It all very much sounds like it is about pay.

Many other professions no longer have ‘pay progression’. Where I currently work you’ll be lucky to get anything let alone inflation. Only way of earning more is on promotion to a different more senior role.

other employers also change terms of contract during employment. For example, reducing pension benefit or reducing redundancy, it happens all the time. Especially when the economy is not doing well and belt tightening is needed.

should a few decide to leave and become bankers, fair enough, but I think most realise even with some slightly less generous terms they are still on to a very good thing.

For a dispute “not about pay”, a lot of the points of contention seem to mention pay.

It all very much sounds like it is about pay.

Only if you ignore all the other concerns.

Many other professions no longer have ‘pay progression’. Where I currently work you’ll be lucky to get anything let alone inflation. Only way of earning more is on promotion to a different more senior role.

other employers also change terms of contract during employment. For example, reducing pension benefit or reducing redundancy, it happens all the time. Especially when the economy is not doing well and belt tightening is needed.

There are no winners for the race to the bottom.

1) I don’t get how you think financial penalties will change behavior or help the trusts.

2) simply a planning issue, not insurmountable

4) You have to ask why managers are using ‘creative’ rotas. This seems to be a public sector issue and I’ve never understood why, but someone might know.

5a) All pay increases should be linked to performance.

t all very much sounds like it is about pay.

I dont think anybody is denying pay is a factor – we dont want to be paid less for doing more work – hardly ridiculous. However dont forget that we didn’t start this, the government did. Tell me honestly when you have heard a junior Doctor complaining that we want a pay rise, we simply want to retain the terms that we have – given that the overriding driver behind this is political ideology of the Conservatives and not patient care.

1) I don’t get how you think financial penalties will change behavior or help the trusts.

It’s simple really. If they get penalised they’re reluctant to do it unless there is very little choice. Without they can please themselves without having to worry about it. Not difficult to work out.

The only way you’d struggle to work it out is if you thought the same amount of staff could work more days and shifts without compromise, see your reply to 2.

4 is not worth answering as its another one of you hate the public sector posts.

Drac – Moderator
4 is not worth answering as its another one of you hate the public sector posts.

😆 C’mon be a sport explain yourself ! 😆

➡ Milking the system come to mind ? 😛

other employers also change terms of contract during employment. For example, reducing pension benefit or reducing redundancy, it happens all the time. Especially when the economy is not doing well and belt tightening is needed.

How many other employers get to do that by publicly slagging off their employees, denying that they work the hours that they do, and then claiming that the pay cut is a pay rise?

I don’t get how you think financial penalties will change behavior or help the trusts.

Because the “financial penalty” is that the current (admittedly very confusing) contract means doctors get a pay adjustment based on how many hours they work and how regularly they are rota’d to work weekends, nights or on-calls.

So Trusts are careful to avoid putting the same doctor on too many hours like that because they would automatically have to pay them more. Which helps to ensure doctors work reasonable hours and has helped the profession move away from the bad old days of juniors regularly doing 100+ hour weeks.

As I understand it, under the new contract the hours would be audited and it would be up to the doctor to make a (career-limiting) complaint.

The dispute is completely about patient safety, there is no issue about pay whatsoever. The only way to resolve the patient safety issue is to pay to the doctors more.

The only way to resolve the patient safety issue is to pay to the doctors more.

THEY. DON’T. WANT. TO. BE. PAID. MORE!

Apparently it really cannot be said enough. At no point in this dispute have the junior doctors asked for more money.

Apparently it really cannot be said enough. At no point in this dispute have the junior doctors asked for more money.

I didn’t say they did and I was heartened that so many of the issues in dispute about patient safety were resolved when the standard hours payment increase was raised from 11% to 13%.

so many of the issues in dispute about patient safety were resolved when the standard hours payment increase was raised from 11% to 13%.

Errr.. except they weren’t.

Have you not noticed that despite promises that current pay would be frozen so that they wouldn’t feel the cuts AND promises to increase the standard pay level, the Junior Doctors continued striking and are STILL STRIKING and have now escalated to a full walk out.

Mefty you’re naughty.

Graham, a quick scan of BMA website and it does seem that “pay” cannot be said enough, in fact rather often – among other core issues admittedly.

Agreed. You could pay me a million pounds and I’d still have massive issues with the contract as above.

Just wanted to make the point that pay progression isn’t automatic. Every junior doctor in training has an annual review at which you have to prove that you’ve hit all the competencies and skills targets that were set that year via an eportfolio. If you fail the review – no progression. The only times this doesn’t happen is during maternity/paternity leave and during breaks for research, to reduce the disincentives to having women/parents and academics in the profession (rightly so, I believe, although I should disclose that I’m a female academic junior doctor…)

Pay and safety are linked though – if all the doctors leave, it’s not very safe. And you can’t just make the remaining ones work harder to cover – that’s not safe either.

Quite possibly and FWIW I think JDs are underpaid. But claiming that pay is not/has never been part of the dispute is disingenuous at best.

I said it wasn’t about pay for weekend working, which was what Ben Gummer (Jeremy wanted a lie in this morning) was claiming in parliament this morning.

Maybe a better way of wording it is to say that the dispute is not about how much we are paid, rather the way that pay is structured and the obvious lack of independent safeguards in the system for patients.

Graham, a quick scan of BMA website and it does seem that “pay” cannot be said enough, in fact rather often – among other core issues admittedly.

Pay is an issue in the dispute – a key one – but the objections are to the pay cuts and the the government changing the pay structure in ways that people see as grossly unfair and opening the door to dangerous hours and poorer working conditions.

At no point have the doctors asked for more pay and it annoys me that the government have successfully convinced people that they have.

One of our friends had people shouting “Get back to work you greedy bitch” at her when she was on the last strike.

Race to the bottom? No I would just like people to have some perspective. The few doctors I know seem very unaware of how the world of employment works outside of their profession. Some thing they’ll find out about soon if you believe all the angst and they all leave in droves for other jobs.

Like I said employers regularly change terms, you have to suck it up or move true they don’t normally insult you whilst doing it. They just tell you via an intranet message. So your choice is to accept or leave. Often though, because market forces are at work you tend to find yourself in a similar boat with a competitor unless you can move to a more senior post.

If all the talk about pay was removed from the conversation I’d be less cynical that they are really worried about patients. Maybe the existing docs would vote for a pay cut so the NHS could keep the same overall wage bill and fund more doctors, this would reduce the concerns about being overworked, stressed and dangerous for patients?

I absolutely agree no one likes their terms being made worse or taking pay cuts. But it happens all the time. Have some perspective.

Pay is an issue in the dispute

Glad we are passed that issue then.

Sorry to hear about friend.

DT78 but this is basically abuse by a monopoly employer of a bunch of people who, unlike my generation, are saddled with 5-6 years of student debt.

If they had a way they could walk away and choose to do something else, or work for someone else, it might be a bit fairer…

… and actually that’s why so many are going overseas or dropping out of medicine completely… They are clever people with marketable intelligence.

So the question is what kind of NHS do you want?

Perhaps you do want one where it is impossible to adequately staff the service thanks to capricious evidence-ignoring decisions by JH which are actually cost-neutral?!

If lots and lots of doctors leave, and aren’t replaced with equally intelligent people wanting to do their jobs from other places then the market will correct and they will have to offer better terms and conditions. I don’t believe it will happen, because even though it is worse it is still a hell of a lot better than other jobs outside. You don’t just walk into a senior job in business you’ll need significant investment in terms of time and money, not dissimilar to that of a junior doctor. Take a look at what lawyers have to payout and the hours they work as juniors other professions are similar if you want to earn the salaries docs earn.

Sorry things are getting worse for you, but it really isn’t that bad….

That is exactly what happened in 2002-4 with the GPs with a recruitment and workforce crisis – and they had to radically alter T&Cs.

It was good for a few years – but now in RPI terms we are worse off than in 2004, working much harder… and there is another workforce crisis coming in the next 12 months… But I’m not complaining, I’m planning my retirement in 4-5 years when I always thought I’d go on for another 7-8…

The trouble is it takes 10 years from Medical Student admission or 5 years from initial qualification to get to the places in the system where the workforce problems happen – so there is a lag phase which means alienating a huge cohort of Drs is risky if you want to keep your service sustainable. There will be no one to replace them, for 5 to 10 years…

And a medical qualification – it turns out – is a pretty good starter degree. I know ex Drs in various fields. So don’t think people won’t walk. They are doing so already.

50% of the most junior doctors stepped away from training last year to do something else, up from 30% 4 years ago. And those figures are from before the dispute really got going. They should have been consultants in around 2020-2022.

Maybe the existing docs would vote for a pay cut so the NHS could keep the same overall wage bill and fund more doctors, this would reduce the concerns about being overworked, stressed and dangerous for patients?

And if there weren’t more doctors available to employ (which there aren’t – most posts are understaffed) then the NHS could use those extra funds to work the existing doctors even harder for the money they used to be on?

That’s not that far from the existing situation where they are reducing pay and using the funds to implement an ill-conceived “seven day NHS” which they don’t have the staff for.

I absolutely agree no one likes their terms being made worse or taking pay cuts. But it happens all the time. Have some perspective.

To be honest, I think if it the government had played a straight hand and just said: “The NHS is struggling, in the current climate we need reduce doctors pay a bit” then it would have met with much less opposition and many would have grudgingly agreed to it straight away.

As you say, that kind of thing happens in other jobs all the time.

But the lies and spin have played a major part in angering the doctors and put them on the defensive.

And for those who are saying “you knew what you were getting into” – I’m right in the middle of the 54,000 junior doctors caught up in this mess, and I decided to go to medical school in 1999, when I was 16. I had no idea that this is what it would be like, but thankfully our medical students now are much better informed.

Do any of you Tories seriously think Jeremy Hunt is doing a good job?

No crossing your fingers when you answer now.

To be honest, I think if it the government had played a straight hand and just said: “The NHS is struggling, in the current climate we need reduce doctors pay a bit” then it would have met with much less opposition and many would have grudgingly agreed to it straight away.

As you say, that kind of thing happens in other jobs all the time.

But the lies and spin have played a major part in angering the doctors and put them on the defensive.

When was the last time we had “straight” debate about our favourite sacred cow. Both sides in this dispute have distorted the issues to suit their needs, (which in the end will most likely test the public’s patience.)

It’s not news that we have a problem funding unlimited demands with limited resources, is it? Someone has to bite the bullet and tackle the elephant – in some form or another we will have to pay for our medical services in the future. Let’s get on with designing a sensible way for this to happen.

When was the last time we had “straight” debate about our favourite sacred cow.

True, but regarding DT78’s point that contracts change in other jobs too – there can’t be many contract negotiations that start with the employer claiming the employees lacked a “sense of vocation and professionalism” and that the “9 till 5 culture” was killing 6,000 people a year.

I suppose that’s what you get when politicians negotiate. I was tuped once. I received a letter telling me that if I turned up to work I would be deemed to have accepted the terms. If I didn’t I would be treated as if I’d resigned. No redundancy, no negotiating. Just tough.

So far both sides of this argument are making themselves look bad in the eyes of the general public

Race to the bottom? No I would just like people to have some perspective

They do. That doesn’t mean they should sit back and let it happen to them. Even the Dr’s that are your best friends. 😆

Perhaps you do want one where it is impossible to adequately staff the service thanks to capricious evidence-ignoring decisions

Its not about pay, so the outcome of the strike won’t affect recruitment. Unless Health Trusts having to pay compensation will attract people to the career in their droves.

Its not about pay, so the outcome of the strike won’t affect recruitment.

You don’t think hours, working conditions or how your employer treats you has any impact on recruitment??

I was tuped once. I received a letter telling me that if I turned up to work I would be deemed to have accepted the terms. If I didn’t I would be treated as if I’d resigned. No redundancy, no negotiating.

I had similar, it sucks. Thats one reason I think the reduction in T&Cs (especially Saturday working pay reduction) is the strongest part of their case.

Since they don’t mind that bit of the deal they should wind their necks in, and suck the rest up. Refusing to provide emergency cover because whistle blowing is going to be less easy? FFS, even if they win how many years will it take to make up the deaths that will be caused in two days of emergencies?

FFS, even if they win how many years will it take to make up the deaths that will be caused in two days of emergencies?

Ok I’ll bite. How many have there been so far?

You don’t think hours, working conditions or how your employer treats you has any impact on recruitment??

Maybe I’ve missed something but AIUI hours aren’t changing, just the hours that qualify for additional cash. Have I got that wrong?

Ok I’ll bite. How many have there been so far?

Have they already done a strike that includes emergency cover? I thought not, in which case presumably no deaths due to withdrawal of emergency cover so far.

Have you bothered to look what will be involved with them striking for 2 days cover wise. I bet no.

Maybe I’ve missed something buy AIUI hours aren’t changing

Must be true. Jeremy said so and we can trust Jeremy:

Jeremy Hunt: “Tired doctors risk patient safety, so in the new contract … no doctor will ever be rostered on consecutive weekends“

Example New Contract rota supplied by NHS Employers:

http://www.independent.co.uk/news/uk/politics/junior-doctors-furious-after-new-example-rotas-show-them-working-three-weekends-in-a-row-a6882541.html

Ermmm! That rota looks pretty good to me.