[Closed] doctors on strike

Yeah I think the BMA and the junior doctors are relying on honesty and reasoned arguments.

Sadly that isn't the way politics or public opinion works these days.

Hunt knows all the tricks and is happy to use them.

Then the senior doctor told my father that they (senior doctors) were going elsewhere for greener pasture ... my bet is that they will come here.

They already do. Despite jamba's protestations about oversubscribed medical posts the NHS is heavily propped up by foreign doctors and nurses.

http://www.theguardian.com/society/2015/jan/28/-sp-nhs-hires-3000-foreign-doctors-staff-shortage

[quote=GrahamS spake unto the masses, saying]Yeah I think the BMA and the junior doctors are relying on honesty and reasoned arguments.
Sadly that isn't the way politics or public opinion works these days.
Hunt knows all the tricks and is happy to use them.

I think they are starting to cotton on - for example in countering the "15 out of 16" bullsh1t. Also saw a v good interviewee on C4 News last night (forget his name), who also made the point that *unt's "statistics" make no sense.

I have to say that everything the government says seems to make sense. The problem is it either has not been reported or is not being put across properly what the BMA is actually saying. Yes lots of headlines but not detail. At the end of the day the government should publish what it is trying to achieve and then let the BMA publish all of the various options that could be put in place to achieve this. The BMA says the NHS already works 7 days a week. Yes if you are very very ill but if anyone has had a loved one in hospital over the weekend we all know the whole place seems to shut down. Simply walk up and down the corridors and they are deserted unlike the normal weekday hustle and bustle.

Doctors need to realise that they are just public sector workers like everyone. They are not special or the chosen ones just an employee like everyone else. They are no different from nurses, paramedics or anyone else in the NHS. Yes they might be more qualified but so it the IT support technical sitting beside the admin staff in 1000's of offices. Doctors have chosen their profession, they weren't forced into it and they need to play by the rules that the managers and government out in place. Just like any other business.

Now I agree that doctors should be paid well and anti social hours should be evenly distributed across them. But at the end of the day the NHS needs to work 7 days a week. And for all the Facebook posts of doctors saying "Look I have just finished a 100hr shift" how is this good. Bloody irresponsible and dangerous if you ask me. Would it be good to see a lorry driver brag that he had just worked a 100hr shift. I think not. Lorry drivers and many many other professions are not allowed to work stupidly long hours so why do doctors not only do it but actively campaign that they want to be able to do it!!

Doctors need to be told once and for all to get in line and that they do not own the NHS. (This is now it works in the private sector) Government at the same time needs to insist on efficiencies in the NHS, modern practices and pay decent salaries. Companies have worked out how to do this for years and years and years so it is not impossible to sort this out. If the NHS falls apart then it is our job as the electorate to boot the politicians out and vote in people that will fix the NHS.

Rant over...

. If the NHS falls apart then it is our job as the electorate to boot the politicians out and vote in people that will fix the NHS.

I suppose out of all that crock there had to be at least a tiny bit that makes sense.

And for all the Facebook posts of doctors saying "Look I have just finished a 100hr shift" how is this good.

well quite

Lorry drivers and many many other professions are not allowed to work stupidly long hours so why do doctors not only do it but actively campaign that they want to be able to do it!!

Good god. Is that what you think they're trying to do?! I don't even know where the BMA start if people are that ignorant.

woody74 - Member
...Lorry drivers and many many other professions are not allowed to work stupidly long hours so why do doctors not only do it but actively campaign that they want to be able to do it!!

eh?

longer hours is not what they're campaigning for.

(mostly, they want to be protected from overly long hours, Hunt wants to remove this protection)

Given that none of the traditional media outlets seem to want to put the doctors' concerns across

Rubbish, there has been plenty outlining both sides positions on the likes of BBC, Guardian and Telegraph websites.

Ok so do we all agree that doctors should not work or be allowed to work unless their is an emergency, more than a 40hr week?

If you don't agree then why not?

Given that none of the traditional media outlets seem to want to put the doctors' concerns across

The BMA Mark Porter bloke was on Radio 4 this morning. If he can't get the doctor's concerns across given that platform then he should stand down and let someone else do the job.

Ok so do we all agree that doctors should not work or be allowed to work unless their is an emergency, more than a 40hr week?

Huh? You're arguing for far, far more protection than even the BMA are. You're on their side, not the government's.

(mostly, they want to be protected from overly long hours, Hunt wants to remove this protection)

Weird that people so wedded to the idea of the NHS are happy to leg it to the Middle East or the USA.

I do so love the way Tories forget their principles when the argument suits

FWIW clearly its possible to both love the NHS and refuse to work under certain conditions.

I have to say that everything the government says seems to make sense

I was tempted to just put [ shout] NURSE[/Shout]

scaredypants: yep, as I understand it, it is effectively a move away from a system of [i]"if your Trust make you work long hours then you'll be paid extra for them - ramping up to the point where it'd be cheaper for them to create a second post"[/i]

And towards a system of [i]"if you work long hours and they get logged then an external auditor might spot it or you can decide to ruin your career by suing your hospital trust"[/i]

[quote=woody74 spake unto the masses, saying]Ok so do we all agree that doctors should not work or be allowed to work unless their is an emergency, more than a 40hr week?
If you don't agree then why not?

Err ... think it's the government who you need to be putting that question to - you know, the ones who you think have got everything right.

scaredypants - Member

I think Hunt's proposal may impose a slightly lower overall weekly max, but there'd be essentially no limit to what proportion of that weekly total could be during what used to be unsocial hours due to the removal of what, effectively, is a financial disincentive fror trusts to make individual doctors work very long daily hours without appropriate breaks/rest

right now, if a hospital assigns a Doctor too many hours, in excess of their contract, the hospital can be fined.

Hunt wants to remove that penalty, there will be NO effective barriers to the number of hours imposed on doctors. The limits offered by Hunt are in effect 'Guidelines'.

Guidelines that will probably have to be ignored.

so, how would we all feel about a new contract being forced on US, that removed all effective limits on our working week, and came with a pay-cut?

i'm not *completely* convinced that the tories want to break the NHS, forcing us all to pay up-front for health care, but if it quacks like a duck...

I have no idea what you wrote after that as I struggle to believe anyone thinks this about any govt let alone this one on this issue. I therefore had no interest in what you subsequently thought

Ok what has the government said (not what you think they said) that does not make sense? I mean their aims make sense. I am not naive enough to think there aren't some other motives the Torys have hidden away.

I am not on the side of the government or the doctors, have no ideological leaning when it comes to the NHS.

but there'd be essentially no limit to what proportion of that weekly total could be during what used to be unsocial hours

And the problem with that is what exactly? So if I read that correctly then the doctors are campaigning to keep longer working weeks, but at the positive of minimum weekend or night shift work?

that's all kinds of wrong.

Doctors definitely aren't complaining about working weekends.

(although one of their minor* complaints is that weekend-work will face a pay-cut)

(*as in, they have issues they're more cross about, i'm not trying to suggest a weekend pay-cut is not a kick in the balls)

[b] I therefore had no interest in what you subsequently thought[/b]

You do seem to struggle with the data and interpretting it 😉

Ok, lets say the doctors agree the new contract - if we want 24/7 health care what do people want to drop from the week time to run at weekends ?

As there are no more staff to go round what or any more money to recruit ones we are going to have to cut services from the week to put them on at weekend ....

Something doesnt make sense to me !

And why didnt I see headlines of cancelled operation for the royal wedding ? there were more people in the nhs yesterday than there for for Will and Kate's little day !

Ok what has the government said (not what you think they said) that does not make sense?

What do you think that means?

How can you achieve it with the same numbers of staff?

And the problem with that is what exactly? So if I read that correctly then the doctors are campaigning to keep longer working weeks, but at the positive of minimum weekend or night shift work?

My other concern over this: If the exisiting trainees are spread over whole fully operational 7 day weeks, then there are fewer of them around at a given point. Same for consultants. How would you ever get the 2 groups together for training ?

One question I have, if Hunt forces the contract change through do the Doctors have to sign it? And if they don't what happens.

I ask, as when my contract changes and I need to sign a new one, if I don't sign it I'm effectively being made redundant. Surely even Hunt would risk laying off all of the Junior doctors; I understand he wants rid of the NHS, so we can all move to privatized healthcare as its worked so well with other essential services that the Tories have moved into the public sector, but that doesn't seem like a very canny move by him to do it so blatantly and out in the open.

more disruptive and likely lead to more fatigue amongst these doctors.

I'm not sure that's true, if you add working Saturday but in doing so remove Monday, provided the hours stay the same then overall there is no difference.

How would you ever get the 2 groups together for training ?

Like any business you manage the company needs in terms of staffing, and then make everyone booked on the course come in the same day. It requires a bit of planning and good management but isn't rocket science.

when my contract changes and I need to sign a new one, if I don't sign it I'm effectively being made redundant.

Presumably this is still the case with the doctors. Maybe 5% wouldn't sign it, but I'm sure most have lifestyles etc. that require earning money, and it isn't like there is another employer they could rush too. But that really would be a nuclear option by both parties and I don't think the BMA and government are that stupid.

Ok what has the government said (not what you think they said) that does not make sense?

So many to choose from, let's take [url= https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/466589/Health_Secretary_to_JDC_Chair.pdf ]Jeremy Hunt's letter to the Chair of the Junior Doctor's Committee[/url] for a concise example or two:

He starts with [i]"this is not a cost cutting exercise. I can give you a categorical assurance that I am not seeking to save any money from the junior doctors' pay bill...
... these changes would be cost neutral, rather than cost saving."[/i]

And insists that the BMA calculations are wrong, hardly anyone will get a paycut, despite plenty of worked examples to the contrary.

And then he repeatedly tells the media that this is an 11% pay rise! And then repeats it so much that people think this dispute is about greedy doctors wanting more money!

Of course this is all driven by the need for a seven day NHS isn't it? He's made that clear.

Odd then that in the same letter he says: [i]"Junior doctors already work seven days and are the backbone of medical care in hospitals at weekends and at night."[/i]

And of course he says [i]"we must eradicate the 'weekend effect' of excess deaths in NHS hospitals"[/i], despite the fact that [url= http://www.bmj.com/content/351/bmj.h4596 ]the paper[/url] he is basing the "weekend effect" figures on says quite clearly that it would be [i]"rash and misleading"[/i] to think these deaths were preventable as it doesn't account for the fact that [url= http://www.bmj.com/company/wp-content/uploads/2014/07/NHS-weekend-deaths.pdf ]fewer patients are admitted at weekends and they are likely to be sicker and thus at a higher risk of death[/url].

http://www.bmj.com/company/wp-content/uploads/2014/07/NHS-weekend-deaths.pdf

And insists that the BMA calculations are wrong, hardly anyone will get a paycut, despite plenty of worked examples to the contrary.

When Hunt said that the BMA's calculations were wrong he was completely correct.

The calculator on the website that many JDs were using to calculate their "loss" wasn't underpinned by the data from the actual discussions or offer, just the BMA's original guesstimate of what would be offered and the rule tables hadn't been checked properly with the result it overestimated the losses and underestimated the increase in basic pay and didn't take into account the increase in pensionable pay on overall remuneration.

When this was pointed out the calculations were very discretely removed in the third week of October and replaced 2 weeks later with one that produced very different (higher) pay forecasts which is precisely why quite a few medics have gone from being adamant they would lose out to now saying the calculator tells them their income won't change.

With this level of opacity and when some of the BMA's negotiators have compared the Secretary of State to Nazis and also said they are intent on using the disagreement to fight a proxy dispute with the government about its Austerity agenda it's not difficult to see why the discussions so far have been less than constructive.

Both sides need their heads banging together but any negotiation in which one side compares a pay dispute to actions in the Holocaust is completely unacceptable - particularly when this is done in the name of professional that commands almost universal public respect.

The basic flaw in Hunt/the government's logic is that they want the NHS to be truly 7 days a week, but have repeatedly said there is no extra money to pay for this.

Whatever way you cut it they want 2 extra days a week out of the NHS whilst paying the same salaries, that is obviously a pay cut

Whatever way you cut it they want 2 extra days a week out of the NHS whilst paying the same salaries, that is obviously a pay cut

Not necessarily, as it is all about using resources as effectively and efficiently as possible.

Not necessarily, as it is all about using resources as effectively and efficiently as possible.

Is that a hand-waving way of saying that you'd reduce capacity during the rest of the week?

The biggest resource the NHS has got is its staff. "Using them as efficiently as possible" generally means doing more work for the same pay in my experience.
If we are talking about resources like Mri scanners then fair point. But we're not.

Is that a hand-waving way of saying that you'd reduce capacity during the rest of the week?

Probably yes.

Like any business you manage the company needs in terms of staffing, and then make everyone booked on the course come in the same day. It requires a bit of planning and good management but isn't rocket science.

Oh wait, I see - [b]Ah[/b], you should have said. He's increasing numbers isn't he ? What silly people we were to distrust him

How can you achieve it with the same numbers of staff?

The Troies have committed an extra £8bn pa to the NHS which is what the NHS was asking for. Labour committed £2bn pa.

I want a much much better NHS than we have but people won't vote for the tax rises for [b]everyone[/b] that will be required. As my many NHS friends agree its very good at critical care, otherwise there are many things its really quite poor at given how rich a country we are. As an aside a provitised BT is about a million times better than the state owned one, when did you last have to wait 3 months for a new phone line ?

understand he wants rid of the NHS, so we can all move to privatized healthcare

@GrahamS if doctors are so badly treated and paid how come the queue of applicants to study and work in the NHS is so massive ?

this is just scaremongering nonsense

And yet here you are, the Tory faithful, telling us how much better off we would be if it was broken up and privatised?

@GrahamS if doctors are so badly treated and paid how come the queue of applicants to study and work in the NHS is so massive ?

If the queue of applicants is so massive why are so many wards understaffed and why do we rely so heavily on recruiting foreign doctors?

@GrahamS if doctors are so badly treated and paid how come the queue of applicants to study and work in the NHS is so massive ?

The biggest resource the NHS has got is its staff. "Using them as efficiently as possible" generally means doing more work for the same pay in my experience.

Using NHS staff efficiently also means a whole bunch of other things as well:

[b]- Using experience correctly.[/b] There's still plenty of day to day work that can be done to the same standard by less expensive resources thus releasing the more experienced / expensive staff to focus on more complex treatment and getting it right first time. 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 with Patients who are living with a long term condition.

[b]Getting the diagnosis and care right first time,[/b] not the second or third time. This avoids unnecessary use of expensive diagnostics or having to treat the patient several times before the condition is properly managed. This typically reduces emergency admissions and associated in patient admissions.

[b]Smoothing the flow [/b]- so instead of the peaks and troughs that occur for scheduled care, diagnostics suites, wards etc. making more continuous use of resources and thus avoiding the need for bank staff etc. This is well established on the continent but something UK Doctors say can't be done her because it's not possible.

[b]Tackling the waste of resources caused by the separation of care / social care[/b] - this generally results in a "we're not responsible" attitude on both sides, a massive waste of resources and the patient invariably stuck in the middle.

[b]Breaking antiquated and inefficient working practices[/b] by using Technology to streamline and automate. Anyone who's been on the receiving end of numerous letters all from the same hospital and same day confirming diagniostics all on different days will probably get this. The NHS hasn't even tried to make it's processes patient friendly and the result of this is missed appointments, endless telephone calls and for some patients - getting sick and requiring an otherwise avoidable emergency admission.

It is however true the NHS is quite unlike healthcare in say Germany

[url= http://www.theguardian.com/world/2011/mar/16/german-health-warning-doctors-paperchase ]German doctors spend a third of their week contesting bills with insurance companies amid a climate of permanent reform [/url]

Yeah sounds great.

see the budget increases I noted above. It is however true the NHS is quite unlike healthcare in say Germany, France or Switzerland. Open your eyes to the fact that might not be a good thing

Healthcare spending as % of GDP, 2013:
UK 9.1 (downward trend)
Germany 11.3 (upward trend)
France 11.7 (upward trend)
Switzerland 11.5 (upward trend)

[url= http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS ]By a BANK - must be good ![/url]

NHS costs approx £2,200 pa for every man woman and child. As only about 55% of the uk population is working age that's £4,400 in taxes required from every working person to meet the current budget

@scardey - exactly. We don't spend nearly enough. To meet those amounts we would need an increase in taxes by wjat 20% (2.5/9) ? People won't vote for it

@Graham, their secretaries should be doing that. The insurance / top up system is the one they have in France

People won't vote for it