

For avoidance of doubt, when the General Medical Council UK was asked to donate finances to the Royal Medical Benevolent Fund. They refused :). The GMC is a Charity :)