Doctors striking?

[LondonMix]

The government are guaranteeing that no one will be worse off (even if technically they should be under the new rules, their pay will be topped up). However, this is only good until 2019. Also, as you rightly point out, it will be a disaster for recruitment and retaining staff.

[Blah Blah]

This is the same government that claimed tax credit cuts wouldn't leave people worse off and tried to hide deaths of people found fit to work by their flawed work capability assessments. I wouldn't place any credability on government claims. They are very poor on impact assessment.

[Loz]

Blah Blah Wrote:

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> Junior doctors on the other hand earn between ?22k and ?28k.

I'm happy to support the junior doctors, but that's not true, BB. They start on a basic pay of about that, but in reality they get about ?35k when they start after extras are added. You can be a junior doctor for many years and salary will rise in that time. Some registrars are on well over ?50-60k.

[uncleglen]

Otta- you cannot say that doctors are 'worth more' than teachers ffs....how would kids get into medical school without a decent bunch of teachers along the way?

[srisky]

The 22k-28k is for a 40h week with no out of hours commitment, effectively Mon-Fri, 9-5pm.

I don't think that is really a great salary for the qualifications/length of degree course required, the responsibility that they undertake (even the most junior doctor has significant responsibility) and additional work that is required out of their own personal expense (e.g exams and course, which are mandatory and cost several hundreds).

The supplement (which increases their base salary) comes from working out of hours and is weighted according to how unsociable the hours are and how frequent - these are not negotiable in the contract of that post.

Most junior doctors change post every 4 months, rising to 6 months/year and registrars to 1 year. Their salary can, therefore, fluctuate quite wildly every 4months-1yr depending how frequent/unsociable the out of hours work is in that particular role. They often don't find out until the first day of their post what their salary will be - makes any sort of financial planning quite difficult.

Registrars often rotate within a region, e.g southeast of England. The main challenge for them to get a post within a region of their choice in order to be in the vague vicinity of family and friends. They are effectively guaranteed a job for 5 years but will have no idea which hospitals within a given region they will be working in over that period or the salary, e.g for one year they maybe at King's then with approx. 2 months to go they may well be told that they have to work in Canterbury (they can make a case for where they would like to be placed but final decision is generally not negotiable). There used to be a nominal financial contribution to travel/relocation but I am not sure whether that still exists. It also makes family life quite difficult.

They perhaps should know some of this before embarking on a career but it would be difficult for most 18y olds to truly understand any career and its implications on your work-life balance and finances.

I am not making a case for an increase in salary (in fact, that is not what the strike is about) but it is not all pockets stuffed with cash and rounds of golf either.

[LondonMix]

They don't deny that some people will be worse off without a top up. What they are saying is that they will guarantee the current earning levels of compensation for those doctors. This has nothing to do with impact assessment, its a formal salary guarantee. I think current estimates are the 20-25% of junior doctors might be worse off without the guarantee so that's entirely clear.

The problem is this guarantee / pay protection is temporary (2019) and won't apply to new recruits. If you already can't recruit the staff numbers you need, reducing pay inclusive of bonuses and increasing the amount of evening and Saturday work (as is very likely) will only exacerbate the problem. That's why I support the junior doctors- its simply a bad long term policy.

No one can make a specific argument about what someone is 'worth'. People decide what to do with their skills based on not only the salary but also working conditions as well as the personal fulfilment (or lack thereof) a job provides. The market rate is set at the level where you can recruit all the people with the skills you need. By that measure and that measure alone, junior doctors are underpaid.

Blah Blah Wrote:

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> This is the same government that claimed tax

> credit cuts wouldn't leave people worse off and

> tried to hide deaths of people found fit to work

> by their flawed work capability assessments. I

> wouldn't place any credability on government

> claims. They are very poor on impact assessment.

[Otta]

uncleglen Wrote:

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> Otta- you cannot say that doctors are 'worth more'

> than teachers ffs....how would kids get into

> medical school without a decent bunch of teachers

> along the way?

"Worth more" was bad wording on my part. But lets be honest, it's not really that difficult to become a teacher.

That's not to say teachers don't work bloody hard, and a lot more hours (often at home in the evenings) than people realise. But a teacher can quickly work their way up to a very healthy salary, and they certainly don't work the unsocial hours that doctors do.

People don't have to agree with me, but in my opinion a doctor should be paid more than a teacher.

[Jeremy]

uncleglen, your logic doesn't stand up - unless you honestly believe teachers should always get paid as much as the eventual salaries of the pupils they teach.

Surely teachers realise that the brightest kids in their school are rapidly becoming smarter than they are. The trick is not to let them know that you know...

[Earl Aelfheah]

Blah Blah Wrote:

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> Medicine and law have always been seen as

> lucrative, respected and stable professions by

> parents, but as with most things it depends on

> speciality.

This reminded me of George Osborne's comments, where he said of his ?20,000 a year private school, St Paul's, that it was "incredibly liberal" because "your mother could be the head of a giant corporation, or a solicitor in Kew."

[LondonMix]

No one's salary is determined in this way. Train drivers make a lot because the job is soul-destroyingly dull.

A broadway actor makes less than a hollywood movie star and talent and effort have nothing to do with it.

People choose to do what they do based on not just how much effort it is or how much skill is required but how the feel about the work. The salary should be set to attract just enough people into the industry and no more. Every other consideration is just noise.

Otta Wrote:

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> uncleglen Wrote:

> --------------------------------------------------

> -----

> > Otta- you cannot say that doctors are 'worth

> more'

> > than teachers ffs....how would kids get into

> > medical school without a decent bunch of

> teachers

> > along the way?

>

>

> "Worth more" was bad wording on my part. But lets

> be honest, it's not really that difficult to

> become a teacher.

>

> That's not to say teachers don't work bloody hard,

> and a lot more hours (often at home in the

> evenings) than people realise. But a teacher can

> quickly work their way up to a very healthy

> salary, and they certainly don't work the unsocial

> hours that doctors do.

>

> People don't have to agree with me, but in my

> opinion a doctor should be paid more than a

> teacher.

[malumbu]

Withdrawal of labour is the organised unions last resort in a dispute. In the modern world most employees would take this decision very carefully. Widespread industrial disputes are a thing of the past. It is a pity when they have to resort to this when all avenues fail.

[uncleglen]

The BBC reported that 98% of junior doctors voted to strike...they did not give the full facts (what a surprise).

30,000 were sent ballot papers out of 53,000 junior doctors.

76% of those 30,000 replied,

98% of replies were in favour of striking

That is 22,344 junior doctor out of 53,000 which is just over one half of them.

[LondonMix]

The BBC always disclosed all of those facts. Did you want them to spell all of that detail out in the headline?

http://www.bbc.co.uk/news/health-34859860

Anyway, the mortality rates at the weekend and at bank holidays is far too high. The rota needs more doctors (junior and consultants) during these times but its absurd to think you can force people to do so without additional compensation.

[mikeb]

Moreover, they appear to have sent out 37,700 ballot papers, much more than uncleglen said. FT says 46,000 doctors are affected by new contract http://www.ft.com/cms/s/0/503a72e8-b915-11e5-bf7e-8a339b6f2164.html#axzz3wwkTOr4C . Not clear why they only balloted 82% of doctors affected, though maybe the others are not members of BMA.

76% response rate is incredibly high (much higher than turnout in a general election let alone local / European elections). And 98% vote in favour is pretty compelling.

I think it's clear the BMA has a much stronger mandate for its position from those it represents than Jeremy Hunt does from the general electorate.

[edit: I think BMA probably has a stronger mandate from the general electorate than Hunt as well, though that is harder to prove!]

[edit 2: PS I am not a doctor ...]

[Blah Blah]

Not all junior doctors are members of the BMA and it was also agreed that there would still be emergency cover by some junior doctors.

[LondonMix]

Yes, a resident I know who works in the NICU abstained and she said most of the residents in NICU did the same. She says NICU residents always ignore bank holidays as well and always keep a full rota despite their entitlement for the day off.

I'm not sure anyone working with babies in intensive care could do anything but without feeling terribly responsible if something went wrong due to a staffing shortage.

[uncleglen]

yes, why on earth would you go into such a profession if you did not wish to provide a full service.

[Otta]

One junior doctor made the point that the service provided during the strike was the same as you'd get on a bank holiday, or indeed a royal wedding.

That said, proceedures wouldn't have been booked in for a bank holiday, so people won't have to have them cancelled.

[LondonMix]

Its an interesting one.

Apparently full coverage in the NICU isn't mandated on a bank holiday as such. Its just people drawn to that specialty feel a genuine duty to always provide full coverage (at least in her experience and in her hospital). I guess its tough looking at parents during the worst moment in their lives and deciding you want to go to a BBQ on a bank holiday instead of agreeing to provide cover.

The doctors get a day off in lieu and extra pay (as anyone would) when working a bank holiday but it seems in other fields outside the NICU many doctors simply prefer the actual bank holiday day off and things operate with skeleton staffing. That and NHS trusts trying to balance the costs of full cover within their tight budgets as staff cost more during holiday periods.

[Otta]

Problem is time off in lieu is pointless when there is no opportunity to use it.

[LondonMix]

Yes, the shortage of staff mean that working conditioners are even more shit than they should be.

[srisky]

There is no extra pay for bank holidays but there is time off in lieu.

[srisky]

Yes, this is not an infrequent problem and it is not unusual for days of annual leave to go unspent

Otta Wrote:

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> Problem is time off in lieu is pointless when

> there is no opportunity to use it.

[srisky]

Striking and wanting to provide a full service are not mutually exclusive, in much the same way that teachers striking and having a passion to educate are not mutually exclusive.

uncleglen Wrote:

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> yes, why on earth would you go into such a

> profession if you did not wish to provide a full

> service.

[LondonMix]

Yes, you are right. Its nurses who get extra pay on bank holidays in addition to time off.

srisky Wrote:

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> There is no extra pay for bank holidays but there

> is time off in lieu.