As a junior doctor in Wales and co-chair of the British Medical Association’s Welsh junior doctor committee, I am proud to work within something as fundamentally powerful as a free healthcare service.

My life has been lived in and around healthcare. I grew up with a disabled grandmother, a nurse for a mum and received my first chronic illness diagnosis at the age of 16, after years of symptoms. It’s exactly this background that influenced me to seek a career in healthcare.

A car crash in 2017 gifted me a prolonged patient experience and the resulting paraplegia means I not only work in the NHS, but constantly rely on it. Without the NHS, I would be drowning in debt, incapable of living and working as I want, or even dead. This is the reality of what an NHS collapse would mean for me and for many others.

In 2018, I wheeled back into a health service I didn’t recognise. In little over a year, it was obvious things had deteriorated. It was around this time I became more engaged with healthcare politics via the BMA.

We know the politics of austerity disproportionately affects the socioeconomically deprived, and we know that being disabled or chronically ill increases the likelihood of financial insecurity through lost earnings and the hidden cost of being disabled. Yet since 2008, the services on which these communities depend have been deliberately dismantled.

Broken, not breaking

I was angry then and I’m angry now, but I am also genuinely concerned. The wealth of a nation is its health and it must be treated that way by our politicians. While they focus on market-based initiatives to restructure the NHS and on productivity increases that could only be the result of magical thinking given the reality of 18-hour shifts, they overlook the long-term costs. Perhaps because those costs are not in pounds, but in the lives of those who will lose access to healthcare. 

The NHS is not breaking; it is broken. Doctors like me are saddened and distressed to see this lifesaving resource crumble. We feel profound shame at the level of care provided due to a lack of resources. The general public is increasingly aware it is a systemic problem, but all too often, we bear the brunt of people’s frustration.

Healthcare workers were revered during the pandemic, risking their own health to save as many as possible. We lost some of them and many are still battling long Covid. These workers understand more intimately than anyone else how the standard of care has declined.

Covid made things worse, but let’s not kid ourselves the situation wasn’t dire long before. The health and social care workforce has been decimated, while a lack of beds encroaches on patient confidentiality and basic dignity, with patients spilling into corridors and crammed into waiting rooms.

Health professionals are burnt out, with many leaving the profession entirely. Every day, I have conversations with staff who just don’t know how much longer they can hold on. The strategic cutting of services to the bone, in the name of productivity, has left us with a system no longer fit for purpose, unable to cope with the demands placed upon it.

People’s health is suffering and, as ever, this follows the inverse care law – those populations needing the most healthcare are the least likely to have adequate access to it. 

Why, with a situation this bad, would healthcare workers consider striking? Balloting is currently open on junior doctor strike action in England, and runs until 20 February. If the ballot is successful, then industrial action will begin with a 72-hour full walkout in March. Similar action is currently being considered in all the UK’s devolved nations.

A major reason for delays is the lack of staff. To reclaim a functional national health service we have to be able to recruit and retain workers and the key to this is pay and conditions.

Junior doctor pay in Wales has been eroded by 26% since 2008, with newly qualified doctors earning just £12.84 an hour. In that hour, they may be asked to review multiple patients, safely prescribe lifesaving medication, suture wounds or resuscitate dying patients. And while there are senior doctors around and experienced nurses to guide them, junior doctors form a key part of the frontline workforce. 

Our demand for higher wages is the visible face of the current movement. But at its heart is safe staffing and the resources we need to do our job. This is what the NHS desperately needs if it is to care for those who need its help.

The government’s message is that we cannot afford to raise workers’ pay; the reality is we cannot afford not to.