Doctors strike

[Mungler]

Indeed, it is the hysterical reaction to anyone attempting to go anywhere near to attempting to straighten out any aspect of the NHS that I find worrying.

[rovercoupe]

Bangerman. Thanks for explaining your view (and for being a doctor). Can you explain though who makes doctors work 90 hours a week? Some people say that their contract is for 40 hours and can choose to work more others say that there is no choice. Can you shed some light?

if you were half way through a operation and your shift ended would you just walk out? if there was nobody to cover the next shift, if there was a chance to do/assist in a operation that would benefit your training, it soon adds upto 90 hours. the list goes on.

[Houseplant]

Bangerman. Thanks for explaining your view (and for being a doctor). Can you explain though who makes doctors work 90 hours a week? Some people say that their contract is for 40 hours and can choose to work more others say that there is no choice. Can you shed some light?

 

There are a few reasons, the main ones being 1) patient care - there is a job to do and if you don't do it, you know no one else will after you "clock off". 2) Expectations from more senior doctors. 3) Career advancement, either to impress seniors, get cases added to log books etc. Whichever one of these reasons, it is highly likely that you won't get paid for it, and it won't be officially recognised or even acknowledged by the NHS Trust that you work for.

 

Locum shifts are a separate issue. Locums are much more like overtime as most people would understand it. The pay for locums is good and it is generally your choice to do a locum shift or not. Having said that, I was certainly put under an awful lot of pressure to do locums in the NHS on occasions.

[Mungler]

Family doctors who are partners in their surgeries earn an average of £102,000 a year – and one in ten earns more than the Prime Minister’s salary of £142,500.

Read more: http://www.dailymail.co.uk/news/article-2775809/Tell-patients-earn-doctors-told-Practices-told-reveal-average-earnings-GPs-March-2016.html#ixzz42UqAueQd

So, a partner in a GP surgery earns on average £102k a year. Would more senior doctors, consultants and specialists earn more?

 

Being at the bottom of an elongated career ladder is pretty miserable at the time - I am 44 and when I qualified in 1997 I earned £10k a year (set by the law society) and I had a fair chunk of debt including student loans and £5k for the LPC course. Careers progress and develop and if you are any good you get on and it gets better.

 

I'd have more sympathy for the nurses who have an equally tough job to do but an obvious career and pay cap / ceiling.

Edited March 10, 2016 by Mungler

[Houseplant]

Would more senior doctors, consultants and specialists earn more?

 

I'd have more sympathy for the nurses who have an equally tough job to do but an obvious career and pay cap / ceiling.

 

NHS doctors pay is in the public domain which is a good thing: http://www.bma.org.uk/support-at-work/pay-fees-allowances/pay-scales

 

If you're really interested, you have to pay attention to the small print and appendices which can be quite difficult to interpret!

 

Re: Nurses, they do have a tough job, but there are many opportunities for career advancement these days. Nurses effectively form the middle and often, higher management in hospitals. On the clinical side, there are nurse specialists and consultants who are well paid and have a good degree of professional autonomy. Personally, I would like to see better pay for nurses doing the dirty work on the front line.

[Grandalf]

Some professions should never contemplate strike action.

Sorry that this may upset some PW members but I honestly believe this.

Police and other emergency services, military service personnel and the medical profession - No doubt there are others..

There is always another way of doing things.

It's alright saying emergency services in hospitals are continuing but when someone has had there 'routine' operation cancelled three or more times it stops being routine.

TALK, TALK AND TALK SOME MORE UNTILL YOU GET IT SORTED.

Now I know you will say it is the government who will not talk but there is always another way.

Strike action is not the answer.

[oowee]

Some professions should never contemplate strike action.

Sorry that this may upset some PW members but I honestly believe this.

Police and other emergency services, military service personnel and the medical profession - No doubt there are others..

There is always another way of doing things.

It's alright saying emergency services in hospitals are continuing but when someone has had there 'routine' operation cancelled three or more times it stops being routine.

TALK, TALK AND TALK SOME MORE UNTILL YOU GET IT SORTED.

Now I know you will say it is the government who will not talk but there is always another way.

Strike action is not the answer.

I can go with that but only if you can keep politics out of the management. We all want a say in the way these things are run so I guess we are stuck with the politics and the right to strike.

[poontang]

I can go with that but only if you can keep politics out of the management. We all want a say in the way these things are run so I guess we are stuck with the politics and the right to strike.

 

You have to have the politics I'm afraid.

It's public money that funds the NHS and the politicians have to oversee that expenditure.

[Wb123]

As a striking junior doctor these are my key issues.

 

New contract contrary to what is reported would be a 42% pay cut for me to work more weekends and nights.

 

New contract comes with an exclusivity clause where i must get my employers permission to undertake any paid work outside my contracted time, and they have first refusal at my basic rate.

 

Ten years of pay freeze has already refuced our pay by half in real terms. I want more money and not to be treated like **** by my employer.

 

 

Due to the above i have accepted a job in ireland where the old contract is continuing and told my english job offers to find someone else.

[markm]

 

I was a junior doctor in the NHS. I'm moved (permanently) to New Zealand. Most of the close friends that are trained with are in Australia and one is in Canada. Take from that what you will.

 

A few points that get missed by the media:

 

1) The term junior doctor applies to almost every qualified doctor who isn't a consultant or GP. It does not apply to medical students. It is a broad term that covers a range of experience/competence. It is quite likely that a "junior doctor" will resuscitate you in the emergency department, perform your operation, administer your anaesthetic, treat your desperately unwell child etc.

 

2) The extra money earned for working out of hours is called banding. This is where the government wants to reduce costs. Banding may be 0 - 50% of basic pay (sometimes more), but basic pay is low by anybody's standards. Regardless, particular jobs are banded and individual doctors have no say in how much out of hours work they do, or indeed how much they earn. It is not the same as over time.

 

3) Hospital trusts routinely and possibly, universally flout the European Working Time Directive with respect to safe working hours. This may be done through administrative slight of hand or blatant lying. In addition, there are expectations on junior doctors from senior colleagues. This may mean working more hours than rostered with no extra remuneration. As a newly qualified doctor, I was doing an extra 2 - 3 hours per day unpaid and unrecognised.

 

4) Junior doctors already provide a 24/7 service. However, I would concede that there aren't enough junior doctors working out of hours. In the same way that there aren't enough consultants, nurses (vitally important), radiographers, physiotherapists etc. The whole system needs restructuring and more money if you want good quality healthcare. The NHS is already one of the most financially efficient healthcare systems in the world.

 

Everybody knows medicine is a tough career choice. It takes decades of study, debt, sacrificing family life and hard work. Yes, junior doctors are trying to protect their income and quality of life in the current dispute, but enough is enough. Jeremy Hunt should have used the carrot and not the stick in this instance.

Apologies if I'm wrong.

 

The government subsidised your training then you ****** off aboard cos the grass is greener?

 

Are you paying any money back to the uk tax payer?

[Houseplant]

Apologies if I'm wrong.

 

The government subsidised your training then you ****** off aboard cos the grass is greener?

 

Are you paying any money back to the uk tax payer?

 

 

After 6 years of being abused in the NHS, I feel that my debt to the UK is more than paid off, so my conscience is clear. Regardless, doctors are people too and want the best for themselves and their families. I also want to work in an environment where I can do the best for my patients and not make bad/dangerous decisions because I'm overworked and exhausted.

 

I assume you have no problem with immigrant doctors coming to the UK from countries where their training is subsidised?

[oowee]

 

 

After 6 years of being abused in the NHS, I feel that my debt to the UK is more than paid off, so my conscience is clear. Regardless, doctors are people too and want the best for themselves and their families. I also want to work in an environment where I can do the best for my patients and not make bad/dangerous decisions because I'm overworked and exhausted.

 

I assume you have no problem with immigrant doctors coming to the UK from countries where their training is subsidised?

Good shooting too in NZ I guess?

Edited March 10, 2016 by oowee

[Grandalf]

Yep, and he's getting free coaching and advice from PW members.

[markm]

 

 

After 6 years of being abused in the NHS, I feel that my debt to the UK is more than paid off, so my conscience is clear. Regardless, doctors are people too and want the best for themselves and their families. I also want to work in an environment where I can do the best for my patients and not make bad/dangerous decisions because I'm overworked and exhausted.

 

I assume you have no problem with immigrant doctors coming to the UK from countries where their training is subsidised?

OK

 

So the BMA suggest it cost a minimum of £269,000 to train a doctor.... (Actually up to £500,000)

 

I'm presuming you got paid during your qualified time.

 

How were you abused for 6 years? (Harsh words)

 

What have you paid back?

Edited March 10, 2016 by markm

[Houseplant]

Good shooting too in NZ I guess?

 

 

Yep, and he's getting free coaching and advice from PW members.

 

 

Haha! Yes and the fishing will blow your mind! I'm off chasing marlin tomorrow

 

Very grateful for all the advice received. Kiwis are a very practical bunch. Advice would be buy a rifle, buy some bullets, walk in to the bush, shoot a deer, butcher/cook/eat deer with a cold beer!

[Houseplant]

OK?

 

So the BMA suggest it cost a minimum of £269,000 to train a doctor.... (Actually up to £500,000)

 

I'm presuming you got paid during that time?

 

How were you abused for 6 years? (Harsh words)

 

 

Yes, you get paid as a junior, but not an awful lot given the amount of time studying and the amount of debt accumulated. Also, a significant proportion of my wages was spent on courses and professional fees for non-optional careers advancement. It was in the order of hundreds of pounds per month. See here: http://careers.bmj.com/careers/advice/view-article.html?id=20004902

 

The abuse comes down to too many hours unpaid and more to the point, unrecognised and too much pressure. With the best will in the world and a hard working attitude, you can't be in three or four places at the same time. Hospital management were entirely unsympathetic and senior doctors generally uninterested.

[grrclark]

The abuse comes down to too many hours unpaid and more to the point, unrecognised and too much pressure. With the best will in the world and a hard working attitude, you can't be in three or four places at the same time. Hospital management were entirely unsympathetic and senior doctors generally uninterested.

A question in which I am genuinely interested in the answer, do you think the BMA or other healthcare unions/affiliations/associations have failed to represent the junior doctors appropriately in the past where there has been an openly accepted and recognised practice of having junior doctors work excessive hours with little or no recognition?

 

It seems that we are now at a point of conflict that stems from a collective failing on both sides to address what is a long running and wider set of problems with the cumulative effect leading to this impasse.

[Houseplant]

A question in which I am genuinely interested in the answer, do you think the BMA or other healthcare unions/affiliations/associations have failed to represent the junior doctors appropriately in the past where there has been an openly accepted and recognised practice of having junior doctors work excessive hours with little or no recognition?

 

It seems that we are now at a point of conflict that stems from a collective failing on both sides to address what is a long running and wider set of problems with the cumulative effect leading to this impasse.

 

 

 

Yes, absolutely, good post. There were significant changes in junior doctor training and organisation under the Labour government. The BMA were weak and the consultants just stood by and let it happen because it didn't affect them, then moaned about the consequences.

[Wb123]

OK

So the BMA suggest it cost a minimum of £269,000 to train a doctor.... (Actually up to £500,000)

I'm presuming you got paid during your qualified time.

How were you abused for 6 years? (Harsh words)

What have you paid back?

Its worth noting that figure includes our wages and pension contributions for a few years out of medical school...

 

Most of our 'training time' is taken up with service provision, note that all the people in so called non training posts i work with do exactly the same work i do.

 

To pay it back would be like asking an employee to return all their salary, plus employers costs.

Edited March 11, 2016 by Wb123

[Chris Bb]

 

 

Yes, you get paid as a junior, but not an awful lot given the amount of time studying and the amount of debt accumulated. Also, a significant proportion of my wages was spent on courses and professional fees for non-optional careers advancement. It was in the order of hundreds of pounds per month. See here: http://careers.bmj.com/careers/advice/view-article.html?id=20004902

 

The abuse comes down to too many hours unpaid and more to the point, unrecognised and too much pressure. With the best will in the world and a hard working attitude, you can't be in three or four places at the same time. Hospital management were entirely unsympathetic and senior doctors generally uninterested.

 

This sounds very much like the training I, and I suspect may others, underwent until fully qualified.

 

Life ain't a bowl of roses and, until one is fully qualified in one's chosen profession one shouldn't expect to earn the big money. I was 29 before I was fully qualified (normal for my profession) and only then was I able to pick and choose where I went.

 

You could choose a job that pays full whack at age 20 but then it's doubtful if you'd ever get into the six figure earning area.

[grrclark]

Yes, absolutely, good post. There were significant changes in junior doctor training and organisation under the Labour government. The BMA were weak and the consultants just stood by and let it happen because it didn't affect them, then moaned about the consequences.

I think this is one of the major issues, earlier in the thread I posted some stuff that is technically accurate, but i completely accept what actually happens doesn't match what should happen.

 

The problem really is that the BMA were content to see behaviour that differed from what was agreed become normal behaviour. The trust and hospital management were quite happy to break the rules as the BMA were going along with and by dint of that so were the junior doctors; the hospitals and trusts are accepting timesheets they know to be false, but it suits them to have that happen.

 

Senior clinical management all went through the same thing so also accept that a deviation from the rules is normal behaviour.

 

Now we arrive at a time when the latest proposal is a step too far, for whatever reason and now there is a massive pile of vomit on the table made up of all sorts of injustice that the wicked government are trying to impose.

 

As all parties have been complicit in allowing working practices that fall outside of prior agreements to continue that weakens their hand in negotiation, there isn't an actual accepted normal for junior doctors in terms of remuneration, working hours arrangement, training, etc because there is so much variability. I think that is why there is so much disparity between what each side contest, if the answer was obvious and easy the there could br no argument.

 

The government cannot provide a case for change on the basis of so much variability so they have to resort back to what the previous agreements were and base their justifictaion for change on that.

 

Of course that means that case for change is flawed because it doesn't really reflect reality and all the toys get thrown out the pram.

 

The government (successive governments really) know this too and they are hugely guilty of complacency in allowing it to happen and failing in their duty of leadership to address the problem, until now at least although I think they are still bottling out of addressing the bigger issues in the NHS.

 

As much as I do sympathise with the junior doctors they are partial architects in this outcome, but much more responsibility lies with the BMA and the trusts to my mind, it is a gross failure in both leadership and responsibility.

[Houseplant]

Good post grrclark.

[old man]

You have a fundamental misunderstanding of how Jnr Drs work and are paid. They do not get to ***choose*** to work 90 hr weeks and nor is there ***elective overtime***. They are already rota'd to cover weekends and out-of-hours periods: they cannot opt in and out of this. They receive a higher rate of pay for these anti-social hours. Hunt wants to expand the periods which are classed as sociable.

 

His motives for doing this have nothing to do with improving the spurious weekend effect (you are most likely to die in hospital on a Wednesday and the stats and definitions used in the NHS England commissioned paper that Hunt repeatedly misquotes are dodgy in the extreme) nor is he interested in improving patient safety.

 

His goal is to bring about the demise of the NHS (in its current form) from within. He wants the Drs to strike, leave, form private agencies that sell their services back to the privatised "NHS".

 

This is already happening. No government can abolish the NHS, it would be political suicide. Getting it to fail via a mass-exodus of workforce is another matter.

 

Hunt knows many Jr Drs will not want to emigrate, though plenty will. But he also knows that they may resign on mass, after their pre-registration or foundation years and form their own private enterprises and sell back labour on their own terms.

 

Hunt, like many politicians, has connections with private healthcare provision and may have a tasty board position lined-up for his "retirement."

 

This isn't about pay, patient care, weekend mortality, nor hours worked. It's about dismantling the free-at-point-of-use NHS.

 

Absolutely correct Sir!

 

The NHS was born with people of my age and will die with us?

I have been told that some Health services local to me are now run by Virgin, oh great joy!

 

The NHS was created for the good of all by dare I say it the Labour Party, OMG! the fact that someone did care is a monumental position compared to the mantra of today, Profit? Profit! Profit!

Sadly, Hunt is just continuing the works started by Thatcher of de-stabilising the country from within in the name of profit for shareholding mates?

Equally sad is the fact that most users of the NHS don't seem to care about it's demise?

When our local hospital ceased to be open for A & E after 10 pm the end result is now a 45 minute 20 mile journey to either Wolverhampton or Stoke.

 

I heard it said that politicians are like cats, by the time you discover the mess they are long gone? Personally I hold them in equal esteem?

[poontang]

 

 

 

 

 

The NHS was created for the good of all by dare I say it the Labour Party,

 

 

 

That's actually a bit of a myth, perpetuated by none other than the Labour party itself.

 

The idea of a NHS was devised by William Beveridge in 1942. Beveridge was a Liberal.

 

After the war the country was led by consensus politics where all parties broadly agreed on the best ways to rebuild the country. Beveridge's NHS was enacted by Atlee's Labour party as they held power, however had any other party have formed the post war government it's certain that they would have followed the same route.

Had the Conservatives held onto power or the Liberals had won the election the NHS would still have been formed.

The simple fact is the NHS was the idea of a Liberal politician, and has since been hijacked by the Labour Party for political gain.

 

There was in fact one major stumbling block to the setting up of the NHS, one group of people in particular who used their collective powers to slow down progress. It wasn't the Tories... It was the doctors!

[hoggysreels]

""" The idea of a NHS was devised by William Beveridge in 1942. Beveridge was a Liberal. """ = Myth

 

The actual idea was from New Zealand pre WW ll