Drastic proposals for change in the UK’s National Health Service have pushed doctors to the brink of a strike, and even convinced some their future lies outside the profession.

However, it is not just British doctors who are affected. In recent years, up to a quarter of Maltese graduate doctors have moved to the UK for work and further training – and many of them are now among those feeling the pinch.

Gaby Scicluna

“It sets the stage for doctors to be overworked, less well-rested and unhappy enough to leave the NHS – at the end of the day it compromises patient safety,” said Gaby Scicluna, a 26-year-old surgical trainee in Manchester.

“It’s going to be cheaper for NHS employers to make doctors work even longer hours; you can work a doctor from 7am to 9pm and just pay them basic rates.”

Junior doctors in the UK, which includes anyone below consultant grade, currently work up to 48-hour weeks, although the figure is averaged over a number of months.

Doctors get paid more for working “antisocial hours” but new contracts proposed by the Conservative government reclassify what antisocial hours are, which doctors say could lead to salary cuts of up to 30 per cent.

They also worry that working even longer hours could affect their judgement and put patients’ well-being at risk.

It sets the stage for doctors to be overworked, less well-rested and unhappy enough to leave the NHS

“We feel as though we’re being set up to fail, to pave the way for privatisation,” Dr Scicluna said. “It will ultimately ruin the concept of free healthcare at the point of delivery.”

Faced with the threat of strikes by some 53,000 doctors, the Health Department has insisted it is not cutting costs and that the new contracts represent a better deal for doctors – but doctors are not buying it.

“Hospitals will have no disincentive to increase [evenings and weekends] meaning less time with my family,” said another Maltese doctor, who asked not to be named.

“Out-of-hours childcare comes at a premium and is often difficult to find, meaning my husband often needs to take leave to cover some of this time.”

The same doctor said those in her position felt “undervalued and demoralised” by the proposals, and feared that potential trainees would be put off entering the profession, leading to even greater staffing problems in future.

There are also fears of a “reverse brain-drain” of UK doctors to Canada, Australia – even Malta.

Writing in The Daily Telegraph, Sarah Ward, a British final-year medical student, said she would be applying for a job on the island as “Maltese doctors do not have the pressures faced by my more senior colleagues in the NHS”.

Nick Mamo

Nick Mamo, a 26-year-old doctor who worked for the NHS in Liverpool and is now reading for a Masters in London, believes the phenomenon is going to become more and more common in the years to come.

“They get to come here, earn the same or more than what they were earning in England even though the cost of living is cheaper, they already know the language, they can finish work early and go to the beach. It’s a no-brainer.”

With competition for places at Mater Dei Hospital and even at medical school already high, the news will probably not be welcomed by Maltese student doctors.

Moreover, the well-trodden path from Malta to the UK is likely to become a lot less popular.

“I don’t think the UK will remain the destination of choice,” Dr Mamo said. “The initial reaction might be that it’s positive for Malta because more doctors will remain here, but we’ll be losing out on the less tangible effect of learning from people from different systems and different ways of working.”