The following is a Press Release concerning conditions affecting the Junior Doctors at the Queen Elizabeth Hospital. It was submitted to the Print Media in Barbados by The National Union of Public Workers (NUPW) on 2009-February 9. The Print Media has refused to carry it in whole or in part. The release was suppressed. It was apparently not considered important enough to be newsworthy. If you disagree (and I really hope you do), please feel free to pass it on via E-mail, Facebook, Myspace, MSN etc. The TRUTH must be told!

Conditions Facing Junior Doctors at The Queen Elizabeth Hospital (Q.E.H.)

The Junior Doctors of the Queen Elizabeth Hospital are amongst the most hardworking and dedicated Civil Servants in the country. However the conditions under which they work are less than ideal and in many cases appalling.

Juniors Doctors make up the majority of doctors working at the Hospital. They are not allowed to have private patients or to charge any individuals fees for their services (either inside or outside the Hospital).

The term Junior Doctor is a very misleading one and must be clearly defined before we progress further. A Junior Doctor simply put is any doctor employed at the Hospital who is not a Consultant. This group encompasses House Officers (Interns) who have recently graduated and Senior Registrars, who hold post-graduate qualifications and are eligible to be appointed as Consultants should a vacancy arise. They are many other doctors who are between these two extremes included in this group. It is important to emphasize that the term Junior Doctor does not mean a young, inexperienced doctor or unskilled doctor.

Consultants are the leaders of the clinical team. They conduct ward rounds and provide invaluable input and guidance into the management of individual cases. Often the consultant’s directives are carried out by the Junior Doctors. These directives can range from simply carrying out various blood tests to performing complex surgical or invasive procedures.

It is therefore obvious that the Junior Doctors are a highly skilled, valuable and integral part of the clinical team and essential to the optimal functioning of the hospital. Currently the Junior Doctors at the Q.E.H. are working under very demanding and trying circumstances yet continue to give of their best.

Many Junior Doctors work seven (7) days a week and some are on call every third day (mainly in the Department of General Surgery). Rarely they can be on call on alternate days. When on call these doctors are responsible for providing care to inpatients as well as dealing with ALL emergency cases for a period of 24 hours. When “on call” finishes, these doctors are then required to work their regular working day. This results in many doctors working (and being in the Hospital) for 36 consecutive hours. Total working time often exceed 120 hours per week.

It is of note that most hospitals (including many in the Caribbean) have moved away from this system recognizing that it is exceedingly burdensome on the doctors.More importantly it may be dangerous to patients’ wellbeing because of the increase in medical errors that occur. Hospitals throughout the world (especially in Europe & U.S.A.) have actually limited the amount of hours a doctor can work to approximately 70 hours per week. Doctors can be (and have been) removed from hospital premises by security if found to be in contravention of this policy.

The working hours are but one of the Junior Doctors many concerns. Appropriate accommodation is another pressing concern of the Junior Doctors. There is not enough space for all of the Junior Doctors required to be on-call and in the hospital in any one night. This has resulted in some doctors having to sleep in chairs and on broken couches in plain view of each other in the Doctors’ Lounge. (Please also note here that the door to the Doctors’ Lounge does not have a functioning lock and thus free access to the area is open to all and sundry at ANYTIME throughout the day or night)

Even more worrying is that even with these makeshift sleeping arrangements, there is not enough room for all the Junior Doctors on-call and some have been forced to resort to sleeping in their cars. Clearly one can see this is an inherently dangerous and undesirable situation. Many cars have been broken into, including those of doctors on the Hospital premises.

To make matters worse the Junior Doctors are not provided with warm water in any part of their lounge and are therefore forced to shower in ice-cold water at all hours of the day and night.

The Junior Doctors Lounge is itself woefully inadequate. There are broken chairs and couches strewn throughout and there is not enough space for the over 150 Junior Doctors employed at the Hospital. Up to last year the doctors were competing for the sparse space in the lounge with an infestation of rats.

Also worrying is the fact that there is no canteen facility available for the doctors (or any of the Hospital staff for that matter). In essence, what this means is that The Junior Doctors are essentially forced to order in fast food or go for prolonged periods without eating. Doctors are consuming the same sugary and fatty foods that they tell their patients to avoid.

It is the norm that in hospitals of this size which by necessity are open 24 hours that there is a canteen catering to staff (and visitors) that is also open 24 hours a day. For example Kingston Public Hospital (in Jamaica) has facilities whereby an on-call doctor is provided with lunch, dinner and then breakfast the next day! The cafeteria at the QEH has been closed for years and all hopes of it being re-opened were dashed when they decided to use the existing space for a new clinic.

These are just a few of the many challenges that the Junior Doctors are facing. The logical question which begs to be asked is “What have the Junior Doctors’ done to improve their situation.” All of the aforementioned issues have been brought to the attention of the Hospital’s Administration. Despite being in constant negotiations with the Hospital Administration, the Junior Doctors have received little more than empty promises of improvement which have up to this time failed to materialize and conditions have continued to deteriorate rapidly.

The Junior Doctors perhaps have the worst physical amenities of any group employed to the Q.E.H. The conditions are certainly not up to the standard that trained professionals in ANY OTHER field (here or abroad) would expect or tolerate.

In terms of remuneration and compensation, the Juniors Doctors at the Q.E.H. are earning the lowest when compared to their counterparts in the Caribbean performing similar roles, our Junior Doctors are however working the longest hours in the worst physical surroundings.

The doctors at the QEH are at their ‘wits end’. They work ridiculous hours and are still expected to function. They have to sleep at the hospital but there is no where adequate to sleep (if they get to sleep at all); they have to eat but there is no food and on top of that, they have to bathe at the hospital but they have to do so in cold water! These doctors give their hearts and souls to their profession. All they are asking for is a salary commensurate with their hard work, improved working conditions and an environment that fosters morale and not discontentment.

In spite of the many challenges and difficulties facing the Junior Doctors they are committed to giving of their best. They love their jobs. All of them accept that some personal sacrifice is necessary by the nature of the practice of Medicine. They however remain hopeful that some improvements can be made to this untenable situation they find themselves in, before they transition from being doctors to patients.