It’s not a race to the bottom Drac 😉

Some of my best friends are Dr’s and they said it’s Ok. 😆

By the way, I like the overly optimistic way they label those “Day off” days too.

On that rota, four of those days “off” actually involve 9 hours at work and probably most of the rest of the day sleeping to get back onto a day rhythm.

That’s how nights work. 😀

This article below is the real game being played. I assure you the “physicians assistant can do 85% what a doctor can do” applies to basic tasks a first year post-grad doctor could do but they will never be diagnosticians and thus the argument is so misguided to hurt to see it on paper. I have worked with quite a few PA’s and they are excellent at manual tasks but they receive a fraction of the education we do and will not move on up the decision-making ladder.

This article demonstrates clearly the junior doctor strikes are about the future of the NHS. Maybe it’s time we all paid personal insurance? Hell doctors would benefit. Is that what we want? Doctor’s don’t think so.

How a Government can beat the BMA

That article is genius. I for one would be delighted if next time I need surgery it’s done by a Territorial Doctor.

I wonder if the author even realised that he’s simultaneously arguing for doctors to be classified as “essential” so that they can’t strike, while arguing that doctors aren’t essential and any random could do it?

From Facebook

People of England, and our Welsh and Scottish friends living on the borders who might use an English NHS hospital.

Good evening.

My name is Dr Philip Lee, I have been a doctor for nearly 14 years and I am a consultant doctor specialising in acute medicine and elderly care based in a London teaching hospital.

I’d firstly like to apologise for my photo intruding upon your timeline. But I appear in my uniform for a reason.

You see, I want to reassure you of something, and it’s important that you trust me on this because the government that’s suppose to reassure you have so far either said nothing, or spread panic inducing opinion through its apparatchik. And people trust doctors.

There is in all likelihood going to be an all out junior doctor strike in England a week next Tuesday. This will go on for two days with all junior doctors walking out between 8am and 5pm both days. This has never happened before in the UK, and all doctors in training who are not consultants will walk out.

Putting aside the reasons they’re striking for a second, let me now say categorically, you and your friends and loved ones will continue to get world class emergency care those days.

If you come to the emergency department having been run over by a car, we’ll be there waiting for you.

If you’re already in hospital, you’ll still be seen by a consultant or staff specialist if you need to. If you need an emergency operation, it will happen.

If your loved ones are in intensive care, doctors will see them as usual.

If you should have a sudden cardiac arrest in our hospital, my colleagues and I will do our very best to resuscitate you, stabilise you, and treat you just like any other day.

If your clinic or test appointment or operation has been rescheduled or delayed, I apologise. But these strikes are happening to ensure patients get the best and safest care, not a stretched out, underfunded, dangerous service.

The emergency service on those days will be no worse, if not better, than an average day. The Department of Health has said none of this.

You see as doctors, we have all sworn an oath to do no harm. Our junior colleagues will not have taken this action lightly, and they do so with a heavy heart but knowing that as consultants, and my staff grade and associate specialist colleagues, we’re 100% behind them. Our support let them protest the changes to our NHS that is not safe for patient care.

I believe in the NHS, and I care for its future. That’s why I’m providing #emergencycover.

On the 26th and 27th of April, if you’re ill, please see your GP, or come to hospital. We will be there for you, just like everyday. And if you’re not ill and walking or driving by, give my friends a honk, or a friendly word. These brave men and women need your support.

Oh and if you “like” this, please share as widely as possible to help spread the word!!

The statement above is disingenuous. The junior doctors are steadily eroding the sympathy of the general public, and the next strike will cause severe issues. Even the previous ones must have caused suffering in the sense of missed operations.

The fact ‘hashtag emergency cover’ is still available doesn’t help the patients waiting for pain relieving operations, or that a whole tranche of consultant led activities will be deferred as a result?

I doubt many people disagree that doctors should be valued by the NHS, but deliberately removing emergency care has gone beyond what I think is acceptable behaviour. Really sad about this.

HAs the BMA set up a locum agency yet – ready for when all juniors refuse to sign their next contract ?

That’d be great

I fully support them.

It only looks bad because no one else dares challenge the government and its appalling decisions – the junior doctors are the only ones to stick the head above the parapet and say enough is enough….

They wouldn’t strike if they didn’t have to… besides, round here the majority spent their strike day last time volunteering in old peoles homes etc…they weren’t having a day off…

The fact ‘hashtag emergency cover’ is still available

but deliberately removing emergency care has gone beyond what I think is acceptable behaviour. Really sad about this.

See how they’ve got you thinking ?

I suspect that the group who are most “professionally” affected by these strikes is the senior docs. They provide the junior cover on strike days and then go off to make up the missed paperwork etc afterwards.
I work in the NHS and don’t know a single consultant who doesn’t support the strike.

Patients missing appointments or experiencing delays is a great shame and I agree it’s about time this shit was sorted out. The difference is that “this shit” in my view is Mr Hunt.

I doubt many people disagree that doctors should be valued by the NHS, but deliberately removing emergency care has gone beyond what I think is acceptable behaviour. Really sad about this.

Good job that’s never happened then.

Drac what are you on about?

Scaredypants you missed my point – consultants fill in for missing junior docs, hence their tasks get delayed which impacts patients? Am I missing something?

Either way not looking for an argument, the whole situation stinks and neither side are right. The people suffering as a result are the patients.

Drac what are you on about?

The emergency care hasn’t been effected, you even said so yourself.

I work in the NHS and don’t know a single consultant who doesn’t support the strike.

Why are the the public illogical with their views regards the strike.

The public trust the doctors with their professional decisions over their health, but then distrust the doctors professional decision regarding the strike (which is still related to the publics health) and instead choose to listen to the government who have far less ‘real knowledge’ of the situation.

I doubt many people disagree that doctors should be valued by the NHS, but deliberately removing emergency care has gone beyond what I think is acceptable behaviour.

But you do not mind when the Government do it? Recently problems have been escalating in the NHS.

An A&E unit has had to close due to government policy
http://www.bbc.co.uk/news/uk-england-lancashire-36042951

Oversees doctors are now being hurriedly brought in to fill gaps in GP Practices. The government over the last few years has reduced the number of training posts, and changed immigration rules that prevent oversees doctors working in many key roles in the NHS. Hospital doctors dont blame patients when they turn up at A&E because they cant get a GP appointment. They still treat them because they care.
http://www.telegraph.co.uk/news/2016/04/07/nhs-to-recruit-indian-doctors-to-plug-gaps-in-gp-services/

I know directly of a major Trauma Centre teaching hospital that is running with unsafe staffing levels. It is running on the goodwill of doctors coming in to do shifts post on call and rota’d days off. This is not safe for the doctors or patients.

I know of A&E’s where the most senior doctor on shift has been a Surgeon Registrar as they can not get the correctly qualified doctors to do the job.

In all these cases doctors are going above and beyond to make sure the hospitals remain safe, where government policy is directly creating a situation where if doctors didn’t step in, patients WOULD be at risk.

These are only the direct examples I have, they will not be the only ones through out England.

Remind me who’s putting patients at risk again ? 🙄

Can’t disagree with the above, just can’t see the strike doing anything to help.

just can’t see the strike doing anything to help.

whereas doing nothing, turning up to work and accepting a disastrous contract will help?…

It’s got to becoming clear to you where the balance of blame lies?

i think you miss my point, turning up for work as you put it will help patients, which I thought was the job (sorry, vocation) of a doctor. A patient cares not where the blame lies if they desperately need an operation which has been delayed by a strike. The balance of blame is entirely subjective but don’t be surprised by people not seeing the BMA as ideologically pure.

Government and profession have completely failed here, and the proposed strike is damaging to patients. The new contract, IMHO of course, is not a disaster for patients, just potentially financially damaging to doctors.

The new contract, IMHO of course, is not a disaster for patients, just potentially financially damaging to doctors.

Dr’s working longer days, more hours in a week will have an effect on patients. That’s why they are striking.

#groundhogday

That’s one reason why they are striking. Also, just because you stated your argument previously doesn’t mean it has been accepted. Using sarcastic hashtags doesn’t help persuade either!

It’s good to hear opposing opinions, and I suspect/guess/predict that you’ll hear a lot more if the next strike goes ahead.

It’s good to hear opposing opinions when they are based on facts and logic otherwise they are just like listening to a drunk babbling to himself in a corner

FTFY

just can’t see the strike doing anything to help.

What would you advise as a better strategy?

Why do you think striking used to be illegal if its ineffective?

That’s a technique you often use I’ve noticed DrJ, I don’t want to patronise you but it doesn’t equate to debate or argument.

That’s one reason why they are striking.

It’s the main reason they are striking, which is why people keep saying it – sorry if that’s becoming repetitious. If you can debate or argue that it’s not the case, feel free.

Not sure that what DrJ has put is constructive in any way…

Bainbrge – why shouldn’t a doctor be paid a fair wage for doing a very hard, skilled job?

Mrs FD got an email recently offering her a private sector health related job £100k + 9-5. Way more than she will earn being a consultant.

It is not a race to the bottom

i think you miss my point, turning up for work as you put it will help patients, which I thought was the job (sorry, vocation) of a doctor.

Turning up for work now helps one patient here and now. The doctors have taken the longer view that not turning up to work will help more patients, not right now, but for the long term.

http://www.theguardian.com/society/2016/apr/17/pressure-mounts-on-jeremy-hunt-over-handling-of-junior-doctors-dispute
Apparently jezza wasn’t imposing the contract after all, merely “introducing” it.

The man is an utter tool.

I’m not sure, but the difference between imposition and introduction sounds like semantics to me – junior docs renew contracts pretty often and if all that’s on offer is the newly “introduced” variant, ….

The public trust the doctors with their professional decisions over their health, but then distrust the doctors professional decision regarding the strike

I don’t trust a doctor anymore than any other professional, a doctor can make a mistake like anyone, they can make an error of judgement. There are 8,000 avoidable deaths every year (stat from health service peofessional quoted recently). Doctors disagree on diagnosis and treatment all the time.

Given how discredited the BMA was over their “calculator” I am not at all sure the strike decision was taken on the basis of sound financial information. I can imagine Junior Doctors are not happy about the prospect of more weekend working

I don’t trust a doctor anymore than any other professional, a doctor can make a mistake like anyone, they can make an error of judgement. There are 8,000 avoidable deaths every year (stat from health service peofessional quoted recently). Doctors disagree on diagnosis and treatment all the time.

+1. There is a worrying lack of accountability too, in my experience.

I’m not sure, but the difference between imposition and introduction sounds like semantics to me – junior docs renew contracts pretty often and if all that’s on offer is the newly “introduced” variant, ….

Cut’n’paste from a Grauniad comment:

NHS trusts were going to refuse to use this new contract and retain the old one under their own mandates. *unt tried to force them by the whole ‘I am going to impose this contract and fine any trust which doesn’t implement it’ strategy.

Now that he’s saying he can’t impose the contract it means the trusts may be able to choose to retain the old contract like they planned to.

I can imagine Junior Doctors are not happy about the prospect of more weekend working

Do you not understand anything about what this whole industrial action is about?

worrying lack of accountability too, in my experience.

What exactly do you mean by accountability ? I think all doctors would agree that they could get better at root cause analysis and become more like the aircraft industry. However see my previous post, how can you improve practice when you do not even have enough staff to do the minimum?

What exactly do you mean by accountability ?

Something along the lines of what they have in the US I suppose.

Now that he’s saying he can’t impose the contract it means the trusts may be able to choose to retain the old contract like they planned to.

So individual trusts are going to resist government pressure to adopt the new version ? Righto

So individual trusts are going to resist government pressure to adopt the new version ? Righto

I doubt it, but the point is that *unt was fibbing when he said he was going to “impose” the contracts.

Now attention can be turned to what arm-twisting is going to happen (already started, in fact) to make the “independent” trusts do what the govt tells them to.

See I am not even convinced the government knows what they want in terms of service, which only helps confirm that the doctor contract is a cost cutting exercise.

Current feedback from service users that I am aware of is that they do not want yo come to clinics Saturday or Sunday, they do want evening clinics.

It is also more the supports services that need to be more adaptable ie physio/diagnostics. These services are not run by, wholly dependant on doctors

Jambalaya, be careful not to assume that all deaths that are classed as avoidable are due to factors that could be attributed to mistakes or misjudgements by doctors. The definition of “avoidable deaths” is much more complex than that. And the word “potentially” should precede it
http://webarchive.nationalarchives.gov.uk/20160105160709/http://www.ons.gov.uk/ons/about-ons/get-involved/consultations/archived-consultations/2011/definitions-of-avoidable-mortality/definition-of-avoidable-mortality.pdf
You’ll see that deaths due to many different causes are automatically classed as avoidable because with timely medical intervention they could be.
Just picking one cause of avoidable mortality, dvt/pe, any deaths due to this are classed as avoidable even though someone might drop down dead in their sleep having never sought medical attention.
There are lots of reasons why we don’t have the fabled “airline levels of safety”, including the fact that we are dealing with human beings (both doctors and patients) that sometimes make poor decisions.