doctors on strike

Lazy useless bastards that they are these days….

You all might know good hard working Doctors, sadly I only know the opposite..

..it’s always been acknowledged that they work their butts off…

Huh?? 😕 Are you trolling yourself now?

until they reach their nirvana of Consultancy where they become rich people doing as much or as little as they desire.

😆

You don’t know a lot of consultants do you?

It’s true that as seasoned professionals at the top of their career they certainly make very decent money:

But they don’t get that on the golf course.

Back in July 2015 when all this was heating up Jeremy said that as part of his attack lies spin reforms he wanted to remove a clause which allowed consultants to opt-out of non-emergency weekend work.

He said: “I have yet to meet a consultant who would be happy for their own family to be admitted at weekends… if you are admitted to hospital on a Friday and you have an important test and then you are told you are going to have to stay in hospital for the Saturday and the Sunday, and then you won’t get a decision on whether you can leave hospital on a Monday or a Tuesday when a senior consultant can come and see you”

Which is all cracking scaremongering – but the BMJ made a Freedom Of Information request and it turned out that hardly any (less than 1%) of consultants actually took the option to opt out.

That is the common mans opinion and this striking none sense is not helping their case.

66% of the public support the strike, 16% oppose it. (BBC News)

Incidentally, to put those consultant salaries into perspective, cabinet ministers like Mr Hunt get £134,565 pa[/url] but he doesn’t really need that considering the £972,538 dividend from his company.

that is the common mans opinion and this striking none sense is not helping their case.

You really are delusional if you think you are the voice of the common man 😯

By all means have your extreme views but FFS no one can think what you say is the common view NO ONE. TBH its so extreme I doubt its even common amongst Tories.

He said: “I have yet to meet a consultant

Now THAT, I can swallow 😀

Getting the diagnosis and care right first time, not the second or third time.

Is that like the Dilbert sketch where the pointy haired boss tells his employees to do what they did last, first and save themselves a lot of work and be more efficient.

Graham S – you can add another 40-60% on top of those base salaries to reflect:

– antisocial hours payments
– the value of the defined benefit pension
– bonuses clinical merit awards
– ad-hoc payments for signing death certificates etc.

And then you’d need to put a value on the following to make a fair comparison with other jobs / employers:

– 35-40 days annual leave
– guaranteed job for life
– the ability to run a job on the side during working hours and using your employer’s resources at no / discounted cost

The BMA is very happy to have a discussion about “pay” as it suits them rather well by obfuscating the objective discussion of total incomes and terms and conditions relative to other jobs.

A good example of this in Primary care is the use of prescribing Pharmacists and Nurses to relieve workload from GPs – in many cases prescribing nurses make better decisions

Thanks for the advice I’ll bear it in mind
(GP partner of 17yre)
Yes we employ nurse prescribers, we’ve had advanced nurse practitioners, we’d like a pharmacist too.
This is undoubtably the future, as so few doctors wish to become gps.
Why do so few doctors wish to become gps?
http://www.bmj.com/content/351/bmj.h6870
Anyway this is off topic it doesn’t relate to the JDs so carry on

The BMA is very happy to have a discussion about “pay” as it suits them rather well by obfuscating the objective discussion of total incomes and terms and conditions relative to other jobs

Its really interesting to see the rapid Tories suddenly getting concerned about these things and not commending the perfect market and the right to be greedy and get what the market will support.

perhaps if they keep striking you will finally develop empathy rather than just use this sort of argument when it suits your agenda?

The BMA is very happy to have a discussion about “pay” as it suits them rather well by obfuscating the objective discussion of total incomes and terms and conditions relative to other jobs.

That table is from an easy-to-find public BMA page. The page includes a link to a 25 page pay circular covering all the details of their pay.

(If you want to see obfuscated try finding the same information on the http://www.nhsemployers.org website – it’s there but it takes digging)

I don’t think consultants get bandings or anti-social hours payments (could be wrong).

But yes they can earn Clinical Excellence Awards which are also listed on that page (though I believe those are to be scrapped in the consultant contracts)

And obviously most consultants don’t get those:

perhaps if they keep striking you will finally develop empathy rather than just use this sort of argument when it suits your agenda?

Which is pretty much the level of “debate” that can be expected on this.

Just5minutes – your post is so inaccurate re consultant pay and just so how little you know

Graham S – the allowances are detailed in the document on the link you provided – see page 14 onwards.

How many employees outside of the NHS would get an additional £60 for delivering a lecture to colleagues in work time that’s already paid for. Or a premium for each customer they see at home in working time they are already paid for?

That’s typical of the ridiculous nature of the current contract.

the ability to run a job on the side during working hours and using your employer’s resources at no / discounted cost

Programmed NHS commitments should take precedence over private work and private commitments should not be scheduled during times that a consultant is scheduled to be working for the NHS. Consultants should not undertake private work while on call for the NHS apart from in cases of emergency or, with agreement from the employer, when on a high frequency and low intensity rota.

Although there is no obligation for a consultant to undertake Programmed Activities (PAs) in excess of 10 per week, one of the criteria for achieving progression through the pay thresholds is that consultants should accept an extra paid PA in the NHS, if offered, before doing private work.

So that’s 40-44 ringfenced NHS hours before they do their private work – unless they actually break the terms of their contracts

Consultants may see patients privately within NHS facilities with the explicit agreement of the responsible NHS organisation. There must be no disruption to NHS services.

Is there a problem here ? Presumably the NHS facility would cross-charge as it felt appropriate. Spire/CareUK etc are by far the major sites for this stuff anyway

Which is pretty much the level of “debate” that can be expected on thiswith you

As noted have some principles beyond blindly peddling tory spin to the point it is just lies.

Debates dont happen with you.

So who is winning the medal for most distorting facts (sic) – Hunt or the BMA? What an unedifying bloody mess. Both parties need their bloody heads bashing together and reminding that it’s not (just) about you.

Still with monopoly employer and monopoly provider it’s hard to expect much better.

Graham S – the allowances are detailed in the document on the link you provided – see page 14 onwards.

Yeeeeeesh – like I said.. the contracts are hard to follow (bear in mind this is NHS Employers that produce this, so don’t go thinking this is the BMA obfuscating stuff – they try to help members make some sense of all this guff).

Right, so no simple bandings there – but some additional payments (with lots of conditions)

How many employees outside of the NHS would get an additional £60 for delivering a lecture to colleagues in work time that’s already paid for.

I’m guessing you mean the line that says:
Consultants – lecture – £60.48

So that apparently cross-references to Schedule 11 of the Terms and Conditions which says (among lots of other things):

In the case of the following services, the consultant will not be paid an additional fee…
• lectures and teaching during the course of the consultant’s clinical duties;
• lectures and teaching that are not part of the consultant’s clinical duties, but are undertaken during the consultant’s Programmed Activities.

So no, looks like they don’t get that one (even though they probably gave up an evening or two of their spare time to prepare the lecture).

Or a premium for each customer they see at home in working time they are already paid for?

Not sure which line item you mean there? But feel free to check the T&Cs for the appropriate clauses under which that is paid too.

That’s typical of the ridiculous nature of the current contract.

Indeed. Makes my brain itch just trying to follow it. 😕

No doubt there will be another thread when/if the consultants decide to kick off about their contract changes.

Graham S – you can add another 40-60% on top of those base salaries to reflect:

– antisocial hours payments Consultants get paid by how many sessions they work. They then do get an antisocial hours payment no more than 10% aand this varies by specialty, some get none[/i]
– the value of the defined benefit pension I think Consultants would agree they get a good pension, however they now pay more to get out less, and the total pension pot they can accumulate has been halved[/i]
– bonuses clinical merit awards What bonus? Some Consultants get Clinical Excellence awards for going above and beyond the normal duties of their job
– ad-hoc payments for signing death certificates etc.Well it actually tends to be Juniors that do this. They get roughly £40 per certificate. Who do you suggest should do this legal document? [/b]

And then you’d need to put a value on the following to make a fair comparison with other jobs / employers:

– 35-40 days annual leave really? I thought the max was 37, but hay what do I know[/b]
– guaranteed job for life [/b]Ok got me there, but mortality rates are high, due to stress, unsocial hours, burn out
– the ability to run a job on the side during working hours and using your employer’s resources at no / discounted cost [/b]please substantiate this, go on, I would love you to. Surgeons that I know who have PP work 7 days a week and most evenings

The BMA is very happy to have a discussion about “pay” as it suits them rather well by obfuscating the objective discussion of total incomes and terms and conditions relative to other jobs. [/b] Are you sure you want to have that discussion. I really do not think you even understand how many hours they work, how difficult their qualifications are to achieve, and how many hours they in reality put in to their work….oh and the cost of this too.

When you compare Consultant pay to Accountants, Lawyers, Senior Managers, MD’s, CEO’s etc, then Consultant packages look far less attractive.

Again, pay a mediocre salary, attract mediocre staff.

Both parties need their bloody heads bashing together and reminding that it’s not (just) about you.

When have the doctors ever said it is just about them?? I agree they are not putting the case across very well. However the Government is offering no further funding but wants a 7 day service. Their only answer to doing that is to pay existing docs less, and spread existing doctors more thinly across the 7 day week.

They cant get more doctors because 1. They have reduced the number of training posts in recent years. 2. They have changed immigration rules so that large numbers of Indian/African docs that would have once supported the NHS can no longer come to the UK to work.

What entire rubbish people on this thread have been spouting. I’ve only worked as a doctor for 2 1/2 years but in that time I have seen enough to understand the way the NHS works. Paid for death certificates?! We certainly b**** well do not! It takes me around 3/4 of an hour to do one due to having to scrawl through patient’s notes to find out the exact date the various and often multiple ailments that contributed to their death started. However, I would never dream of asking for extra money for this. It’s one of our responsibilities and is a fundamental part of caring for patient’s, albeit after death. WE DID up until April get money for cremation forms paid to us by the funeral directors, although many people gave theirs to charity. This has now stopped completely as it was felt generally this wasn’t ethically appropriate.

I have just had my first holiday since September. I worked in 5 wards over the christmas period with 1 day off over 17 days. As a junior with my experience I am expected to manage up to 30-40 patient’s by myself, patient’s who are frequently close to death and any decision I make may shorten or lengthen their life if I make the right or wrong judgment. This I did expect when I went to medical school and although often under-prepared for some of the things I see, I know how to manage situations and when to ask for senior help. This help is available 24/7 either in person or on the end of a phone.

The bandings system is in itself very flawed. I get a 50% extra overall if more than 1/3 of my work time is spent outside monday – friday 7am-7pm currently. This meant as an FY1 I took home a gross salary of around £31000 gross in the first year. I did however come out with £72000 of student loan debt, £10000 graduate loan, £6000 of credit card debt plus myself and my partner also owed £3000 to family members. We did work in the first years due to the longer summers but the summer was reduced to 4 weeks in the final 3 years and the study was relentless. We felt we simply couldn’t work part-time and be guaranteed to pass our exams. Some do but they often suffer significantly for it. As our training is 9-5, Mon-Fri with study afterwards it’s not difficult to see why. It’s also not difficult to see why increasing the amount of student loans people have to pay back will make medicine again a purely elitist vocation (which is in nobody’s favour) but I digress. My actual take home pay was less than the above figures as some of the jobs were very carefully rota-d so that you would be at 32% anti-social hours!

Typically in a rota I would work 1 weekend in 3 or 4, sometimes working 80 hour weeks, often working 4 nights in a row. I have gone around a week at times without seeing my fiance just because our hours don’t overlap. All of these hours I am a decision-maker. All of these hours I review patient’s, decide on treatment plans, discuss issues with patient’s families, attempt to implement treatments for incredibly complicated patient’s who often will have several drugs that interact or that they shouldn’t take, or that may have caused some of their medical issues. When the S*** hits the fan it is me the nurses come to for help, me who has to decide what to do next.

I don’t actually have much time to spend money but why is it so difficult for people to believe that for this responsibility and sheer emotional duress I undergo that I should not be rewarded somewhat for what I do. Are these salaries gross, fat-cat salaries that other members of the population can only dream of? Having worked in Aberdeen where the average salary for workers in the oil industry seems to be 80-100k looking at their porsches and bmw’s, why does the fact that senior registrars who often act up as consultants at the end of their training can earn a maximum of £60-70000 seem to be paraded in the press as the definition of greedy doctors that somehow must be stamped out?! What social values does this signify about society and if the argument that the public sector can never expect to earn what the private sector does, I would ask those who post this question to answer me both why and what economic philosophy this is based on. On top of this, can I say that we as doctors are outright REJECTING any notion of private healthcare in the UK DESPITE it offering us greatly inflated salaries as seen in many countries including the US because these systems do not guarantee fairness and free healthcare at the point of use.

The first crazy message the government has spun about the NHS is emergency care needs to become 24/7. What a fantastic, wool-pulling load of old cobblers this is! What the f*** do they want the public to believe we do when we work all these un-social hours?! Do they think people don’t understand that the rota’s we work are made in such a way that this is EXACTLY what is achieved. We are there 24/7, 365 days a year, undertaking PURELY EMERGENCY CARE.

What doesn’t happen at weekends and at night is routine hospital appointments, elective surgery and out-patient scans. TO DO THIS, the amount of money needed would be huge. You can forget your £8 billion pound figure, which is already costed and in line with other close members of the EU. We are talking 20, maybe even 30 billion extra a year to put this in place. The administration costs of this are huge. The costs of an extra day per week for all the consultants, registrars, nurses, ward clerks, radiographers, laboratory scientist’s, cleaners, porters, IT staff and every other part of the essential infrastructure that maintains the NHS on a day to day basis would be incredible. Simply making sure more doctors are in on a Saturday won’t change a thing apart from reducing pay and reducing morale.

As Jeremy ‘unt has stated, this is going to be cost-neutral. The most important part of this is we are not actually asking for MORE money, just NOT FOR LESS. We also reject the notion of a need for us to work more anti-social hours because the way the NHS works now is incredibly efficient at emergency care. So many international comparisons place the NHS as a world leader and there is no health service in THE WORLD that offers non-urgent care 24/7!

The second aspect of all of this that makes all of the junior doctors sad is that the binding penalties that Jeremy ‘unt seems to want to scrap were fought for and won at great cost by a preceding generation of doctors. That generation remembers with horror sometimes doing 4 days on-call with the occasional 3-hour kip. Hospital’s weren’t meant to but as doctors had no method of complaining and it was often career suicide to do so, people either put up or quit. Are the memories of people so short that they don’t remember this? The whole reason this had to change is that doctors were leaving the NHS in droves! Why did that stop? Because these safeguards meant the risk of mental ill-health had reduced to a level that many could cope with and support structures had improved. We are striking as a result of this as much as anything else the government are proposing. We know that guidelines with no teeth are guidelines that won’t be adhered to.

Nobody wants to see those days return. Please understand it is very difficult to see the exact implications from outside the NHS of what this will really mean for the medical work-force but we are all standing up FOR the NHS as we actually believe it’s pretty blooming good!

Well said speedstar.

Speedstar…………very well put sir. I have some cousins with kids who are either in medical school or are working as trainee doctors and they tell very similar stories.

Be assured that the vast majority of the public back you all the way.

typical lazy doctor Speedstar – its a leap year so what you only covering 24/7, 365!!!
(Niall, husband of ‘junior’ doctor last seen Friday last week)
Edit – in case any doubt, well put and accurate but no doubt to some your inside knowledge will be wrong as they know more from internet browsing.

Very well put. Thanks for your input.
I’m disappointed that you’ve brought experience and facts in here though. It gets in the way of the idiots and their poorly informed snap judgements. 😉

I’m not sure these people ARE idiots matbee. But I think some people want to believe some things about others and some people don’t really know what to believe. It is incredibly easy to convince a non-insider public of some things with the artful use of media crohnies and we have seen that in the Sun and Daily Telegraph in the last few days. What I would ask people is to look at their own jobs and outlook and understand that as workers in public services we all need to fight to sustain and improve these services. Even if these plans are well-meaning by the current government (and many are suspicious they are not) we as doctor’s are very convinced this will not accomplish the ends publicly stated as being sought.

Thanks to the others for their comments. GrahamS you’re putting up a great fight. I now know this is a leap year (!) and I wll most likely be working one extra day this year ;D

And don’t forget to work the clock changes too – night shift when they go back and long days either side of when they go forward for extra penance 🙂

Haha yeah I know that particular (unpaid) hour hurt more than some. Thankfully I wasn’t on night’s at that point!

When I worked in ITU (nurse) it was most upsetting figuring out where to put the extra set of obs on chart for that hour.

Sorry, back to proper discussion content – your wrong so there!

speedstar – Member
What I would ask people is to look at their own jobs and outlook and understand that as workers in public services we all need to fight to sustain and improve these services.

You do know public services means bureaucrats don’t you?

I would not use the term ‘public services’ coz that just represents people that inflate their own importance to justify the taking of the people’s hard earn money … they are like leeches filling up themselves without you knowing very skillfully.

😯

That’s an intersting point although I think we are coming from a different semantic perspective and possibly this title has become associated with bureaucracy, of which there is a significant amount (necessary and unneccessary) in the NHS. By public services I mean medical staff, police staff, Fire service staff etc. The provision of the service is what must be fought for and I know our colleagues in the fire service in particular have been placed in very difficult times in recent years. Again I question whether the public’s values have been misappropriated by the government?

Oh and Northshoreniall just write it at the edge 😈

Again I question whether the public’s values have been misappropriated by the government?

Undoubtedly. Unfortunately, they (media? Government? Shadowy corporations? Makes you think… 😉 ) are getting very, VERY good at this, and the general public remain as unaware of their manipulation as ever. It only really hits home how shockingly calculated and deliberate the misinformation is when the subject is something very close to home.

It’s not about the money.

The thing about being a doctor is that it’s constant across the world – give or take a few differences here and there. I don’t think it’s accurate to call doctors ‘public service bureaucrats’ since outside of the UK, people do the same job, the same profession, but in private facilities and aren’t classed as public sector workers. In fact, in some (most?) countries around the world, doctors are held in high esteem and rewarded commensurately.

But it’s not about the money.

Of all the people involved, the junior doctors are exceptionally well-placed to understand the ways in which the NHS can and should evolve. They’re also a group who act as advocates for their patients – because a tory government certainly won’t. By ignoring and alienating this huge resource, the health secretary is (to my mind) either tacitly admitting that he doesn’t actually want to improve the NHS, or that he holds the opinion of this group of doctors in such low regard that he won’t even entertain their concerns. Either way, this is not the way to run the NHS.

It’s not about the money.

By making NHS contracts antisocial and unappealing, these changes will drive doctors into non-NHS work – independent sector treatment centres etc that won’t be constrained by the whimsical soundbite notion of a “24/7 NHS”. Hence the expansion of the private healthcare sector. The private healthcare sector, that, as far as I can work out, Mr Hunt owns most of. HateUNextTuesday.

It’s not about the money.

I dislike the way this dispute is labelled The junior Doctor’s Dispute. That immediately suggests that Junior doctors are to blame. It should rather more accurately be called, ‘Another Government Provoked Dispute/Cock Up, which this time impinges badly on Junior Doctors and the service they give the public’, as opposed to a very full list of previous Government Provoked Disputes which impinged on Teachers, Fire Fighters, RAF, Navy, Army, Police, etc etc etc. and the various services they give to the public.

Not funny, came out in a cold sweat there.

Very well said, speedstar.

Whilst both sides need to calm down & re-focus, for sheer manipulation & spin (esp of stats & the muddled claims about weekends), the DoH & Hunt come out of this far worse than the BMA.

This was like something out of In The Thick of It…

Having worked in Aberdeen where the average salary for workers in the oil industry seems to be 80-100k looking at their porsches and bmw’s, why does the fact that senior registrars who often act up as consultants at the end of their training can earn a maximum of £60-70000 seem to be paraded in the press as the definition of greedy doctors that somehow must be stamped out?! What social values does this signify about society and if the argument that the public sector can never expect to earn what the private sector does

Oh dear where to start, as there is so much wrong with this ranty paragraph. (1) the guys offshore are paid a premium as it is a dangerous environment
(2) plenty of O&G workers have significant responsibility with bad decisions that can result in many deaths
(3) Job security, North Sea O&G job losses are now into the thousands, since 2014, and the ones still in work are on longer shift patterns and/or less money. How does that compare to doctors in the NHS?
(4) So you think oil isn’t important to UK society?

(4) So you think oil isn’t important to UK society?

You think North sea oil is more important than a working NHS?

I think you are missing his point dragon.

As I read it, he ISN’T saying that O&G workers don’t deserve that pay.

He is asking why no one seems to bat an eyelid at the pay packets in jobs like those, but doctors get regularly demonised as greedy for being paid quite a lot less than that.

@billyboy….following on …I suggest a bet…question is ..who can the tories upset next?

We’ve had…fracking, working tax credit, disabled benefit cuts, human rights act, legal aid being cut, bedroom tax, royal mail shares being sold to city fat cats, environmental budget cuts making the floods worse and now doctors..this was just off the top of my head…what’ll be next?

This is why Corbyn will never win…he listens to others way too much….

You think North sea oil is more important than a working NHS?

Not more important, but oil is integral to how we currently live as a society (plus tax revenues). And on a wider point energy supply is more important than the NHS.

doctors get regularly demonised as greedy for being paid quite a lot less than that.

Doctors aren’t getting paid less once all benefits are taken into account, and it is allied to the fact that O&G workers are in a properly competitive private sector, so it up to companies to determine what they pay.