This Is Going to Hurt: Secret Diaries of a Junior Doctor

The United Kingdom’s National Health Service (NHS) was established in 1948. Providing medical services to all UK residents, it operates on the principle of ensuring healthcare is accessible to all, regardless of financial circumstances. NHS consultations, hospital care, surgeries, and emergency services are all free at the point of access.

The National Health Service is often referred to as a “national treasure” in the UK due to its commitment to healthcare equality. However, as the system is funded primarily through taxation and National Insurance contributions, it operates within the constraints of a fixed budget. This has led to significant challenges in meeting patient demand, which is exacerbated by an aging population and the rising costs of treatments. The system also faces a shortage of healthcare professionals, leading to increased workloads and stress for existing staff.

Adam Kay decided to publish his junior doctor diaries as a memoir because of a dispute that began in 2015 between the UK government and junior doctors. The author describes this event as “when the government started waging war on doctors” (261). Junior doctors protested when the Health Secretary, Jeremy Hunt, attempted to impose new contracts on them without their approval. These contracts proposed to increase junior doctors’ basic pay while scrapping overtime rates. In practice, this would mean that doctors who exceeded a 56-hour week faced a pay cut. 

When junior doctors voted to take job action, Jeremy Hunt implied that their motivation was greed. In This is Going to Hurt, Kay counters this argument by sharing his own experiences as a junior doctor, demonstrating that “It’s not a profession you go into to satisfy the dollar signs behind your eyes” (86). In addition to emphasizing the dedication required for the role, Kay highlights that while doctors may not wish to exceed a 56-hour week, they are often compelled to do so to ensure patient safety. Bringing to life the realities of working in the NHS, Kay advocates for better treatment of healthcare professionals and a greater appreciation of their work.

This is Going to Hurt is both a celebration of the NHS and an account of its systemic failings. While praising the philosophy of the UK’s free healthcare system, Kay highlights its chronic underfunding and the bureaucratic inefficiencies that place an immense workload on its staff. The memoir also criticizes political decisions that affect the NHS, such as cuts to funding and resources and government-imposed targets. The author’s diary entries illustrate the tangible effect of these policies on the day-to-day operations of the health service. Further, Kay offers a cautionary warning to the UK’s healthcare system. He argues that without greater investment, the NHS will cease to exist, and private healthcare will become the only option for UK residents.

This is Going to Hurt highlights issues specific to the UK’s National Health Service but resonates globally, addressing mental health struggles among healthcare workers, the sacrifices made by doctors, and the funding required to keep a health service running. The memoir has sparked discussions about the need for reform and greater support for those in healthcare roles.