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On GP wages: people who don’t think GPs should be able to afford to ski obviously aren’t bothered about not having a GP.
Brilliant. And true.
Two separate arguments here: is 2.8% a reasonable pay increase? and is the base salary enough?
Is 2.8% a reasonable increase? probably. I'm looking at 2-3% in the private sector, inflation's coming down too, so as a deal it's pretty vanilla.
Is the base salary enough? no, probably not. It's the NHS that fixes people up and sends them back out to work, so they can drive the economy, so it stands to reason that the better NHS we have then the better economy we have. But it all comes at a price as the books need balancing and promises have been made to not put up taxes when in reality that's exactly what needs to happen - but no-one's going to like that!
Only other thing that's going to increase the size of Government spending is either economic growth or borrowing, and we definitely don't need more borrowing. We should pay some off but then that'll reduce the amount of money to spend on NHS wages.
Balancing the books is not easy and every decision to spend more is met with another one that needs to be made to spend less, so if we spend more on the NHS what do we spend less on? Defence? Roads? Police? I don't have the answers.
I don’t know any doctor that feels underpaid, just ones that feel over worked
That's really not the tone of our BMA-led trust WhatsApp group. There may be embarrassment about admitting that to non-doctors, though (and in any case I think what people are driving at is similar pay for not doing a load of effectively mandatory overtime)
Doctors particularly seniors are well paid compared to the rest of the public sector. Whilst I do not disagree they are underpaid overall they have done better than care assistants, cleaners, junior nurses etc over the last 14 years.
I'd like to see some thought given to biasing rises to the lowest paid for now. Sorry docs - you can wait your turn 🙂
@ratherbeintobago indeed. Just look at the rather ridiculous reaction on here to the fact that I've been on a skiing holiday.
There's also a taboo amongst doctors about admitting that money is a motivation for practicing medicine which starts at our med school interviews.
they have done better than care assistants, cleaners, junior nurses etc over the last 14 years.
Sorry, that's just not true. "Rich" doctors have been an easier political target than our less well paid colleagues, who I believe have had relative protection from pay freezes etc.
I don’t know any doctor that feels underpaid, just ones that feel over worked
That’s really not the tone of our BMA-led trust WhatsApp group. There may be embarrassment about admitting that to non-doctors, though (and in any case I think what people are driving at is similar pay for not doing a load of effectively mandatory overtime)
My feeling is if conditions of practice / workloads were better sorted that would go a long way towards improving retention. Probably cost more than a pay rise but lead to a better service. And yes - some hospital doctors hours and pay structure are stupid.
Re doctors pay, giving them bigger payrises is just enabling them to go part time / retire earlier thus reducing capacity overall making the existing issues worse – it won’t make them ‘happy’ they aren’t on the breadline so its not a material impact in that sense.
Those retiring or going part time are doing so because it’s costing them to go to work. My wife’s colleague is dropping from 14PA’s to 10 because it’s costing her to go to work.
I know many that disagree with that. From where hospital doctor pay used to be it has been massively eroded. Other professions offer much better pay. Newly qualified are all going abroad where they can earn far more .
You don’t become a doctor to become rich these days
Mrs FD has a consultant post out at the minute . Very prestigious job , great part of the world , but not one single uk trained applicant.
I am Dr and I have never been on a skiing holiday
@Kramer The other thing is that Ireland has just negotiated a new consultant contract, the starting salary for which is 3x what it is in the UK. Even if you accept that a lot of Ireland is 10% more expensive to live in, this is causing a few people to pause for thought.
And it's also causing massive problems in NI.
@tjagain The issue is that doctors are relatively well paid, but that doesn't mean the pay erosion isn't worse.
There is not a "one size fits all" for doctors pay and retention. GPs, consultants and FY1s al need different things. We also need to train more of them.
I merely suggest that given the budgetary restrictions lets bias pay rises towards the lowest paid in public service. Those who are ending up with top up benefits or even using food banks
For those stating that improving quality of life alone for GPs will solve the problem, it won't.
25 years ago, we had a pretty good quality of life as GPs, less complaints, shorter hours, much better hospital support, and better hours.
We could not get doctors to apply to training schemes because of the low pay.
If got fixed when New Labour gave GPs a massive pay rise.
If you want decent quality GPs with decent access (and you probably should, because it would fix many of the problems with the NHS) you need to pay us well enough and improve our conditions.
Successive governments keep on trying to get a GP service on the cheap, and that's why we're so chronically short.
If I'd been doing the same job for the last 20 years, I'd be the equivalent of at least £20k worse off. Add inflation over that period to the £32k I initially took for the engineering team role and that should be the equivalent of £70k+ now - just to keep up with the rise in the price of everything. £70k is still senior+ money and we're all getting screwed.
I am Dr and I have never been on a skiing holiday
You should try it. It's a great way to meet <checks notes> other doctors. 😉
GPs are different, and I dare say @Kramer knows better than I, but my general feeling was that GP is the one part of the NHS that was truly world-class, and what they need is the resource to make things better (which will include pay) rather than a reorganisation to make things more like secondary care.
For hospital doctors, it's relatively straightforward - we need pay restoration, and what I do now is not worth less in real terms than what I did in 2008.
@Kramer Believe me I have lots of other things I'd like to spend my money on than skiing. More bikes for one thing.
they have done better than care assistants, cleaners, junior nurses etc over the last 14 years.
Some of those will be on min wages, and those have had a percentage increase more than GP/doctors have.
And will still be unable to pay their rents and utility bills while some of their colleagues will be skiing.
you need to pay us well enough and improve our conditions.
The biggest headaches I have now (in no particular order) are probably patient expectations, regulatory framework (the onerous level of compliance), ICB interference, the continual shifting of workload to GP, performance monitoring - pointless league tables, data gathering for 3rd party bodies, hoop jumping for funding.
And will still be unable to pay their rents and utility bills while some of their colleagues will be skiing.
And the option here is paying highly trained, highly skilled professionals what they're worth, which means they can go skiing, or not doing so, which means they'll be skiing in NZ or Canada having emigrated, which means you can't access a GP.
Obviously all NHS staff deserve pay restoration.
And will still be unable to pay their rents and utility bills
Oh sure, but they've still seen a larger increase. Last year alone was nearly 10%
And the option here is paying highly trained, highly skilled professionals what they’re worth, which means they can go skiing, or not doing so, which means they’ll be skiing in NZ or Canada having emigrated, which means you can’t access a GP.
Obviously all NHS staff deserve pay restoration.
Well said. I just found that skiing comment rather tone deaf but I may be being a little sensitive after a year where my outgoings have gone up massively while my pay hasn't. But, I'm not a teacher or a medic so have no more comment to make, other than maybe some sarcasm. 😀
@kramer just to be clear I do think doctors are underpaid, I say that as my partner is a doctor, so I see the level of responsibility required for the job.
However, if you want to drive the discussion and get people to agree that doctors should be paid more, it’s probably best to leave out the anecdotes about your skiing holidays, as this will alienate many people. Just because you don’t get paid what you deserve, doesn’t mean you aren’t in a position of relative privilege, and you should be mindful of that
FYI I get paid more than my partner, so I’m not speaking from a position of envy here
Re doctors pay, giving them bigger payrises is just enabling them to go part time / retire earlier thus reducing capacity overall making the existing issues worse
Exactly what we are experiencing locally. I mean, I get it. How are you going to fit in all your holidays if you're working full time?
Re doctors pay, giving them bigger payrises is just enabling them to go part time / retire earlier thus reducing capacity overall making the existing issues worse
I'd argue the contrary - letting people do fewer hours makes them less likely to go early, and paying more makes it easier to recruit/retain.
The communist dream, eh, IdleJon, everybody should be poor. Fact is that medical studies are long, expensive and hard work, and it takes more than just vocation (which we all hope is the main reason our doctors doctor) to get to be any kind of doctor. There's an opportunity cost too, if you're talented enought to get through medical school you could probably get into other even higher paid professions.
It's slightly easier to become a teacher and again having a vocation is a big part of it for most. However, in my case the desire to go skiing, own an energy efficeint house, bring a kid up without economic constraints, live somewhere properly nice... trumped the teaching vocation. So I have low pay, shitty conditions and a dick of a headmaster to thank for my subsequent success in life.
I assume that’s aimed at me. Fair enough. I don’t know you and couldn’t care less about you and how much you do or don’t get paid. However I’m not the one who is trying to persuade others that I should be given a pay rise. So you can consider the advice, or ignore and carry on as you are - your choice
It wasn't either or, the point was one of the challenges is capacity doing anything that reduces capacity is not going to be helpful
I gave the example of funding medical qualification. I mean we desperately need doctors. Why do we put in a huge financial barrier to those who are unable or unwilling to saddle themselves with huge debt? I think all bar one doctor I know is from a family of doctors who were able to fund them through med school.
People from poorer backgrounds 'moving up' are less likely to be thinking a guaranteed job for life paying double+ naitonal average with a great pension is rubbish. I can also assure you, unless you are very lucky, you can't just jump into another profession and earn £100k+ no matter how bright you are, you'll need to retrain and get experience.
As for moving abroad, there are pros and cons, I doubt there are enough posts for everyone whose threatening they can just pop over to NZ or canada
I’d argue the contrary – letting people do fewer hours makes them less likely to go early, and paying more makes it easier to recruit/retain.
Yes, certainly in GP land, the people I know, myself included, who work part time, do so to maintain their mental health.
If I didn't have the option to work part time, I'm pretty sure I'd have left the profession or emigrated.
I also studied for a long time, am told by my colleagues that I'm good at my job, and work hard. I'm also aware that I'm luck to be able to do so, but I won't be ashamed of getting paid more than some, and spending it on things that I enjoy and are good for my mental health.
Oh sure, but they’ve still seen a larger increase. Last year alone was nearly 10%
Given "official" Uk inflation over the last four years i strikes me that nurses have still lost out. Take into account that inflation has been highest on the non discretionray spending such as housing, transport and energy and people on low incomes have seriously lost out to inflation.
One NHS sector that is definitley overpaid is the host of non-productive managers and admistrators that the modern world has created. 😉
the same argument for retention can be made all across the public sector
I doubt there are enough posts for everyone whose threatening they can just pop over to NZ or canada
That really depends, from my team of 12 we have lost two consultants to Canada in the last 18 months.
We're losing a partner to Qatar in two weeks. He's only been a partner for less than two years.
What are the employment prospects for doctors in Tobago? Looks good to me:
https://tntmedical.com/category/job-opportunities/
Yes, certainly in GP land, the people I know, myself included, who work part time, do so to maintain their mental health.
If I didn’t have the option to work part time, I’m pretty sure I’d have left the profession or emigrated.
This has almost become the default with GPs I believe.
I doubt there are enough posts for everyone whose threatening they can just pop over to NZ or canada
I don't know a single person who's looked and not been able to find one.
Doctors are very expensive to train, which is why so many developed world countries import them from other countries.
The next one that is opening up for GPs is the US. Where the average GP makes roughly three times as much as they do over here.
the same argument for retention can be made all across the public sector
Agreed, especially in education.
However I'm not aware of another sector where similarly and less qualified colleagues have had a 20% pay rise compared to our 6%. Bearing in mind that every year that it's not sorted is putting us further behind.
Skiing holidays don't stop you crying in the shower before you get ready to go to work. Reduced workload and better support might.
Also on a side note, % wage increases drive a bigger wedge between the rich and poor. It's a smokescreen to make people think things are fair.
Whilst we add to it, it’s not just medical staff
There are some pretty ropey senior managers in the NHS.
Why would you go and work in the NHS as a Director when you can earn £500k in industry as a Director
I’m nowhere near £100k+ whole time equivalent
are you taking into account your pension provision?
honestly life in 'other' professions is not a walk in the park, certainly not those earning really good packages. I'm not saying its worse than the NHS, nor that the NHS is fine and doesn't need more funding, just that I think the finite money that can be provide should be focused on the elements that will improve the situation the most. And increasing already good packages isn't what I see as the top priority for that funding.
The communist dream, eh, IdleJon, everybody should be poor.
Or another way to look at it is that there's enough money in this country that nobody should be poor and Kramer can still afford his skiing holiday and be paid what he feels he deserves.