Doctors' strike

[Earl Aelfheah]

Kind of surprised there isn't already a thread on this (unless I've missed it). What are people's views of what's going on? From what I can tell, the government are looking to take an already stretch service and stretch it further, without increasing the numbers of doctors, in fact actively driving many more out of the profession. I am not one to look for conspiracy where incompetence is nearly always a simpler and more likely explanation, but it does seem that both tactically and strategically, this has been handled so badly as to make one wonder... Is there something else going on?

[Jeremy]

Like you say, rrr... seems to me like they're trying to stretch their resources further, at minimum cost.

Ultimately medicine is still a well paid career, but as far as I can tell, the proposed changes amount to an effective pay cut for many, as well as shifts that would put patients (and doctors) health at danger. I can't imagine why the govt ever thought the doctors would just take it on the chin. It's been handled disastrously.

[nxjen]

If the terms and conditions in working for the NHS become so unappealing for junior doctors then there will perhaps be an exodus of fully trained doctors from the NHS to the private sector. NHS will then have to form more partnerships with the private sector to maintain staff levels in NHS facilities. Outsourcing to the private sector appears to be the end game. Appalling, the doctors have my support.

[Otta]

It's a total shambles, which is doing nothing for this government's credibility frankly (although there is no opposition to actually take advantage of it).

It will be very interesting to see what comes of the legal challenge being made by 5 junior doctors, questioning whether the government can legally impose this new contract.

Personally I think it's quite shocking how low the pay is for people that have studied for years to qualify as a doctor. But what I think they should do is raise their basic salary, and reduce opportunities to supplement with overtime rates.

[steveo]

I know one young doctor who has just passed her finals after ten year's study and is unhappily looking at Australia brochures

[Jules-and-Boo]

The end game is privatisation - outsourcing / replacing with private medical companies. Yes, making conditions so bad that the doctors will leave the NHS.

It's very clear.

Same with schools - the new academies do not actually need qualified teachers and so education can be outsourced to private companies.

Not forgetting, private companies have the interests of making money as top objective....

[steveo]

Jules-and-Boo Wrote:

'the new academies do not actually need qualified teachers'

Eh?

[Jeremy]

Otta Wrote:

-------------------------------------------------------

> Personally I think it's quite shocking how low the

> pay is for people that have studied for years to

> qualify as a doctor.

The salary itself is not so much of a problem for me, as eventually the money is fairly good (all doctors I know personally have become fully qualified GPs, surgeons, etc by the time they had families, and live quite comfortably).

The problem (IMO) is more about having a change of T&C forced upon them, and stretching cover so thin that the level of care is severely compromised.

[Jules-and-Boo]

'the new academies do not actually need qualified teachers'

yes and here's the link to the BBC news detailing the new ruling

http://www.bbc.co.uk/news/education-19017544

[????]

my son goes to a private school - the single most represented group of parents (by far) are Doctors.

I really fail to buy the the 'poor doctor line' they do a great job mainly, they study a lot at high academic levels to get there, and as juniors they work some very long hours, but in the long term they have financial, job and retirement security that the rest of us can only dream of. They really shouldn't strike IMO

BUT, i feel there is something else going on

[Mick Mac]

I don't think a junior doctor could afford school fees necessarily

"How much do junior doctors get paid?

Trainee doctors currently have a starting salary of ?22,636 - at Foundation Year 1 (F1) - rising with experience to reach ?30,000 within four years. Doctors in specialist training (ST) receive a salary of between ?30,002 and ?47,175, while those who make the grade can earn up to ?69,325. You don't just walk off the street to start as a trainee doctor either, as they are expected to have a medical degree, which can take between five to six years to get.

Junior doctors enjoy a boost to their salary thanks to a complex system of supplements. This means they can earn on average ?40,000 in the initial stages of training, according to the Department of Health's estimates, and ?56,000 in the later stages. "

But like other professions - its tough starting out - employers want their pound of flesh and tend to get it from young keen employees. These employees like doctors are motivated by and can see the financial reward (a mix of public and private consultancy) in the future.

In that respect the NHS changes reflect the business model of other professions.

(im putting aside the vocational arguments etc for the moment)

Consultants at around the age of 40 probably could afford school fees. They receive from and give back to the private sector. They are not on strike - obviously.

[Jeremy]

But as I said before - all doctors I know had a pretty comfortable salary by the time they had families. I'm not sure a junior doctor would typically have a family to provide for, unless they came into the profession late.

I don't necessarily agree with ??? on the strike, though.

[????]

I didn't say Junior Doctors did I. If you read my thread it goes on about the outcomes of a career as a doctor in the longer term. You need to concentrate Mick,

[Otta]

It's all very well talking about the long term (and I get the point), but after years of study, a salary of under ?23k is laughable. I was on more than that in my first professional job 14 years ago.

As I say above, raise the basic to something reasonable, and decrease overtime so doctors are not working a stupid and unsafe number of hours.

[Mick Mac]

???? Wrote:

-------------------------------------------------------

> I didn't say Junior Doctors did I. If you read my

> thread it goes on about the outcomes of a career

> as a doctor in the longer term. You need to

> concentrate Mick,

I think I said all that. I'm getting inside your brain - and you still think its you talking.

[Blah Blah]

Just because they can earn something doesn't mean they do.

Jeremy Hunt is a full supporter of privatisation - there's no doubt about that. And slowly his department has been strangling funding accross the country so that certain areas are doomed to see a drop in service and outcomes - which in turn will affirm his case for privatisation.

The NHS already does outsource because of things that have been cut. In the area of psychiatry and mental health (the area I work in), there has been the closure of wards that once had 5000 beds accross the country and the loss of 3000 staff. Now, the NHS regularly has to hire beds in the private sector at a cost of ?1000 plus per week (each) because it has no beds for increasing numbers of patients. And sometimes, there are no beds avaialable in the private sector at all. So where do we treat people then?

Junior doctors are under particular stress as it is. It doesn't matter how much you pay anyone. If a person is working extrememly long hours, some of them unsocial, in an environment that is under resourced, they are going to suffer.

It looks as though there is a legal challenge to this contract anyway. A contract can not be 'imposed' without both sides agreement to it. But it will take time for that legal challenge to work through the courts. In the meantime, I expect the strikes to continue and fully support them.

[Mick Mac]

Its a bit rich tbh when Doctors complain about creeping privatisation - they give their time and take the money. They feed the beast.

The junior doctors don't benefit - and their NHS cake is not as nice a cake as their predecessors' cake, but that's life I'm afraid.

[Blah Blah]

I don't understand you point Mac. It's not the fault of senior doctors and consultants that demand has grown while funding of services has not.

[*Bob*]

On the subject of pay, if you take the emotive nature of the work itself out of the equation - and look at it as a job that involves a few years of being minced through the mill for a relatively humble salary, but with high prospects of a very good long-term career and substantial income after that - it would look very appealing to a great many.

It's hard to criticise people who might have to try and keep you alive one day though, so I won't. Just in case.

Generally - hands up who likes having the rules changed not in your favour; the rug pulled out; less for more - in any career? Nobody! No wonder they're pissed-off.

[Earl Aelfheah]

Whilst it's true that neither employee or employer may unilaterally vary the terms of an employment contract, it is possible for the employer to serve notice (following consultation), dismiss and re-engage staff on new terms. In order to do so, the employer must demonstrate a sound business reason for needing to enact the dismissal.

I think Hunt would be mad to try this however. You could see substantial numbers of staff just walking away. I have heard it suggested of course, that this is the point. It would leave him with 'no choice' but to privatise /outsource large parts of the service for the 'sake of patient safety', whilst laying the blame at the feet of the BMA.

[LondonMix]

Otta Wrote:

-------------------------------------------------------

> Personally I think it's quite shocking how low the

> pay is for people that have studied for years to

> qualify as a doctor. But what I think they should

> do is raise their basic salary, and reduce

> opportunities to supplement with overtime rates.

Otta, that's kind of what the government is doing. I actually don't agree with Hunt on this at all though.

The basic salary for all junior doctors is going up, but pay for unsociable hours and opportunities for overtime are going down. 80% of junior doctors will be better off but the 20% who typically work lots of unsociable hours (A&E, maternity etc) will be worse off despite the pay rise. The government has guaranteed that those worse off based on the new rules will be guaranteed their current pay levels for 3 years.

There are 2 problems with this:

1. What happens after 3 years?

2. A&E, maternity etc are already understaffed because the work is so unsociable. Decreasing the pay for unsociable work is only going to make it harder to recruit junior doctors in future.

I don't think many existing doctors are going to leave the NHS. However, the impact on recruitment could be devastating and fairly immediate.

I get the government needs to cut costs but you can't pay people less than they are willing to work for. The current recruitment crisis makes this abundantly clear and the quality of service will only deteriorate if few junior doctors go into emergency care.

I think its more idiocy than a conspiracy though. Spiraling NHS costs are a real concern given the UK's demographics. Tough decisions need to be made about taxes or the level of service acceptable to the public.

[Jah Lush]

I fully support the strike. Save our NHS. Fecking Tories want to put a price on everything.

 

[Earl Aelfheah]

There are two issues here though. One is pay, on which I get that some people are fairly ambivalent.

The second is how far you can stretch an already stretched resource before something breaks. I can't believe that anyone feels that doctors in training work short hours, or that it would be good for them, or their patients if they worked more. There is a shortage of Doctors in the NHS already. To increase the hours they work, without increasing overall staff numbers seems very dangerous to me, regardless of pay. I think it's here that they have extremely strong grounds to resist the changes and where most of the public are supportive.

[LondonMix]

No one is asking junior doctors to work more rahrahrah!

Doctors are being asked to work the same or fewer hours. However, more of the shifts on the rota would be weekends and evenings, when cover right now is comparably low.

Because the NHS pay more for weekend and evening work under the old contract, the reduce the financial impact of this change, the NHS want to reduce pay for unsociable working times. They have redefined basically what's considered unsociable so they don't have to pay for early evening shifts and shifts on Saturdays.

[LondonMix]

The only way to set pay is to do so at a level at which you can recruit. It has nothing to do with any other consideration.

The government's policy is wrong because even at current pay levels there is a recruitment crisis in emergency work and maternity services. Lowering pay (by reclassifying which hours attract extra pay) is idiotic under these circumstances. It will only make the shortage in these areas worse.