The professional association for doctors said the closure of schools and childcare providers during the lockdown had caused problems for thousands of healthcare workers – forcing fit and healthy doctors to stay home when the NHS needs them more than ever.
A poll by the BMA found that 13 per cent of 4,100 doctors had been unable to work or had been forced to cut their hours for this reason.
Helena McKeown, chair of the BMA representative body, said both male and female doctors who have children are struggling but that evidence showed the burden of high childcare costs often fell particularly hard on women.
Dr McKeown, who is a GP, told The Independent that doctors’ anxiety around the inability to find childcare could make them more likely to commit errors while caring for patients with Covid-19 and other health issues.
She said: “This is evidence-based. We don’t want doctors lying awake at night worrying about childcare or worrying about childcare while with patients. One in five of our doctor parents have had to use new childcare during the crisis. It is incredibly stressful to get a child settled with a new childcare person. There is a massive emotional burden of doctors worrying about how their child is being looked after.
“We have had doctors who have said to us, ‘My main stress during the whole coronavirus nightmare has honestly been about childcare.' Stress causes a reduction in the ability to make decisions and increases the likelihood of a mistake being taken. Errors in medicine are worse as they are life-threatening. Doctors are humans too. Having fewer doctors because of issues with childcare impacts on other doctors who work with parent doctors.
“They have had to do more shifts at short notice. It is a domino effect. This affects our ability to provide one-to-one care with our patients, and to be refreshed, and be 100 per cent on the ball. Medicine is 24/7. These issues have been a worry of mine for most of the crisis because of the 13-hour shifts that doctors have had imposed on them, which wasn’t negotiated.”
Dr McKeown said unpredictable hours were also a factor, with some medics currently working three 13-hour shifts before having three days off. Rotas can often change at the last minute, she said.
In addition, the hourly cost of childcare has risen, Dr McKeown said, while the need for social distancing is putting off some workers. She raised concerns around how doctors will fare if early-years childcare providers go out of business because of coronavirus upheaval, adding that this could widen existing gender inequalities in the medical profession.
“Already there is a 17 per cent gender pay gap with doctors,” Dr Mckeown said. “The majority of junior doctors are women.”
The Organisation for Economic Cooperation and Development (OECD) previously found that the UK has one of the most expensive childcare systems in the world.
One NHS doctor, who asked to remain anonymous, told The Independent: “Our daughter’s nursery initially said they would remain open for key workers and then informed us by email at 8.30pm that they would be closing for all from 5.30pm the next day. This led to me and my husband taking time off for childcare supported by my sister who is a locum GP.
“It took multiple emails and phone calls to various people at our local authority over a number of days to finally speak to someone helpful that gave us details of local nurseries and child-minders that were still open. We have now managed to find a local child-minder, but the whole process took two weeks, during which we were still working on calls and swapping shifts to make things work.”
Another doctor, who also did not want her name used, told The Independent the nursery she used had also closed unexpectedly. "We had no idea how we’d manage with both of us in acute hospital specialities with constantly changing rotas and being asked to cover last-minute whilst colleagues had to self-isolate," she said.
She added: “My new rota is really tough for making childcare plans as there are loads of ‘flexi’ shifts where you are backup if someone is sick. So you either have to pay for a load of childcare you probably won’t need, or potentially expose your child and family to Covid-19, or hope that they can take her last-minute at nursery if you get called in.
“All of this is on top of the effect on the poor children. It’s very unsettling for very young children to be placed in a new environment with new people. The government should have realised private nurseries would choose to close if 80 per cent of staff wages were paid after closure – this was clearly going to be the better option financially. They should have made plans for a few nurseries to remain open in each area, and not left it up to busy parents to work out what to do, with no notice.”
While 75 per cent of NHS workers are women, some 90 per cent of single parents are female.
The BMA said doctors who do manage to track down childcare are often paying much higher fees because of “short-notice rota changes” and lengthier shift patterns. The body is demanding that the government, councils, local NHS organisations and childcare providers join forces to ensure better provision for NHS staff.
Purnima Tanuku, chief executive of National Day Nurseries Association, which is backing the BMA's demands, said: “Early-years providers and their staff are critical workers supporting other key frontline workers like doctors and other emergency staff. Just under half of nurseries told us they are open, including those based in hospitals, delivering the care the key-worker staff need. We know from our members that a lot of nurseries which have stayed open during this crisis to support NHS staff are running at a loss, with some losing thousands of pounds a week.
“The government have announced that nurseries can fully reopen from the beginning of June and that the furlough scheme will run into October, but nurseries delivering emergency childcare need support now. Childcare places for our frontline medical staff along with other critical workers won’t be available if nurseries and other providers aren’t supported to be sustainable.”