Forum menu
You should try working in a private hospital. You would come to a different conclusion once you had heard them talking about what drives them.
I would agree with that , there are a sub group of surgeons who start medical school with the only objective of doing private practice and earning big money.
They are not the majority though
The best of course for NHS management is when you get a combined NHS / Local authority. Lothian community partnership *rolleyes*
They even ran a care home under this umbrella. It was an utter shambles. No cross agreement on standards and responsibilities, ie local authority staff that are not qualified nurses administering drugs. However a nurse in overall charge. The nurse in charge cannot let non nursing qualified staff administer drugs and no recognition by the NHS of any of the training the council staff have.
Over the years I have seen much talk of integrating councils and NHS however not once have I seen it happen with any success.
I think most doctors rightly expect to be well paid. I don't begrudge them this. I could have gone to medical school but I knew I did not want to work that hard. 🙂
I am sure I will be corrected if I am wrong but have we not seen huge inflation in doctors salaries outside the UK? Also the types of jobs compared to above have also done very well in recent years have they not?
Oh - and of course 2.8% is pathetic. should be double that
Mrs FD was offered a 7 figure salary to go and wrk in Canada for less hours, more pleasent environment. If it wasn’t for family reasons we would have been off like a shot.
I know a few people (some docs, some other professions) who have been in similar positions - the simple fact that even massive salaries don't tempt alot of people to upend their world tells you that earnings is not the simple motivator here and throwing money to compete with other opportunities might just be "spending money we don't need to" and diverting money from fixing the real problems which actually make people leave (like overwork, poor support etc). My brother got offered the chance to move to Ireland for double his (very healthy) NHS salary... and despite having no family issues that would have stopped him he turned it down because "the work didn't look as interesting (he does a lot of research stuff just now)".
agree, I think this is something really badly effecting NHS management. Good people earn more privately , so on the whole the NHS is run by mediocre managers
I might suggest that part of that problem is the public view that we (the country) spend too much on management and the money should all go to Drs and Nurses. Its probably a false economy which in at least some cases will be made worse by the belief that "dr's are more intelligent and committed than ordinary people" (to slightly paraphrase your post).
My cousin is a similar high achiever. He looked at medicine when he was young, but blood wasn’t a thing he could handle. Very similar background to Mrs FD ie state school. He went down an ICI graduate route after getting a first at Oxford . He’s now retired mid 50’s and a multi millionaire . He talks quite a lot to Mrs FD about their work paths. He’s always said his path was the easier one
Do you think that everyone who joined the ICI graduate programme became a multi-millionaire? Does your wife regret her life choices? Thats not to say would she like to be a multimillionaire and have the freedom to retire at mid 50's - but does she think "I made a huge mistake, I wish I could go back". Does she ever wonder if to get to that level of financial success she might have needed to make some horrible decisions or take advantage of situations that might not have fitted with the mindset which presumably drove her to be a surgeon and helping people?
I know a few people (some docs, some other professions) who have been in similar positions – the simple fact that even massive salaries don’t tempt alot of people to upend their world tells you that earnings is not the simple motivator here
I could have gone to Canada or Aus and earned a lot more. Just didn't appeal to me. US I would have got an awful lot more but I wouldn't consider it for a moment
Add in the fact that the stress in medicine is due to effectively playing god with people’s lives
For those of you who think good managers in private companies have it easy and nothing is that important think again. We are also often playing God with peoples lives. The way we treat people has a significant affect on their health, managing redundancies and performance can be life or death, I can think of at least 3 people who have committed suicide after losing their jobs, thankfully in those cases it was not me taking their livelihood and self worth away. And then there's chronic sickness and mental health issues we have to deal with on a daily basis, something very few of us if any have had any training to deal with, issues that are getting worse because of the state of the NHS. Then there's knock on affect of having to support the people who do actually make it into work who try to pick up the slack of the people off sick.
And that's all on top of the often extremely stressful day job of making the technicalities of the business work. Stress is relative, being screamed at and bullied via corporate culture is very real and very serious, and those of us that try to do our jobs well do care a lot about what we do and how we do it. Taking your responsibilities seriously as a manger is hard when you have everyone else expecting you to make the right call and sort things out, that's why managers get paid more. How many of the teachers on here have said they moved to management grades but then moved back to a core teaching role. Being a good manager isn't something everyone can do. It can also be pretty technical for those at the top if they understand their businesses properly, it's not all surfing meetings and golf.
Conversely being a GP isn't life threatening situation after life threatening situation, there's loads of mundane appointments and worried well in between.
As said before trying to compare the difficulty or worth of roles isn't helpful, and critically it's not how our system works. So unless there's a wholesale change in the way our society coming (spoiler alert there is not) not much will change.
I wonder how much of the negativity (justified or not) coming from people already in the NHS puts off potential new recruits.
@rolicase
You can pick your comparisons...
Starting salary for a magic circle solicitor in London is £150k... BBC
Average salary at Boston Consulting Group for management consultants is £99k... Indeed BCG
The key element of the engineer's description missed in your search is 'executive', so a board level role and not a purely engineering one.
Any one of those positions is significantly better remunerated than a doctor when benefits and bonuses (30-50%) are taken into account. But to apply for the legal and BGC roles you would still likely need the same minimum of 3 A's at A-level as would an application for medicine at a good university.
stumpyjon
Thats a lot of stress for sure but its different. Having had a taste of both types of stress there is a qualitative difference. I do not deny that what you are describing can take its toll as well ( it did on me)
Starting salary for a magic circle solicitor in London is £150k… BBC
Average salary at Boston Consulting Group for management consultants is £99k… Indeed BCG
The key element of the engineer’s description missed in your search is ‘executive’, so a board level role and not a purely engineering one.
Any one of those positions is significantly better remunerated than a doctor when benefits and bonuses (30-50%) are taken into account. But to apply for the legal and BGC roles you would still likely need the same minimum of 3 A’s at A-level as would an application for medicine at a good university.
Sure but why would you compare elite solicitors and board level engineers with an ordinary doctor?
If you're capable of getting to the top of a solicitor or engineering firm then you're capable of rising up the ranks in the NHS, surely.
I do not deny that what you are describing can take its toll as well ( it did on me)
I left one job in an ambulance after physically collapsing at work. They sacked me for it. I had a good lawyer though and they were useless so I walked away with a big cash lump, didn't really make up for 18 months of hell though.
do you want doctors to be people who are motivated by money or medicine?
That's a false dicotomy.
I've known some very good doctors who are at least partly motivated by money, I've also known some very destructive ones who are motivated by the desire to help.
What I’m not doing is constantly referring to my pay scale because being a GP means I deserve to be paid more when you correct for qualification.
And that's not what I'm doing either.
What I am saying is that the government has acknowledged the degradation of doctor's pay in real terms over the past 15 years and given hospital doctors of all seniorities a 20% pay rise that they haven't given to us GPs.
At the same time GP recruitment and retention is in dire straits and the government purports to be making solving it a priority. In that case, where's our 20% pay rise that all our colleagues have had?
There is a level of arrogance associated with just assuming because you are a doctor you can walk into others professions because they are ‘easy’. Thinking about this thread has made me realise that is what riles me , I’ve heard it from several doctors
That's not what I said, so I think you may be projecting slightly?
The argument if different decisions were made many years / decades ago for a different career choice is a not a logical one,
It is, because although years ago you were correct, people didn't tend to opt out of medicine once they were on the career path. Now they very much do because the other options are more attractive.
If you’re capable of getting to the top of a solicitor or engineering firm then you’re capable of rising up the ranks in the NHS, surely.
Did you miss the bit that said 'starting salary'?
Conversely being a GP isn’t life threatening situation after life threatening situation, there’s loads of mundane appointments and worried well in between.
Question. Which is harder, finding a needle in a haystack, or a needle in a pile of needles?
The common misconception is that the life threatening situations are the difficult bit. They're not. It's the so-called "mundane appointments and worried well" (your words, definitely not mine) that are the difficult bit that take the skill and knowledge.
@roli_case
If you’re capable of getting to the top of a solicitor or engineering firm then you’re capable of rising up the ranks in the NHS, surely.
To where?
I'm a GP. There's nowhere else for me to go, apart from into management.
Did you miss the bit that said ‘starting salary’?
No but a starting salary at a magic circle firm isn't anywhere near the average, as I demonstrated earlier. And obviously being board level at an engineering firm isn't a starting salary either.
The point is you have to compare like for like and with all due respect to doctors, you're nowhere near being able to assume that just because you studied for a few more years you'll have automatically made it into the magic circle or to the very top of an engineering firm. If only it was that easy!
To where?
I’m a GP. There’s nowhere else for me to go, apart from into management.
Same applies to most if not all private sector professions. If you don't have what it takes (either in terms of motivation or ability or whatever) to progress through the management ranks in the NHS, what makes you think you'd have been able to do it in another profession in the private sector?
I know engineers with about 20 letters after their name, years of study combined with decades of experience managing multi-discipline teams delivering complex projects earning no more than about £70k per year. I can't help but think it does seem quite arrogant to think that just because you're a doctor, you'd have been able to breeze past those people all the way to the very top.
The point is you have to compare like for like and with all due respect to doctors, you’re nowhere near being able to assume that just because you studied for a few more years you’ll have automatically made it into the magic circle or to the very top of an engineering firm. If only it was that easy!
A-level's is about as close as you'll get to like-for-like. The grades required for studying medicine are way above average and on a par with the sorts of grades associated with an application to magic circle (3 A's and /or some A*'s).
So like I said at the start, choose your comparison... Academically, doctors compare very favourably academically with the rest of the population and against most other professions too.
If you don’t have what it takes (either in terms of motivation or ability or whatever) to progress through the management ranks in the NHS, what makes you think you’d have been able to do it in another profession in the private sector?
Is this serious?
I’ve not read all that, but are people arguing that NHS employees shouldn’t be given a 2.8% pay rise?
If you’re capable of getting to the top of a solicitor or engineering firm then you’re capable of rising up the ranks in the NHS, surely.
To where?I’m a GP. There’s nowhere else for me to go, apart from into management.
Was this a consideration when you chose your career? (That's a genuine question, btw, from someone who never knew what he wanted to do and still doesn't!)
We’re losing a partner to Qatar in two weeks. He’s only been a partner for less than two years.
Maybe try reflux meds or anti-mucolytics?
I’ve not read all that, but are people arguing that NHS employees shouldn’t be given a 2.8% pay rise?
No we are argueing about who deserves it more *rolleyes* and who has been shafted in pay deals |:-)
That makes more sense
Was this a consideration when you chose your career?
No. It's an interesting and rewarding job in itself, with a reasonable degree of autonomy.
There is a career path to management. IMV most of the people who take it do so because they can't really hack it on the frontline and it's an easier option.
Two people I know who've dipped their toes in the water are quite disillusioned because compared to clinical work it's all a bit meaningless.
Interesting stuff scattered within the usual rubbish.
Bottom line for me are the shocking recruitment and retention figures in teaching. I think in physics the gov reached 17% of it's recruitment target.
According to Google:
2022/23, almost 44,000 teachers left the state-funded sector, which is about one in 10 of all qualified teachers
A-level’s is about as close as you’ll get to like-for-like. The grades required for studying medicine are way above average and on a par with the sorts of grades associated with an application to magic circle (3 A’s and /or some A*’s).
So like I said at the start, choose your comparison… Academically, doctors compare very favourably academically with the rest of the population and against most other professions too.
23% of A-level students got 3 A's according to government stats below.
Can't find a very authoritative source just now on how many kids do A-levels but it seems like it's about 65%.
So those getting 3 A's at A-level can say they're in the top-15% of the population academically at that stage.
Top-15% in terms of average earnings is probably about £60k, ONS will have the actual figure if anybody wants to look it up.
So you'd have to conclude that there many of those who had the smarts to become doctors based on A-level grades, are now earning much less than doctors, would you not?
My partner is a maths teacher, she has SKE's for Chemistry, Physics and Biology as well. She does not mention these to anyone at work as "why would I want to get paid the same to teach multiple different subjects as I do to teach one?"
Leaving asside any discussion on what different jobs "should" be paid, there is one significant difference with public sector pay - the "employer" gets 25-40% of the rise straight back to their own budgets in income tax. So a 2.8% rise only costs maybe 1.8-2% in overall terms.
So you’d have to conclude that there many of those who had the smarts to become doctors based on A-level grades, are now earning much less than doctors, would you not?
And many are earning more. Which is the original point! Pick your comparison!
Apologies to the rest of the thread.
And many are earning more. Which is the original point! Pick your comparison!
I'm not sure what original point you are referring to but I was responding to the idea that to become a doctor, ones need particular academic ability which would be better rewarded in other jobs.
We then took 3 A's at A-level as the academic standard an individual needs to reach in order to demonstrate potential to become a doctor. So if that point was true you'd expect people who have 3 A's at A-level to be earning more than doctors on average.
But the stats don't support that, the average person who gets 3 A's at A-level likely actually earns a lot less than a doctor.
Don't get me wrong I don't think this argument is without flaws, but at least it's adding some objectivity.
Leaving asside any discussion on what different jobs “should” be paid, there is one significant difference with public sector pay – the “employer” gets 25-40% of the rise straight back to their own budgets in income tax. So a 2.8% rise only costs maybe 1.8-2% in overall terms.
what if you work for a town or a county council? Do their budgets increase with an increase in income tax?
23% of A-level students got 3 A’s
Not all A levels are of equal difficulty. 3 A's from Sociology, Business and PE doesn't really compare to Biology, Chemistry, Maths or Physics etc which medical students need.
Not all A levels are of equal difficulty. 3 A’s from Sociology, Business and PE doesn’t really compare to Biology, Chemistry, Maths or Physics etc which medical students need.
True. If we account for that, is it fair to say that to have the potential to be a doctor you need to be top-10% in terms of academic ability?
If so I'd say we're still a very long way from being able to guarantee that person could make it to board room positions in the private sector.
Top-10% is great but it is not a rare level of ability by any means. And let's not forget that to do very well in the private sector you usually need a lot more than just academic ability.
Top-15% in terms of average earnings is probably about £60k, ONS will have the actual figure if anybody wants to look it up.
Couldn't help myself. The 85th decile in 2022, which was the latest year on Gov.uk, earned £51,700. A gross income of £60k would be around the 89/90th decile.
We then took 3 A’s at A-level as the academic standard an individual needs to reach in order to demonstrate potential to become a doctor. So if that point was true you’d expect people who have 3 A’s at A-level to be earning more than doctors on average.
But that alone won’t get you in to medical school. You have to have work experience too and other extra curricular stuff . In fact not sure 3 A’s does get you in to medical school school.
A levels are easy compared to Royal College Exams that come later.
Two people I know who’ve dipped their toes in the water are quite disillusioned because compared to clinical work it’s all a bit meaningless.
It can be very challenging, you have to be really committed. Eve though I was still reasonably clinical the management side is very different, trying to keep staff moral up, dealing with that 1% of staff who take up 90% of your time and still won’t listen, then there’s trying to get some senior staff to listen to what it like for clinical staff.
But that alone won’t get you in to medical school. You have to have work experience too and other extra curricular stuff . In fact not sure 3 A’s does get you in to medical school school.
A levels are easy compared to Royal College Exams that come later.
I don't doubt it. A-levels alone don't mean anything in most private sector professions either, and are likewise easy compared to the professional qualifications that come later.
And let’s not forget that to do very well in the private sector you usually need a lot more than just academic ability.
From where I have been sat you need much more than good a levels to get into medical school too.
I am a teacher in Scotland. Last year, while inflation had been running at 11%+ we were offered 4.27% . I voted to reject, but the majority of my colleagues accepted, so that's what we got. The EIS union proclaimed that COSLA had said that the offer represented "the first step towards pay restoration." (IIRC overall a 22% reduction in real terms since 2008)
I cannot find any reference to COSLA actually saying that though. Surely the union isn't spinning their members a line? Let's see what this year's "restorative offer" looks like.
I don't trust the unions an inch. They were duplicitous during the last round of industrial action. They had a mandate for strike action over a 1 year, 10% claim, and ended up settling for a 30 month agreement where the final uplift was 1.2% (inflation at the point of uplift delivery was 4%). Slow hand clap.
At best they are inept. At worst, it looks like collusion.