Why is it either/or?
Because if he had said that then he couldn't keep the argument going.
Nonsense - the reason its not either/or is because theres no point keeping things that we don't need - like how the penny pinching bastards closed all the TB sanatoriums!
Your game is incredibly poor today.
Nonsense - the reason its not either/or is because theres no point keeping things that we don't need
Define need for me please.
There's plenty things that people ask the NHS for when they dont really need it. Blame the patients, not the NHS.
There's plenty things that people ask the NHS for when they dont really need it. Blame the patients, not the NHS.
I am the first to agree on that being a really important discussion that needs to be had.
The doctors aren't getting paid less though are they as the basic wage isn't changing as its only the overtime and extra cash they can get is.
That "overtime" isn't optional. Those shifts are part of their contract.
if they don't like it change job or move country.
They can. And that would be a disaster for the NHS. No one wants that (except possibly those trying to break the system so they can privatise it).
Fortunately many doctors are committed to the principle of social health care.
And others don't fancy giving up a job they have trained their entire adult lives for.
most other people are having to suffer pay cuts in real terms so what makes doctors any different?
For one thing "most other people" don't have the government pretending it is actually a pay rise and misleading the public about the hours that they already do.
Likewise most people's pay banding doesn't also serve as the financial safeguard that protects them from unusually long and unsociable hours, and by extension protects the safety of their "customers".
Likewise most people's pay banding doesn't also serve as the financial safeguard that protects them from unusually long and unsociable hours, and by extension protects the safety of their "customers".
Surely the European working time directive does that?
instead of acting like a bunch of petulant teenagers threatening to ago on strike, why don't the junior doctors just collectivley withdraw their working time opt-outs?
[url= http://m.bma.org.uk/working-for-change/junior-and-consultant-contract/ddrb-recommendations-analysis-for-juniors/removal-of-vital-safeguards ]According to the BMA[/url] the Working Time Regulations aren't nearly as effective as the current system and could see doctors only being entitled to one twenty minute break in an eleven hour shift.
instead of acting like a bunch of petulant teenagers threatening to ago on strike, why don't the junior doctors just collectivley withdraw their working time opt-outs?
So rather than debating and voting on carefully considered industrial action they should just act unilaterally and pull the rug from the very health service that they are trying to protect?? How is that less "petulant"?
That "overtime" isn't optional. Those shifts are part of their contract.
how can it be overtime if its part of their contract? (actual question)
Likewise most people's pay banding doesn't also serve as the financial safeguard that protects them from unusually long and unsociable hours, and by extension protects the safety of their "customers".
at least they get paid for it. lots of jobs are salaried and you dont get overtime. when I worked in science I got paid the same wither I worked 20 hours or 50 hours.
how can it be overtime if its part of their contract? (actual question)
Because it is not overtime.
Contrary to what Jeremy Hunt tells you, the NHS is 24/7 and requires doctors working shifts to cover all hours.
Their current contract recognises that shifts at anti-social hours are, well, anti-social so it adds additional pay bands for junior doctors whose current position means they are working a lot of those shifts.
So the government's "plan" to afford its "new" 24/7 NHS is to massively penalise the doctors providing the current 24/7 NHS, call it a pay rise and then pretend to be incredulous at the "greedy doctors".
at least they get paid for it. lots of jobs are salaried and you dont get overtime
It's not a race to the bottom.
Some other jobs are shit so their job should be shit too is not a good argument.
Their job is shit enough!
(and I say that as someone sat alone in an office at 9pm on a Saturday working unpaid overtime)
<Oops, sorry, late to the party>
Poah 'overtime' means normal work really. Standard full time posts are 48 hours a week - which in reality usually means 50-60. Depending on specialty weekends are 1 in 3 to 1 in 5 where you usually do three thirteen hour days or nights fri to sun with normal week either side.
100 hour weeks of nights although not common still happen as 'standard hours' so it is in effect overtime but not optional.
Doctors get paid fairly well but being expected to work those kind of hours, and if JH gets his way more weekend/late night working and a pay cut of up to 30% is a bit of a joke.
when I worked in science I got paid the same wither I worked 20 hours or 50 hours.
Yeah, well, me too. But when I was tired and made a mistake, I got a calculation wrong, or my programme crashed. Nobody died.
Or they do the Mash.
The monster mash?
I think the "hunt effect" thing is pretty fascinating tbh. People say that politicians and the press can't strongly influence public opinion but here's evidence that by just repeating the same lie about the 24 hour NHS over and over, Hunt has convinced people so thoroughly that they're actually putting their health in jeopardy.
It's a new and exciting way for a secretary of state for health to kill people. Got to hand it to the man, he's innovative. I wonder if they saw this coming, with hindsight it's pretty inevitable, if you lie about the service available people won't use it. What's next?
(and I say that as someone sat alone in an office at 9pm on a Saturday working unpaid overtime)
And also having now returned home to find my wife sat in front of the PC also doing unpaid overtime, working on her Junior Doctor ePortfolio. It's nearly 1am. I'm in bed. She's still working. The kids will be up a half six. 🙁
The monster mash?
Do the Mash!
It is pretty fascinating tbh. People say that politicians and the press can't strongly influence public opinion but here's evidence that by just repeating the same lie about the 24 hour NHS over and over, Hunt has convinced people so thoroughly that they're actually putting their health in jeopardy.
Unfortunately it is not a new game. To quote Nye Began "How can wealth persuade poverty to use its political freedom to keep wealth in power? Here lies the whole art of Conservative politics in the twentieth century."
Yeah, well, me too. But when I was tired and made a mistake, I got a calculation wrong, or my programme crashed. Nobody died.
I could quite easily kill someone or myself in the lab if I was tired and made a mistake.
It's not a race to the bottom.Some other jobs are shit so their job should be shit too is not a good argument.
Their job is shit enough!
thats not what I said.
From next year we're going to be paying MPs £74,000 a year (currently £67k), plus expenses for food, travel and second homes, whilst they also have enough spare time for second jobs such as regular column writing and consultancy work. The argument for this is that it's a very important job that wants to attract the best, an argument which strangely doesn't apply to other areas of public service, such as the NHS or the education system.
I'd argue that looking after the health of other human beings is not just important, but vital, whether that's nurses, doctors or surgeons. Cock up as an MP and you get lambasted by the papers, have the mickey taken on Have I Hot News for You, and maybe, just maybe, you'll lose your job. Cock up as a doctor, and you're risking other people's health and possibly their lives.
A doctor requires years of study and training, and will continue to have to learn and adapt throughout their career. An MP has to basically win a couple of popularity contests. An overworked, tired doctor can make mistakes that costs lives. An overworked, tired MP nods off on the cushioned benches of parliament.
I'm thinking that if there are savings that need to be made, we're looking in the wrong place.
Decent summary here:
I think you need to get your basic definitions sorted,tbh..
OVERTIME - as a junior doctor, this would be time over and above your scheduled hours. I.e.your shift finished at 8am, but you take part in the ward round/continue looking after a sick patient. You WOULDN'T get paid a penny for this. Frequently doctors try claiming for the overtime by managers manage to get out of it.
UNSOCIAL HOURS - This is what the deal refers to. Your Rota will include day work, night work, evening work, weekend work. It's the nights and evenings (you know, un social times, that attract extra pay above and beyond the basic pay. Often 40% more.
This is what's going...
DrP
And the other definition that confuses people:
JUNIOR DOCTOR - isn't just a spotty-faced new graduate or a "petulant teenager". It's all doctors until they reach Consultant level. My wife is a 40 year old mother of two. She is a Junior Doctor and has been for fifteen years.
How many hours do junior doctors work? Is it the 48 that is in the headlines or is it way more than that?
Are GPs junior doctors? Given that they've completed their training.
Standard full time posts are 48 hours a week - which in reality usually means 50-60.
Are GPs junior doctors? Given that they've completed their training.
No, they are General Practitioner that means no longer a Junior.
Wanmakylung - full time is 48 hours but that's an average over six month rota. Currently it's up to 91 hours a week officially but often 100 for week of nights, days off elsewhere then bring average down,
Many jobs are over 48 hours on average but the only way to reduce that is more time off in daytime hours which no one wants as impacts on training.
One of key issues is nights/weekends etc need minimal levels of cover and cannot be cut.
We probably need to change the way we deliver some stuff - lots of stuff that is done by a doctor does not need a doctor to do it of that makes sense,
GPs are not juniors. Shortest route to being a GP is five years post med school. Some specialties nearer fifteen years post medschool hence you can be a junior doctor for a lot time depending on career route.
Junior just means not consultant or GP.
Sorry yes, I should probably have said "all [i]hospital[/i] doctors until they reach Consultant level".
GPs have a different path.
Some specialties nearer fifteen years post medschool hence you can be a junior doctor for a lot time depending on career route.
And longer when you factor in maternity/paternity leave and/or less-than-full-time working.
See if I was asked to do 90 or 100hrs in a week i would cease to function. i cannot see how it can be in the best interests of patients for them to be looked after by people in that state. You could not pay me enough to put myself in a position where I knew that my mistakes could cost someone their life and that I had to make those decisions while exhausted.
The other definition that people should know is what we get our 'banding' for. This is the "extra" 40% over the basic rate. [b]It is not just because our hours are antisocial.[/b]
So when you're fresh out of medical school, you're paid £22,636/yr* (gross, of course) for working a 37.5hr week. I think we can all agree this is a pretty low wage for someone who's spent such a long time in education. Some jobs will just have basic rate and no out-of-hours commitments (on calls). I.e. they're unbanded so that wage is what you get. Most new doctors will do three four-month rotations in their first year, and usually not more than one of these rotations will be unbanded. Many doctors doing these jobs will of course stay later to help out and not get paid a jot for this - much like in any other 9-5 career. Of course, there is all of the other career progression / continuing professional development stuff which is quite burdensome and done outside of these hours, plus most people I know will spend yet more time reading / learning.
For rotations involving weekends, evenings, nights you get paid more. Your hours are increased to 48hrs/wk (a 28% increase over a standard 37.5 hr working week) and you get paid (a bit) more because these hours are antisocial, so your pay packet increases by 40%. As you can see, most of that extra comes from just working more salaried hours.
Regarding antisocial hours: My wife and I are both doctors, and we will each work on average 1 weekend in 4 or 5, though these weekends are rarely 'in sync'. Organising any social event at the weekend involves lots of planning because weekend where we're both free are a luxury. Worse still is when she's on "long days" (09.00-21.30 or similar) and I'm on nights (21.00 - 09.00). In those situations we don't see each other for a week. Don't tell me that's not antisocial. If I could drop all my on calls, have a basic salary and keep my evenings / weekends free, I'd do that in a heartbeat. Contrary to what Ceremy says, this is never an option. I've never met a doctor who could opt out in that way.
I haven't really written about the effect that the new contracts are likely to have on patient care...
Anyway, I don't mean to rant. I love my job and I get great satisfaction out of doing something tangibly worthwhile. But new contracts imposed from the top that amount to a complete lack of respect for one of the most educated, hardworking and selfless groups of people is a disgrace.
*NHS Doctors' payscales are published and easily found online. This is the starting figure for 2015/16.
So new grad drs are paid the same as a physio/nurse/OT/SALT etc who has been in post for 6 months or so. That surprises me.
Like!
Correct. Nurse practitioner posts often better paid too than many more 'senior' junior docs of you look at pay for mon to fri hours
That surprises me
And then you get nurse specialist who are the flavour of the month. They replace middle tear doctors, earn about £45-50k. They are great at specific tasks, but do not have the rounded understand that docs do, just hope you don't have a complication, or a history that doesn't fit the norm
Doctors cost more for a reason
That's slightly patronising FunkyDunc. The Nurse Specialists I've met certainly don't struggle with such things, they tend to have a vast amount of experience before getting to that level.
If you're after a hate figure then look at some of the advertisements for "physicians' assistants" - a non-doctor role with similar responsibilities to junior docs, except they get paid £48k after a couple of years of subsidised training.
But these people, and nurse practitioners mentioned above, are not the enemy here. Don't get caught up in squabbles that detract from the bigger picture.
To avoid misunderstanding I would agree nurse practitioners are excellent,
They earn equal and in some cases more than the 'junior' docs who may often have to give advice in some roles - just trying to make the point that juniors (I.e. All non consultant docs) are fantastic value for money when you compare pay for mon-fri for other groups.
That said there is no doubt that cutting pay of all other NHS staff will be the next target.
Unfortunately I feel this situation will just be the first of many to come. The NHS is struggling for many reasons:
- A population living longer than ever before.
- People living longer with chronic conditions than they ever have
- The availability of more complex, and hence expensive, treatments.
- Increased demands on social care - and when they fail to meet the needs, the NHS tends to pick up the slack
- A more demanding patient population than ever before.
While this may have impacted the ability of the NHS to carry out certain functions, such as elective surgeries/clinics/GP care etc - it's ability to treat the acutely unwell patient remains unrivalled - possibly anywhere in the world, and certainly anywhere that has a free at the point of care health system. However, how long this can continue remains to be seen.
I'm not entirely convinced the NHS can continue to exist in it's current form, as it simply cannot without massive increases in financial investment. However, this government do not seem to be in the slightest bit interested in preserving it in any form. The government claim their current actions are about allowing trusts to maintain a 7-day a week service and removing financial penalties for rostering doctors out-of-hours - but if they roster more doctors to work out of hours - who does the jobs they were doing during routine hours?!?!
Sadly I can't see any other explanation other than the government attempting to set up the NHS to fail, and fail spectacularly. Private health-care systems are set up to make a profit - not provide the patient with the best care. Elective work, clinics etc are far more profitable than acute services - so I wonder which will become the priority?
I'm not going to get into the "are they paid enough" debate, as although that's what the current argument surrounds I think there are far bigger issues at play. All I'll say is that if we end up in a private system - I can assure you the pay will only go one way!!
I'm a junior doctor. I love my job. I think the NHS is one of the gems this country has, and I'm not willing to let this government run it to the ground without a fight!
E
That said there is no doubt that cutting pay of all other NHS staff will be the next target.
They're coming after the unsocial hours pay.
Jeremy Hunt was co-author of a book called [url= http://www.independent.co.uk/voices/comment/jeremy-hunt-and-privatisation-are-no-recipe-for-saving-the-nhs-but-try-telling-the-blairites-that-8120781.html ]Direct Democracy: An Agenda for a New Model Party[/url].
If you were in any doubt of his intentions then these extracts may help:
"We should fund patients, either through the tax system or by way of universal insurance, to purchase health care from the provider of their choice. The poor and unemployed would have their contributions supplemented or paid for by the state."
...
"Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain."
...
"Instead of tinkering with a fundamentally broken machine, it (the Conservative Party) should offer to update the model."
Nice link. Didn't know that. U.S. Style healthcare would be a disaster.
Equally current NHS format either needs more money or less services as it is not sustainable.
Guess the question is is any politician prepared to stand up and have that difficult conversation....
Like this you mean?
http://www.theguardian.com/commentisfree/2015/oct/17/junior-doctor-nhs-jeremy-hunt
But new contracts imposed from the top that amount to a complete lack of respect for one of the most educated, hardworking and selfless groups of people is a disgrace.
your pay for someone fresh out of uni is pretty standard - it goes up a lot quicker and higher afterwards.
p.s you forgot to add god complex and arrogant to the end of your sentance above 😉
