Do you trust your hospital trust?

After the rumours about junior doctors being screwed over by their employers, there turned out to be some truth in the matter. Helen Bryden was among the first doctors to speak out

When our salary banding was set at 1A instead of 2A—for a rota that was only just compliant with 2A hours—I should have known things were not going to go smoothly. We were appointed to a post advertised as “attracting a 2A salary banding,” and the timing of our disillusionment spoke volumes.

The day before our much anticipated first payslip, we received a brusque letter from a faceless person in the previously unheard of human resources department of our trust. Reassured by our consultant that this was a mistake, we set about contacting Mr Human Resources, the originator of the letter. Neither the consultant, the postgraduate tutor, nor myself had any success in the next three weeks. On a day off, I phoned his office every hour and was very impressed by the range of reasons given why he was out, busy, or otherwise unavailable. The best I got was a letter from his secretary.

Resolution finally came after a chance meeting between Mr HR and our consultant, both of whom attend rota based meetings. The added catalyst of BMA intervention on our behalf oiled the wheels and the trust had to act. We were made to jump through a couple of token monitoring hoops—large hospital trusts are not programmed to apologise and have done with it—and, in the fourth month of our six month post, we were allocated the correct banding with back pay. Naturally, the trust kept the interest it had been accruing on the eight salary deficits.

Having heaved a sigh of relief and spent the back pay on outrageous fripperies, I settled back into the niceties of being a junior doctor. The eight of us were getting fairly slick by now, and the Christmas and New Year rota was especially kind: we headed into January in good spirits. Unfortunately, this was short lived: the trusts monitoring exercise for the six months was upon us—better late than never. We imagined we knew what to expect—after the earlier round we had completed to get our banding corrected—but nothing prepared us for what was to come.

As soon as monitoring began, the trusts agenda became apparent. We were to stick to contracted hours: no staying late to finish up, and this was not negotiable. For five months we had been doing our jobs on the wards, making clinical decisions, getting things done, and generally trying to do the job to the best of our abilities. Lots of people were all of a sudden acutely interested in what we did, and specifically, what times we did it at. We met the bed manager, the clinical nurse coordinator, and several members of the human resources department—some with names and others without.

As monitoring progressed and we refused to be bullied—we were in favour of doing our jobs safely and efficiently, rather than fulfilling the trusts wishes on paper timesheets—things got more tense and heated exchanges took place.

After four days of intense harassment, despite the best efforts of our consultants to shield us from events, and support us, we could take no more. We rang the BMA for advice, and contacted the independent new deal support group, and I became our spokesperson.

I wrote to people I had never heard of, sending a total of seven letters; shamelessly pulling no punches, I named names and cited witnesses. We were not going to put up with this harassment and blatant invalidation of the monitoring exercise. Our story exposed such bizarre behaviour by members of the trust that I was interviewed by the BMA News as part of a feature on the new deal. This provoked further interest and in the space of a few short days our story had appeared in the national press and there had been a parliamentary question put to the Scottish health minister regarding the trusts behaviour.

Suddenly we had the trusts undivided attention: it had a week to resolve the issue to satisfy parliament. Amazingly, after that, I met Mr Faceless and Unavailable from human resources, and we were soon on first name terms. I was invited to meetings with the trust, and people would phone me to check if I was available for them to come and see me. It was difficult not to let this go to my head, especially when Mr Human Resources gave me his mobile phone number so I could get back to him wherever he was.

The issue was resolved to the satisfaction of the trust and with reassurances that things would be different next time. So far, my second preregistration house officer post has passed uneventfully, despite it being with the same trust. I look forward to the monitoring for this six months to see if it really has mended its ways. I dont trust them an inch, but at least I dont fear them either.

Also see Ian Urmstons editorial this month about starting out on the right foot as a house officer.