doctors on strike

Well it certainly seems to be a part of it.

From Auntie http://www.bbc.co.uk/news/health-34775980

Yeah they’re wrong.

Ah I see. The BBC are incorrect.

Riiiight.

Fact or supposition ?

Let’s just call it foresight.

Jamablaya:
As I posted on the other thread the Tories won the election with a higher nhs spending pledge than Labour (+£8bn pa vs £2bn)

and

Tory Health Minister Jeremy Hunt
“Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain”

Doesn’t take a genius to understand where the Tory ideology will take them.

On page 31, I posted this:

The dispute is categorically NOT about pay for weekend working. It’s barely about pay at all.

In no particular order, here are some of the things that I disagree with on the imposed contract:

1) No financial penalties for Trusts that allow their doctors to work unsafe hours
2) More weekend working with the same number of doctors means less cover during the week, when most of the day to day work is done (due to everyone else doing elective work M-F)
3) Thin end of the wedge with regards to other doctors and allied health professionals having their pay cut
4) “Creative” rotas that have doctors working random shifts with absolute minimum length of breaks, meaning tired and disorientated doctors looking after patients that have no continuity of care
5) Widening of the gender pay gap due to:
a) no pay progression whilst on maternity leave,
b) no provision for how less than full time training (LTFT) will work in the new contract
c) a pay structure that could mean that 2 female junior doctors on 60% contracts (ie doing a total of 120% of a full time job) could together earn less than the equivalent male doing 100% of a full time job
d) no pay progression for the final 5 years (full time) of training, which could mean that female doctors in their 30s could work for 10 years (gaining experience and skills) without any hope of a pay rise
6) Disincentives for doctors to do academic research, further diminishing our status in the worldwide scientific community
7) No pay progression in the final 5 years of training, which is where the biggest gains are made in terms of experience and skills.

Junior doctor rotas are already at breaking point. My own place of work has 7.6 people working a rota meant for 12. Next weekend, we don’t have any doctors covering the day shifts on Saturday and Sunday. Imposition of this ridiculous contract will mean that the exodus of doctors from the NHS will accelerate and I suspect we are in for a very hard decade or so in the NHS (if the NHS survives at all).

It’s still true.

In fact, we don’t have any doctors to do the weekend day shifts AGAIN this weekend. It’s like groundhog day.

@JT – yup that’s the French system, a proper mix between private and public – we have a right dogs breakfast and it’s not working – our expectations of it are nowhere near what we fund though state. The French have much higher taxes, vat on food etc and they still have greater use of private health service provision via personal insurance. We need a serious rational discussion.

Put simply – if it was purely about money then Junior Doctors would welcome privatisation due to the vastly inflated pay cheques that it would bring.

They don’t. It’s not.

No financial penalties for Trusts that allow their doctors to work unsafe hours

On 4 January Daniel Mortimer, chief executive of NHS Employers, wrote that a system of financial penalties for trusts who abuse doctors’ working hours had been proposed.

He said trusts who breached working time protections would have to pay fines to a “Guardian” who would spend the money on “supporting the working conditions or education of doctors in training in the institution”. He added: “The BMA seemed unwilling or unable to discuss this major development with us.”

Creative” rotas that have doctors working random shifts with absolute minimum length of breaks, meaning tired and disorientated doctors looking after patients that have no continuity of care

Without being a fly on the wall in the negotiations, it’s hard to know what the real sticking points are. The BMA has made no secret today that it sees status of Saturdays as the main obstacle.

At the same time, the doctors’ union is not conceding that all the other areas of disagreement in these complicated negotiations have now been completely settled.

If it is the case – as the government claims – that earlier fears over unsafe working hours have now been allayed, this message has not trickled down to striking doctors on picket lines.

They are still telling the public, perhaps wrongly, that this industrial action is still at least partly about unsafe hours.

Source

Remember, BBC reporting is very heavily skewed towards the London ‘Establishment’, especially now that Cameron has one of his pals as editor in chief of news…

The BBC has just done their lunchtime report, they’ve concentrated on ‘pay rises’ ‘unsocial hours’ but never mentions the unsafe practice. 🙄

@Drac – I agree.

I think it’s got very muddy and emotional that some of the orginal concerns are struglling to get through. They interviewed a doctor on the picket line and her reason for striking didn’t come across well either…although you do have to be media savy to sum up your concerns in a minutes soundbite on the radio..

Maybe that’s why they used her footage.

allthepies – Member

Ah I see. The BBC are incorrect.

Riiiight.

The BBC are reporting what they say are doctors’ reasons for the strike. It’s not a big reach to say that if this reporting doesn’t tally with doctors’ reasons for the strike, it’s probably not the doctors that are wrong.

Or maybe the doctors should tune into the BBC to find out what they think, and then act accordingly.

we need no discussion tories and there apologists need to learn that the people want the NHS to be in the public sector rather than engineer shit like this so they can then argue its “not fit for purpose” then make it more expensive so their chums can make more money.
There is no public support for a privatised NHS except amongst Hunt and a few other loons.

My apologies – the details regarding financial penalties for breaches of the contract appeared after my initial posting on page 31. In the previous version of the contract, there were no financial penalties for Trusts.

However, on the point of penalties for Trusts for breaching the contract:

1) Junior doctors do not have any protection under whistleblowing law (recently tested in court)

2) Breaches of the contract must first be reported to the junior doctor’s educational supervisor, the person that decides whether or not a doctor progresses in their career

3) In the case of doctors working longer hours because of sick patients, they will have to get “permission” from the consultant in charge before working any time over and above rostered hours – hardly likely at 9pm on a Friday evening when you are dealing with a patient that is dying

3) The educational supervisor (another consultant) will then decide whether the breach meets criteria to be reported to the Guardian

4) The Guardian will be a senior member of that consultant’s Trust, potentially the person who decides whether or not the consultant progresses in their career

5) The Guardian will take direction from the Department of Health regarding what actually constitutes a breach of contract

This system is wide open to abuse and manipulation.

The current system involves mandatory (ie breach of contract if you don’t do it) reporting of hours by every junior doctor on a rota for a 2 week period every 6 months, which is collated by an independent administrative person and published publically. Trusts are fined a set amount per doctor that breaches the EWTD hours regulations.

You missed out the bit about the BMA still holding out for more of the fine to be paid to the doctor who has been “overworked” – even though it is the patients who theoretically suffer. Nothing to do with money this dispute, not at all, oh look a badger.

There is no public support for a privatised NHS except amongst Hunt and a few other loons.

Once again those that disagree are “loons” and its a fact no one is suggesting privatising the NHS. This is a perfect example of how a rational discussion is currently impossible

There is a very big difference between a fully privatised health service and what we have now, in fact pretty much every other successful developed nation has a different system

There is a very big difference between a fully privatised health service and what we have now, in fact pretty much every other successful developed nation has a different system

Free at point of care?

You missed out the bit about the BMA still holding out for more of the fine to be paid to the doctor who has been “overworked” – even though it is the patients who theoretically suffer. Nothing to do with money this dispute, not at all, oh look a badger.

I think one of the problems with the Guardian proposal is that the fines are paid into the trusts’ educational budget, and that the fines may well work out cheaper than employing a locum for the same shift. I’m not entirely sure if the current version of the contract still has these problems but perhaps someone could enlighten me.

Enforced moving of money from one part of the trust budget might be a fine but it doesn’t really seem like a penalty.

You missed out the bit about the BMA still holding out for more of the fine to be paid to the doctor who has been “overworked” – even though it is the patients who theoretically suffer. Nothing to do with money this dispute, not at all, oh look a badger

To be fair, I agree with you on this point. I don’t give a toss where the money goes, as long as it acts as a deterrent to Trusts taking the piss out of their staff. We certainly don’t get the money now (IIRC, around £5000 per doctor that fails “monitoring”) and I don’t care if we get it in the future.

FWIW, although I’m a junior doctor, I’m not (and have never been) a member of the BMA due to (IMO) their total mishandling of multiple issues over the years (Modernising Medical Careers, pensions, whistleblowing case to name but a few). I would like to think that I’m capable of looking at the evidence, weighing it up, and coming to a conclusion by myself and have certainly not been “misled” by the BMA (their emails, like those from Health Education England, are deleted immediately on principle).

Enforced moving of money from one part of the trust budget might be a fine but it doesn’t really seem like a penalty.

You are right, smaller fines should be paid but they should come out of operational and clinical senior staff’s remuneration – sorry, got to go, flock of pigs flying outside.

Enforced moving of money from one part of the trust budget might be a fine but it doesn’t really seem like a penalty.

Sorry, should have read “Enforced moving of money from one part of the trust budget to another might be a fine but it doesn’t really seem like a penalty.”

Once again those that disagree are “loons” and its a fact no one is suggesting privatising the NHS. This is a perfect example of how a rational discussion is currently impossible

A rational debate is not possible with you [Oh can I call this bullying like you do when it happens to you?] and some people want to us any event as a method to undermine the NHS and use it as an excuse to privatise the NHS whilst lying about their end game. Their is no public will for this – will anything in the UK get more public support than the NHS in a vote to keep it – what do you reckon 90% + in favour?
What **** debate do you want to have then?

I am happy to discus show much funding is fair but not the model of delivery. As I said only right wing loons, you, Hunt, Farage, want to discuss that sort of issue.

jambalaya – Member

its a fact no one is suggesting privatising the NHS.

Well of course the Tories won’t talk about “privatising the NHS”, it would be political suicide for them to do so.

But they are quietly getting on with it anyway.

And if they mention it at all they refer to it as “denationalisation” rather than the dreaded privatisation word.

Although it of course means exactly the same thing.

jambalaya – Member

I understand that, however it’s worth noting my neighbours include a surgeon and a dentist with with very nice houses, top end Mercedes and nice yachts. Nothing against any of that of course, they deserve it.

The fact that some surgeons and dentists are rich is not the point. You suggested that doctors were in it for the money. I doubt many of them actually entered the profession with the ambition to become the Warren Buffett of healthcare.

There are people who think money is everything, and those people will tend to assume everyone else thinks the same. Even when told otherwise, they’ll assume it’s a lie or self-deceit or naivety. It colours everything they say and do, and you can’t argue with it. Anyone who doesn’t have money is jealous, anyone who gives money away is only doing it to feel good. And of course they’ll believe that this strike is all about money, too. And every time anyone mentions money even as an aside or a denial, they’ll go “ah hah! I knew it- they’re thinking about money”

Free at point of care?

Often not, no (certainly not in many other EU countries). We need to look at how things are done elsewhere and how they are funded. We need to be honest and ask ourselves what’s important and how will we pay for it, the NHS is important so fund it how ?

Oh can I call this bullying like you do when it happens to you?

JY. I have never once accused anyone here of bullying me, I have never reported a post. You well know this so why post that ?

@ernie increasing provision of care via direct payment and/or private insurance is inevitable. What we have cannot work in my opinion. You are quite right it’s electoral suicide to discuss this so no one does and the can just gets kicked down the road, but it doesn’t change the reality.

And every time anyone mentions money even as an aside or a denial, they’ll go “ah hah! I knew it- they’re thinking about money”

But as that Fullfact piece I linked to earlier, it is not really about patient safety either as most of those issues have been largely resolved, of the remaining issues money does figures pretty highly.

jambalaya – Member

What we have cannot work in my opinion.

When I point out that Hunt talks about “denationalising” healthcare you respond by making the case for privitisation.

So is it fair to assume that you now fully accept that the Tories are committed to NHS privitisation and that your “its a fact no one is suggesting privatising the NHS” comment is just meaningless twaddle?

.

EDIT : Btw since your comment “You are quite right it’s electoral suicide to discuss this” betrays your recognition that NHS privatisation would be extremely unpopular with the British public you need to ask yourself why that is.

Why would the British electorate never vote for a party which openly said that it would privatise the NHS? Isn’t privatisation a good thing? Why the public hostility to it? Can you explain?

mefty – Member

But as that Fullfact piece I linked to earlier, it is not really about patient safety either as most of those issues have been largely resolved,

It doesn’t say what you think it says.

This may have been a sticking point for a while, but it would appear that substantial progress was made – if statements by the government’s negotiators are to be believed.

But crucially, he did claim that the government had “reached agreement” with the BMA on the broader package of measures to protect junior doctors from unsafe hours.

If that’s true, all those placards warning about tired doctors and patient safety must be redundant. According to the government, these are issues that have now been resolved to the satisfaction of the BMA.

At the same time, the doctors’ union is not conceding that all the other areas of disagreement in these complicated negotiations have now been completely settled.

If it is the case – as the government claims – that earlier fears over unsafe working hours have now been allayed, this message has not trickled down to striking doctors on picket lines.

They are still telling the public, perhaps wrongly, that this industrial action is still at least partly about unsafe hours.

My bold. The factcheck doesn’t state that these things have been resolved; it states that the government says they’ve been resolved.

On the subject of fines for excess working; yes, a “penalty” system has been developed, whereby trusts would have to pay fines… to themselves. (the Guardian can spend the fines on education for doctors in training, something they already have to pay for)

I propose a new system where every time I call someone a **** on STW, instead of getting banned, I have to pay a £10 fine. That fine is to be paid from my bank account, to my paypal wallet, and the Guardian will make sure I only spend it on bike bits. I think this’ll discourage me from calling people ****s, don’t you?

No the Tories are not remotely committed to Privatisation of the Health Service, they won the election not least because of the economic credibility which protects the NHS and a commitment to spend £8bn more vs £2bn from Labour.

What I say is health service provision needs a radical overhaul. It just cannot work in today’s world with today’s expectations and it was never intended to, it was setup to provide universal basic health care. Modern medicine and longer life expectancy it simply cannot cope with.

EDIT : Btw since your comment “You are quite right it’s electoral suicide to discuss this” betrays your recognition that NHS privatisation would be extremely unpopular with the British public you need to ask yourself why that is.

Why would the British electorate never vote for a party which openly said that it would privatise the NHS? Isn’t privatisation a good thing? Why the public hostility to it? Can you explain?

@ernie because people will not accept the economic reality we face, not least when you have one if not both the main political parties saying the impossible is possible. They are being sold a lie. The amount of money required to have a world class health service is far beyond anything the British electorate is currently prepared to pay for by way of increased taxes.

No the Tories are not remotely committed to Privatisation of the Health Service

Well that ignores the fact that increasingly large amounts of the NHS budget is being handed over to private companies. And that Hunt, the Tory health minister, has said :

“Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain.”

So it is very clearly completely untrue.

I think that the truth and you jambalaya, is a bit like oil and water – you don’t mix very well. Would you say that’s a fair analogy?

On the subject of fines for excess working; yes, a “penalty” system has been developed, whereby trusts would have to pay fines… to themselves.

…and the doctors, you missed that bit out.

Personally, I think the government negotiators, who are officials rather politicians, do have credibility – the BMA appear to have been less forthcoming with Fullfact about what is outstanding.

mefty – Member

…and the doctors, you missed that bit out.

No agreement’s been reached on what level that would take, so yes, I missed it out- it could be 100%, it could be 0.00001% more than what the doctor is owed for the work done, which hardly constitutes a penalty. Also, Danny Mortimer was clear that the fine was only applicable where rules are “consistently breached”.

Thoroughly bored with this – there is a huge difference between modernising health service provision and wholesale privatisation – there will always be state provision of fundamental basic healthcare. Whatever happens with the JD strike is totally irrelevant to solving the health service funding crises we face.

@ernie because people will not accept the economic reality we face….etc, etc, etc,

Yes I understand what you are saying, but you have not explained why you think the British people wouldn’t support privatisation of the NHS.

Is privatisation considered by most people to be a bad thing? If so why is that? Why don’t they think that it would be a good thing?

Thoroughly bored with this – there is a huge difference between modernising health service provision and wholesale privatisation – there will always be state provision of fundamental basic healthcare. Whatever happens with the JD strike is totally irrelevant to solving the health service funding crises we face.

So it’s NOT about salary – progress!

So. How far are the Doctors going to make this stand?

Lives are now being played with by both sides.

I’ve no sympathy for either side.

Lives are being played with? Read any of the rest of the thread?

Now? Yes.