[Closed] doctors on strike

They are not open to seeing how health services are delivered elsewhere

The arguments are not convincing and, despite your obvious annoyance, the British public absolutely adore the NHS as it is.

Its not that we wont listen its that the arguments are crap and "appreciated" only by the most right wing of people, on STW or in the real world.
emotive soundbites like "not open" serve only to highlight the paucity of your rationale.

Especially given that Jamba's failed to address the core issue at the heart of the current strike.

Especially given that Jamba's failed to address the core issue at the heart of the current strike.

JY after my mum was in agony and virtually imobile for 6 months as a result of being ignored by her GP she and my father certainly don't adore the NHS. Pressure on it is a key reason they are voting Leave (lifelong Labour voters and both voted Yes to EEC in '75). Many people rightly prasie the dedication of many NHS staff and specific areas of outstanding care but you are quite wrong to say they adore the service and you won't hear many French, Germans, Belgians, Dutch, Swiss etc wanting to swap their service for ours. Americans regard the NHS as a total disaster.

The issue around rhis strike and its resoltion one way or another it an irrelevance to the future of the nhs imo. I honestly don't care how its resolved. It's not the big picture issue.

Americans regard the NHS as a total disaster.

Is that right, aye?

Pressure on it is a key reason they are voting Leave

And how do they think leaving the EU will help the 'pressure' on the NHS?

Americans regard the NHS as a total disaster

Really?

you won't hear many French, Germans, Belgians, Dutch, Swiss etc

In fact the rubbish (and expensive) health service is one of the major complaints Brits living in NL have - amply borne out by my personal experience.

And how do they think leaving the EU will help the 'pressure' on the NHS?

I suppose because the hospitals will no longer be full of queues of Bulgarians and their weird foreign diseases.

Or some such bolleaux.

Every single one of my American friends regard the NHS with envious eyes, whenever the subject of healthcare comes up i'm regaled with personal stories of how their healthcare provisions cut or refuse certain services on the grounds of cost etc.

More jambafacts.

Americans regard the NHS as a total disaster.

WTF??? 😯

Are you seriously offering Americans as some sort of experts on affordable healthcare ?

They spend double the amount of their GDP on healthcare than we do.

And the greatest cause of bankruptcy in the US is unpaid medical bills, approx 1.5-2 million every year.

Your straw clasping gets evermore bizarre jambalaya

An entertaining read

https://www.washingtonpost.com/lifestyle/style/british-health-care-free-for-citizens-low-priced-for-visitors-is-that-the-whole-story/2014/03/24/7d0c3386-9e57-11e3-b8d8-94577ff66b28_story.html

@jambayla - what is the evidence that Americans see the NHS as a disaster?

My understanding is that if you have the money in the USA to pay for your health care then great. If, however, you don't you're screwed. I've seen shocking documentaries showing how poor people have to queue in their hundreds ,for hours during the middle of the night, in the hope of have a free consultation with a doctor.

Although, I wonder if you'd think that if they tried harder to earn some money that they would not be poor, so actually it's their fault anyway....

what is the evidence that Americans see the NHS as a disaster?

Well at the moment, the NHS doesn't make anyone filthy, stinking rich. For a multi billion pound effort that is absolutely criminal and thankfully our mate JH is going to fix that.

For a bit of light relief, Frankie Boyle's take on it -

[url= http://www.theguardian.com/commentisfree/2016/apr/27/jeremy-hunt-doesnt-understand-junior-doctors-book-dismantle-nhs?CMP=share_btn_fb ]Jeremy Hunt doesn't understand the NHS[/url]

[i]SOME[/i]Americans regard the NHS as a total disaster.

Only the ones that want to see THEIR (not any) doctor now and have a friendly chat before being prescribed a nice big bottle of Vicodin.

Pressure on it is a key reason they are voting Leave

Many people rightly prasie the dedication of many NHS staff and specific areas of outstanding care but you are quite wrong to say they adore the service

Yes that will be why no one is supporting the doctors and their is such a populist movement to reform the NHS. Their is a fine line between trolling on here, having an opinion and just making things up that make folk point and laugh.

and you won't hear many French, Germans, Belgians, Dutch, Swiss etc wanting to swap their service for ours. Americans regard the NHS as a total disaster

you cannot even type things that might actually prove the "point" you are trying to make 🙄

And it was not even funny 🙁

Americans regard the NHS as a total disaster

Americans regard the NHS as a total disaster

I don't think that is true at all. I am resident in both UK and US and most doctors I have visited in the US have trained or worked in London at some point and are very complimentary about the NHS and how efficient it is. Most openly state that the US is very inefficient but your experience will be a million times nicer which is definitely my experience. The level of care actual medical competency between the two countries is comparable, the only thing in my view better in the USA is preventative care - having an annual physical for starters - but something that would bankrupt the NHS.

What is definitely common is the amount of BS that is spouted both in the US media about the NHS and the UK media about US hospitals. Pretty much both state that the other have people queuing outside and dying on hospital beds. It is not true. Like all things, don't believe the BS in the media.

the British public absolutely adore the NHS as it is.

And that there is the big problem. No one likes change, people are scared of change. People also are belligerent when it comes to compromise. But like all big corporations, no matter what the industry, if they do not evolve and change to the changing environment around them they disappear. Simply sitting back with arms folded stating we like it as it is thanks and we won't change simply is not an option, otherwise the beloved NHS (which we all love by the way) will disappear and the alternative will be something far worse by most accounts.

😆

An entertaining read

Very telling how insurance can ramp up the levels of bureaucracy... although that's also been a consequence of Lansley's byzantine '12 HaSC Act. IMO, co-operation isn't just necessary to get things done at the sharp end (in acute care) - it also helps to keep costs down.

I've just finished my shift - the (emergency surgical admissions) ward safely & calmly covered by consultants at all times, including the care of some very sick patients. From what I've heard today, the public are not swallowing DoH spin - even if they are equivocal about strike action. They grasp, all too readily, that patient safety will not be improved by stretching existing resources ever more thinly. And given [i]existing[/i] gaps in acute rotas (in the very clinical specialities that will be penalised by contract imposition), Trust CEOs are going to have a major headache trying to make it work - not to mention the knock-on effects on training, etc.

It's a shambles. But it's a shambles that Hunt seems to want.

much larger study than the one hunt based his weekend death argument on

http://hsr.sagepub.com/content/early/2016/05/05/1355819616649630.full.pdf+html

Conclusions: [b]There are fewer deaths following hospital admission at weekends. [/b]Higher mortality rates at weekends are
found only amongst the subset of patients who are admitted. The reduced availability of primary care services and the
higher Accident and Emergency admission threshold at weekends mean fewer and sicker patients are admitted at
weekends than during the week. Extending services in hospitals and in the community at weekends may increase the
number of emergency admissions and therefore lower mortality, but may not reduce the absolute number of deaths.

I saw an excellent talk today about big data in medicine and it touched on something that shows how fundamentally Hunt misunderstands medicine

http://www.pulsetoday.co.uk/political/political-news/gps-diagnostic-skills-could-be-obsolete-within-20-years-says-hunt/20030142.fullarticle

They should go on all out strike by not giving anything away.

Demand all that they want.

Never give up and strike to the end.

Prolong and increase the strike to 3 days a week.

On top of that also go for wildcat strike and down tool during the peak hour ...

Hunt misunderstands medicine

Good to see all those awful safety issues have been resolved by paying Doctors more to work weekends. The ones who don't work many lose out to pay those who work loads.

What is the agreement that the Dr's haven't excepted yet?

I think it would be courageous to vote against - public support will evaporate.

But what is the offer?

BBC is a bit slow - picking up via Twitter but main issue is one outlined above.

[quote=mefty ]I think it would be courageous to vote against - public support will evaporate.

If the offer on the table is just more £££ then they'd have to vote against given that money was a side issue (apparently).

have been resolved by paying Doctors more to work weekends.

That ^^ sounds like a classic piece of Tory misinformation.

Junior doctors didn't ask for more money to work weekends, they were already receiving that. What they were objecting to, among other things, was the imposition of pay cuts for working weekends.

It would appear that the ACAS agreed proposition provides a comprise whereby only junior doctors working less that one weekend in eight will receive a pay cut.

Factual information for anyone who is interested...

Nice bit of Toryesque lying there mefty

From the BBC

the basic pay rise is to be reduced from 13.5% to between 10% and 11%
weekends will no longer be divided up between normal and unsocial hours, instead a system of supplements will be paid which depend on how many weekends a doctor works over the course of a year
extra pay for night shifts is to be reduced from 50% to 37%
extra support will be made available for doctors who take time out, such as women who go on maternity leave, to enable them to catch-up on their training and thus qualify for pay rises - after claims women were being unfairly penalised
junior doctors will get an enhanced role in advising and liaising with the independent guardians who keep an eye on the hours doctors work

A Tory thinking it was just about money and also getting something wrong
I am stunned by this revelation...who knew they were like this ?

[b]mefty[/b] do you want to look at the ACAS document and see how much of it has changed, how it is about enshrining fines on excess hours, whistleblowing etc etc, and how it does still remain cost neutral overall, before you relay more rubbish straight from JHs nether regions?

Muppet 🙄

And despite Tory attempts to suggest otherwise it's not just about unsocial hours pay, eg just to pluck one paragraph out of docrobster's ACAS link :

[i]An agreement that breaks can be taken flexibly during a shift, and should be evenly spaced where possible. How ever where breaks are combined the contract will make clear that this must be taken as near as possible to the middle of the shift. No break should be taken within an hour of the shift commencing or held over to be taken at the end of the shift.[/i]

It's clear that safety considerations for patients and junior doctors featured very high.

So it was all about pay ......and safe rotas and maximum hours and training and speciality recruitment and whistleblowing to protect patients ? Why would the Drs or the public ever trust Hunt ?

Oh Mefty 🙁

The ACAS brokered agreement, which the BMA are happy with, actually reduces the proposed 14% basic pay increase down to between 10% and 11%.

Factual information for anyone who is interested...

Thank you that's better than "I heard on Twitter".

I'll take a read as this is going to have a knock on effect for the rest of the NHS.

The ACAS statement is a bit light on detail, but my initial thoughts are:

Good points:
Enshrining whistleblowing protection in the contract
Protected time off after 3 (or is it 4) night shifts
Some attempt to redress the gender/less than full time imbalance

Bad points:
Guardian still isn't independent of the Trusts it will be supposedly investigating
Lack of pay progression for at least half of the time that someone is a junior doctor will still unfairly disadvantage women/less than full time trainees
Lack of safeguards for "non resident on call" trainees regarding working after a night shift
Out of hours payments will still hit the specialties that already have trouble recruiting the worst, exacerbating rota gaps

I will await the publication of the full contract with interest (and, despite what JH says, will again read every page of it before making up my mind about it).

One thing to note - this contract will be staying no matter what the vote of BMA members says. Results of the JD ballot will be due on 6 July; even if they/we reject it, there won't be enough time to amend it before the start of August. So this is it, like it or lump it.

going to have a knock on effect for the rest of the NHS.

Consultants next, then AfC staff, I'm sure.

Consultants next, then AfC staff, I'm sure.

Yup but there's another biggy in the background too. Hunt failed on his promise to review Ambulance staff within a year.

To be fair to Mefty it would appear that the ACAS brokered agreement, whilst obviously a compromise (as all ACAS brokered agreements are) represents a very significant victory for the BMA/junior doctors.

It shows what can be achieved through unity and determination. It vindicates the BMA/junior doctors and proves that they were right to go on strike.

With that in mind I would expect the Tories to put the best possible spin on the situation, you can't realistically expect them to do otherwise.

FS are doing more and more medical calls, supposed to be cardiac only but more and more it's minor stuff. It's ambulance control that are being less than truthful when contacting our control. How long before the government impose this on the FS and it becomes a dual role.

It's ambulance control that are being less than truthful when contacting our control.

They can only go on the information received, that'll be in the very few seconds of a call.

Hmm. Yeah right! Like when we go to assist gaining entry and they're not in attendance yet. We get there and they stand down ambulance.

It's all about fudging attendance times IMHO.

One thing to note - this contract will be staying no matter what the vote of BMA members says.

My understanding is that the ACAS brokered agreement requires no more industrial action and BMA membership approval.

I didn't think that bits of the agreement could be ignored.

Or diverted the ambulance to an R1 or R2 call.

Maybe at times they get it wrong but we get sent to calls that are never how they sound on regular occurrence.

To be fair to Mefty

Drac - Moderator
I'll take a read as this is going to have a knock on effect for the rest of the NHS.

Whatever the result of the Junior Doctor's contract negotiations, Hunt was always going to come after someone else next.

Fully supportive of my Junior Doctor colleagues in their fight against our clueless 'leader', standing by for us nurses to be targeted next.

Whatever the result of the Junior Doctor's contract negotiations, Hunt was always going to come after someone else next.

I know.

Whatever the result of the Junior Doctor's contract negotiations, Hunt was always going to come after someone else next.

I would have thought that the result of the Junior Doctor's contract negotiations will have a profound affect on other healthcare professionals and the NHS.

A significant defeat for Hunt rather than an easy victory is obviously going to make him recognise his limitations. It will also provide lessons to other healthcare professionals with regards to what can and can't be achieved.

Much of the future of the NHS hinges on the junior doctor's dispute. imo

😥

The public are behind you and grateful for all you do in the face of adversity sometimes even from the very public you are trying to serve

As always THANKS to you all every last one of you.

+1

Well done ACAS!! Two sides who test the patience of most observers, finally strike a deal. About bloody time!

Love the spin ^ and the counter claims of spin.

Who won? No one. Same money, spent differently. As before some loses, some winners.

Hopefully (!) better cover at the weekend AND better pay for those working at the weekend - not that it's anything to do with pay obviously!

Edit: time for both sides to prove their worth now and show that the actual winners really are the patients! We shall see....

WOW the Doctors won so well even THM could not spin as a victory for the tories 😉

Two sides who test the patience of most observers

Good work doctors.

Well I have been in the pub, very nice local bitter that I could smell being brewed when I did the school run, if you are interested - I posted in reaction to Christopher Cook's twitter feed, who is the BBC Newsnight correspondent. His conclusions paraphrased.

standing by for us nurses to be targeted next.

I'm pretty sure Nurses unsociable hours are already similar (but not identical) the new ones for junior docs. So Nurses have already been targeted at some point.

Who 'won'?

http://www.bbc.co.uk/news/health-36327930

I would have thought that the result of the Junior Doctor's contract negotiations will have a profound affect on other healthcare professionals and the NHS.
A significant defeat for Hunt rather than an easy victory is obviously going to make him recognise his limitations. It will also provide lessons to other healthcare professionals with regards to what can and can't be achieved.
Much of the future of the NHS hinges on the junior doctor's dispute. imo

Ernie - Whilst I understand what you're saying, I'm not so sure what the Junior Doctors have managed and how they did it can be easily be used as a template for the rest of us, least of all us nurses.

Unfortunately, whilst many of my colleagues and I fully supported the Junior Doctors, when the topic of "would you go out on strike if/when they come for us" is raised many respond "oh no, I couldn't strike, it's not fair on the patients".

No matter how much you explain how worsening conditions for staff, leading to staff leaving and struggles to recruit replacements, will have a far graver impact on patients in the long-term I still often hear "I still couldn't strike".

Part of the problem is likely staff being split among two very different unions and one of them in particular seemingly more interested in doing the government's bidding for them than truly standing up for its members (the RCN).

Mr Hunt likely knows that many nurses have no stomach for strike action, given the amount who make very public statements of this on various forums etc that nurses use. I'm sick of seeing nurses beat down their colleagues with comments such as "well you obviously don't care for your patients if you can contemplate striking", but these types of remarks are not unusual.

TBH the proof of the pudding's going to be in enforcement and execution, the TOIL thing in particular looks like trouble waiting to happen- getting approval not straightforward and staffing already inadequate so you can almost guarantee that doctors will struggle to reclaim it. Without a straightforward claim process and the capacity to convert to holidays or pay it's got to be a concern. And who guards the guardians?

The defnition of night shift I thought is almost funny. Start before 8pm, and it's not a night shift, even if you start at 7.30pm and work til 8.30am, apparently.

Well I have been in the pub

[b]mefty[/b] lamest Edinburgh defence for ages.

mefty - Member

I posted in reaction to Christopher Cook's twitter feed, who is the BBC Newsnight correspondent. His conclusions paraphrased.

Don't forget to mention Christopher Cook is a former special adviser to a Tory government minister.

Bloody left wing biased BBC

UK needs a proper grown up discussion about health provision in this country, what we've got doesn't work and more money isn't going to fix it.

At least this is sorted, could have been months ago

Don't forget to mention Christopher Cook is a former special adviser to a Tory government minister.

I didn't know that - but it appears he denies it, says he merely helped Willetts write "the Pinch", which is apparently quite good - Willetts is a pretty straight guy - as a result not very effective. Cook was the journalist who exposed Gove's use of private email, so he is certainly not completely partisan, if at all.

mefty lamest Edinburgh defence for ages.

I think the Edinburgh defence relies on one saying you were joking - I wasn't I was just reporting what a journalist who follows the area closely said on his Twitter feed as he analysed it - have a look yourself [url= https://twitter.com/xtophercook?lang=en-gb ]link[/url]

Did you do the full Cameron or did you manage to get home with all your children?

I don't take my daughter to the pub in the week, you watch too much Shameless.

jambalaya - Member

At least this is sorted, could have been months ago

Is this the first time that I've heard you criticize a Tory government jambalaya? I think it might be.

But you're right of course.......all that strike action and inconvenience it caused wouldn't have been necessary.

On the plus side, junior doctors have been radicalised in a way which wouldn't have been possible without an industrial dispute.

I have heard many junior doctors speak at trade union organised meetings and I have been quite frankly impressed. For the first time in its history the BMA organised activities with other trade unions.

A trade union activist I know who went on a junior doctors demo said it was the "poshest" demo they had ever been on as many junior doctors apparently took their mums and dads along with them.

I suspect that for many junior doctors the experiences of the last few months will last them for the rest of their lives.

So as someone on the "radical left" I'm truly grateful to Jeremy Hunt for creating the conditions which have resulted in a more radical BMA, and the now recognition by many BMA members of the wider struggles.

[quote=jambalaya ]UK needs a proper grown up discussion about health provision in this country, what we've got doesn't work and more money isn't going to fix it.

OH god I hope the mighty white chariot of private enterprise and profit is ready in the wings to exploit the ill and needy.

I don't take my daughter to the pub in the week

Can I play the edinburgh for my comment - it was not meant to
be a slight on your parenting it was just a joke. Apologies if it overstepped the mark it was not meant to be taken that way

No implication, just assumed that in Shameless they take their kids to the pub, I appreciate it was an attempt at a joke.

BLess you for only giving me a gentle smack with the olive branch you took from my hand.

[url= http://www.theguardian.com/society/2016/may/18/junior-doctors-bma-jeremy-hunt-agree-deal-end-contract-dispute ]Junior doctors split over deal with Jeremy Hunt to end contract dispute[/url]

Suggests it's not a done deal.

Although considering Dr Malawana's standing among junior doctors it would be surprising if his recommendation was rejected.

According to the link he says :

[i]“I truly understand that people are scared and worried. I know there is fear and a hell of a lot of anger. I know that the government’s reaction to the contract this evening has not been helpful. Government needs political victories. However, wait for the contract details.”[/i]

BLess you for only giving me a gentle smack with the olive branch you took from my hand.

It just wasn't very funny in my view - but humour is like that - not really an issue, just sometimes it doesn't work, but I certainly didn't take any offence, very rarely do, but I should have said that in my earlier post.

Tiny point
re: "and more money isn't going to fix it"

You obviously mean "a little more money isn't going to fix it"

Since a load more would allow us to buy our way out of the PFI schemes and start training enough nurses instead of asset stripping the rest of the planet of badly needed health care staff.

Would allow the NHS to set up its own I.T. development house instead of paying £11.5 billion to CSC for a piece of vaporware.

Would allow GPs to spend more than 5mins with patients.

Would allow us to bring cleaning, catering, portering, estates, pathology, CSSD, Xray diagnosis & I.T. Depts etc back in house with proper training, career progression, standards & pride.

Would stop troubled teenagers being reverse auctioned off to private care providers often 100s of miles away from their families.

Would allow community trusts to properly resource community hospitals, reopen closed wards and allow them to start admitting patients from the Acute hospitals and freeing up the A&E logjams.

Would allow the NHS to recruit some proper substantive Chief Execs & D.o.Fs instead of having them in post shorter than a football manager & in thrall to american management consultants doing their "stint" in England as the next step on their respective corporate ladders.

P.S Labour were worse & money makes everything better (as long as its not spent on vanity projects - looking at you Blair & Lumley)

Rant over... Done me some good... As does reading your stuff, for the LOLZ

Tiny point

Very good but you missed the rather large elephant in the room, ie, the EU.

Many of those excellent points which you have made will be unachievable due to EU competition directives.

A point which is shared by Dr David Owen :

[url= http://www.bbc.co.uk/news/uk-politics-eu-referendum-35979759 ]EU referendum: Owen says Leave vote will help reverse NHS competition[/url]

Now I don't have the slightest respect for Lord Owen a former Labour cabinet minister who considerably helped Thatcher win a general election by forming a breakaway political party to fight Labour.

But it is extremely pertinent that this analysis should come from him when you consider that one of his principle reasons for leaving the Labour Party and forming a rival party was Labour's policy of withdrawal from the EEC. This man is not a natural anti-European, far from it. And he is of course a former GP.

So to fix the problem I would suggest "more money [i]and[/i] withdrawal from the EU".

Unless you think private healthcare providers are the solution.

"Unless you think private healthcare providers are the solution."

It would certainly solve the problem of 42 page squabbles about it on STW.

So to fix the problem I would suggest "more money and withdrawal from the EU".

Conveniently missing the obvious contradiction in that position.

Lots of stepping back to the future going on at the moment - welcoming back "the struggle" comrades here and a return to isolationism/narrow minded xenophobia on the Europe referendum thread. Do we never learn?

To the tune of the red flag: "We'll keep the union flag flying high..." a very odd mix.

Still in the winners v losers core part of the show, the Guardian seems to be going a little off-piste

But the BMA was on Wednesday night facing a growing backlash from junior doctors furious at what some called “a sellout” and “a joke”. Dr Manish Verma said: “It doesn’t seem like an improved deal. It’s the BMA’s turn for propaganda to try and sell this as a good deal. Looking at the Acas document there seems to have been lots of areas where we have conceded. It’s unclear where we have gained anything.” Others, though, predicted that trainee medics would back the deal reluctantly due to fatigue after eight days of strikes.

Dr Will Rook, a junior doctor in general medicine, said the new deal was worse than its predecessor, which the BMA rejected in February. “It hasn’t addressed a lot of the concerns I had in the first place around trying to spread a five-day service over seven days without having extra people to do the job. It also appears to further devalue our work-life balance. A 10% supplement for working one in two weekends a month is a joke. The disruption it causes is immense”, Rook said.

"What do we want....?"

"Dr Will Rook, a junior doctor in general medicine, said the new deal was worse than its predecessor, which the BMA rejected in February."

Alan Johnson was saying on This Week that as a union leader you can be sure that once you strike the deal you get will never be better than the 'pre-strike' deal. He said strikes only work as a threat. Had the ring of truth and he should know.

So to fix the problem I would suggest "more money and withdrawal from the EU".

Unless you think private healthcare providers are the solution.