doctors on strike

I’m now genuinely confused as the BMA are calling for strike action against a deal they negotiated and said was a good one.

What I find galling about the current strikes is:

a) the pretence it isn’t about pay. It is. It isn’t anything to do with saving patients and the NHS. If they were upfront and said that they deserved more money than they receive then I’d understand. Nothing worse than a veneer of morality for those who can see through it.

b) the pretence it isn’t holding patients lives to ransom. It is. If the strikers were prepared to say, ‘yes, you can’t manage without us and this is how strong our negotiating position is – look a dead person’ then at least I’d be able to assess their position and agree or disagree.

c) the pretence it isn’t a fashionable Tory-hating agenda.

As it is, the strikers are losing the moral high ground and are acting like the childish people who disagree with the referendum result, the independence result, the Tories at the last G.E. …

a) the pretence it isn’t about pay.

it is about pay, but its the incentives to work weekends and rotas are so stretched already that are a major issue, reducing it to ‘just about pay’ misses the point

b) the pretence it isn’t holding patients lives to ransom.

plenty of ‘on strike’ jr doctors will end up working through it

c) the pretence it isn’t a fashionable Tory-hating agenda

have you met many doctors? id say they are naturally quite right wing, often privately educated

makecoldplayhistory – Member

I’m now genuinely confused as the BMA are calling for strike action against a deal they negotiated and said was a good one.

Simple really; the BMA enact the wishes of their members. They negotiated a deal, they put it to the ballot, the voters said no, so now the BMA proceed on that behalf.

it’s nothing like refusing to accept the referendum result; in fact it’s exactly the same as the government recommending remain, but then when the vote comes in for brexit, progressing with brexit.

If they were upfront and said that they deserved more money

Have they ever said this? Last I checked the pay argument was:

“We’re doing too much already, please don’t remove the safeguards preventing us from being made to do even more, whilst simultaneously reducing pay for some of the hours that we will inevitably be forced to work.”

I assume they are not more upfront about that ^ argument as even that would get spun into ‘greedy doctors’ by a the majority of the media 🙄

Aside from the abhorrence I have for the current trend towards apocalyptic levels of spin, what does the Govt expect public servants to do when faced with an employer demanding acceptance of major changes and suggesting negotiation is limited to minor issues only? As a taxpayer I want sensible fiscal control but not at the expense of a Govt taking a morally redundant stance that no other employer could. Especially when it concerns fundamental services.

No right to strike

Yeah – imposing a punitive contract on a vital highly skilled profession for which there is a global demand. What could possibly go wrong?

If they were upfront and said that they deserved more money

Christ not that again.

How many times has it been pointed out on this thread that: AT NO POINT DURING THE DISPUTE HAVE JUNIOR DOCTORS ASKED FOR MORE MONEY ?!?

One source of the original dispute (before everyone got so entrenched) was that they didn’t want less money for doing the same job. That’s rather different, no?

And while you’re talking about “pretence”, I heard Jeremy Hunt on the radio this morning saying he had “bent over backwards” to resolve this , that everything was up for negotiation if only they’d come to the table.

Anyone who has been following this dispute knows that is complete spin and almost the exact opposite to his approach of refusing further negotiations and refusing to cancel the contract imposition to avoid strikes.

FWIW though, as I said earlier, I think the Junior Doctors are unwise to resort to further strikes. It is far too easy to spin that against them (which is why Jeremy is suddenly playing the victim instead of the hardline enforcer).

How many times has it been pointed out on this thread that: AT NO POINT DURING THE DISPUTE HAVE JUNIOR DOCTORS ASKED FOR MORE MONEY ?!?

Well that would come as news to the Chair of the BMA Junior Doctors Committee at the time of the negotiations last year – Johann Malawana. He discussed conceding the weekend pay issue if the government increased the total medical pay bill for Junior Doctors by £500m-£700m.

http://blogs.spectator.co.uk/2016/05/confirmed-the-junior-doctors-strike-was-about-money-not-patient-safety/

Good lord, you mean Junior Doctors’ Committee privately discussed the possible compromises?

What utter bastards eh? It’s like they didn’t even want to strike.

The whole deal has always been cost neutral, with no more money overall to Drs, just shifting money away for those who provide the 24 hour NHS, removing effective protection from them, making it more difficult for women with career breaks etc etc

I’m not sure the decision to strike was brilliant though given all the other political stuff going on. But I do know there is huge bad feeling towards JH throughout the NHS, with no chance of him building support and it is gobsmacking he wasn’t moved in the reshuffle.

Graham –

It’s like they didn’t even want to strike.

I believe that of its members but not of union officials themselves.

AT NO POINT DURING THE DISPUTE HAVE JUNIOR DOCTORS ASKED FOR MORE MONEY ?!?

Yet, they have. As The Spectator put it,

“But beneath the sanctimonious proclamations of moral superiority lurked an eternal truth: it was just about cash. Cold, hard, cash. And, of course, politics. There’s nothing wrong with that but it’s as well to be honest about such things. Something to remember next time.”

underlining by me

@Stoatsbrother – I suspect that it isn’t so much JS leading a witch hunt against Jr. Doctors and the wider NHS and more that there’s a lack of money and someone needs to become unpopular.

@Whoever suggested I don’t know many Drs. Related to some. Went to Uni with many. Champagne socialists I’d say, who come from more right-of-centre families.

from J5M’s spectator link

However, Dr Malawana discussed conceding the weekend pay issue if the government increased the medical pay bill by £500m-£700m … Well fancy that! It’s amazing how cash can improve patient safety

Course, rather than buying old Johann and his chums each a yacht in the Caribbean, that increase might mean having MORE doctors – say, to get nearer to properly staffing hospitals during those critical weekend periods when currently patients are all left to die in forgotten corners of darkened rooms.

I am certain the JD’s have been very careful not to directly ask for more money. If it wasn’t about money at least in part the BMA wouldn’t have added a pay calculator to their site.

DrJ we need multiple employers, if Doctors don’t like one they can move to another. The issue is having a single employer providing essential services and a right to strike. Doctors can have one or the other but not both imo.

As I have posted before medical school is hugely over subscribed, there is a very long list of people who want to be Doctors and have the skills to do so but can’t get a place to study.

The Government wants to improve the service and have offered more money to do so. The Doctors don’t think they’ve been offered enough of a payrise to work more weekends and nights.

As I have posted before medical school is hugely over subscribed, there is a very long list of people who want to be Doctors and have the skills to do so but can’t get a place to study.

Maybe but that doesn’t help if whoever qualifies then becomes an emigrant due to better working conditions elsewhere
… unless you’re suggesting we train loads of extra ones to make up for that “wastage”

Don’t we have multiple employers ie. NHS or the private secotr. That’s ignoring alternate employers such as a previous poster’s friend off to Aus?

My wife and I weren’t happy with working in government schools in the UK. We now live in Asia and are happy to do so. I’d see the Dr and teacher market as being pretty similar in this analogy.

we need multiple employers,

No what we need is a health secretary committed to making the NHS work better and not pursue a confrontational strategy to further his own ideological goals. The issue of a right to strike didn’t arise before and the only reason it does so now is that JH has totally lost any credibility as an honest negotiator.

#jambylogicfail

The Government have not as yet offered more money. they have shifted it away from those who work at nights and weekends.

If there was more than one employer then the government might be more justified in playing hardball. There isn’t, so they should be extra careful not to be high-handed and try to be fair. But they have lied about capacity to deliver their version of a “24 hour NHS” when, not only is there not the capacity to achieve it, but their justification is based on repeated and wilful misinterpretations of the evidence.

Medicine is indeed over-subscribed and it is attitudes like JHs and yours Jamby that mean lots of younger Drs don’t stay on and move into other realms.

Trouble is you can’t know who is going to put up with the rubbish Junior Drs have to put up at 27, when sifting applicants aged 17…

But since you applaud people who don’t like the changes in Ts&Cs exercising their choice and walking away, you obviously don’t mind waiting the 10 years it takes someone from entering medical school to being a really autonomously practicing Dr and would like medical School entry expanded by – say – 20% – even though the cost of doing that might easily pay for giving the current Junior Drs a decent deal and fixing the problem now?!

facepalm.

The Government wants to improve the service

Anyone who works in the NHS might take issue with that statement; you don’t improve services by cutting funding (in real terms, you know, when things get more expensive, your pocket money needs to go up to compensate…) nor do you improve the service by holding down wages and then capping agency work, while asking more from everyone.

The NHS is being run down by a media savvy, ideologically driven, politically motivated government. They, like you, have no alternative plan for the provision of healthcare to the population.

Don’t we have multiple employers ie. NHS or the private secotr

Yes and no.

There are some privately run hospitals badged as NHS like this one (not sure about pay, but not as qualified/experienced)

High quality healthcare for NHS and private patients

Some consultants own private hospitals, or lease space in them, but you can not do that as a junior doctor. (used to be big money, but not so much these days unless you want to work 7 days a week 12+hrs a day)

And there are increasing numbers of doctors work for agency. (better paid than NHS staff)

Jamba – this year for the first time ever there were places for medicine through clearing – applications are falling – admittedly slowly.

Working more nights and weekends – not that simple – most rotas now rely on locums to provide current levels of staff as not enough doctors. More weekend work would simply mean less doctors Monday to Friday and/or more locums as staffing levels are already stretched in many places.

The contract dispute has unfortunately come at a time when morale has been falling for many years, and it is no doubt in part the handling of the whole thing and not just the contract itself that is the issue.

They, like you, have no alternative plan for the provision of healthcare to the population.

I disagree with that statement. I think they know exactly what they are doing. They are preparing the way for full privatisation by driving down the cost of all sections of the NHS.

When things have got that bad that there are no doctors, too many patients and cost have been artificially driven low, then the only solution left will be for private insurance to come in, and private organisations take over what is left

The Government wants to improve the service and have offered more money to do so. The Doctors don’t think they’ve been offered enough of a payrise to work more weekends and nights.

Where is the extra money they have offered? Training posts have been removed, pay rates are being capped. As above all areas of the NHS (and social services) are being asked to save money, and being penalised if they do not. In real terms money invested is going down, plus usage is going up

Whoever suggested I don’t know many Drs. Related to some. Went to Uni with many. Champagne socialists I’d say, who come from more right-of-centre families.

I’m married to one. Yeah maybe we are probably both “champagne socialists” given that we are middle-class, but don’t vote Tory. Neither do her parents (retired Scientist/Lecturer/Ofsted Inspector and a retired Teacher).

If it wasn’t about money at least in part the BMA wouldn’t have added a pay calculator to their site.

The (flawed) calculator was for them to calculate how much money they would LOSE under the new contract – not how much more they could ask for.

DrJ we need multiple employers, if Doctors don’t like one they can move to another.

Privatisation in other words? Well that’s certainly on the cards and is something that many junior doctors are very concerned about.

But if the government want to privatise then they need to come out and say that so we can have an open public debate about it – not do it by stealth whilst slowly dismantling the NHS.

As I have posted before medical school is hugely over subscribed

But unfortunately that is translating into a surplus of doctors. The NHS remains hugely understaffed in almost every speciality. Spend ten minutes looking at any hospital rota and you’ll understand that.

The Government wants to improve the service and have offered more money to do so. The Doctors don’t think they’ve been offered enough of a payrise to work more weekends and nights.

I hate to say #jambafact but that isn’t true. If you’ve read this thread or followed the dispute then you know that isn’t true.

Even the government repeatedly claimed that the contract was a cost-neutral change and that doctors would somehow (magically?) work less hours but provide more cover.

DrJ we need multiple employers, if Doctors don’t like one they can move to another. The issue is having a single employer providing essential services and a right to strike. Doctors can have one or the other but not both imo.

That certainly got rid of railway strikes. Wait…

I hate to say #jambafact but that isn’t true.

I’m amazed that people here are still trying to correct jambabollox. He is a looney.

Ok sir, just a few questions…

You’re 45, you’ll need our add-on Prostate exam cover, and our add on yearly colonoscopy, although we do have an offer on that at the moment. You ride a mountain bike? That’ll be under the extreme sports package which is extra, I’m afraid. You’ll also have to take out tick-related disease cover for the time you spend outdoors wearing shorts. You do your own servicing? Exposure to chemicals in the home is an upgrade to our kitchen as a workplace policy, and GT85 and WD40 do fall neatly in that. Unless you are a total XC mincer, you’ll need orthopaedic cover for any potential fractures, plus the dermatology add-on for sunburn. We notice you frequent STW, so we strongly advise mental health cover, although given you’ve been on there for more than 12 months, we will limit any pay out and regard it as a pre-existing illness.

Do you have any children you’d like to cover?

He discussed conceding the weekend pay issue if the government increased the total medical pay bill for Junior Doctors by £500m-£700m.

So, they discussed conceding what was effectively a pay cut (cutting weekend pay) in return for more money, presumably elsewhere in their pay packet. This could only be spun as JDs striking for more money if it could be proven that the JDs would all end up better off, i.e. if the cut in weekend pay was less than each JD’s share of the £700m. I doubt you’ll find the figures for that one.

The Government wants to improve the service and have offered more money to do so. The Doctors don’t think they’ve been offered enough of a payrise to work more weekends and nights.

Semantics. The government offered a basic pay rise, which was shown to only just (at best) make up for the cut to the weekend pay, and at worst to leave JDs out of pocket. So whilst the JDs may have been aggrieved at the size of payrise, it was only because their GROSS pay was still effectively being cut.

For all those additional doctor hours to be cost neutral something has to give…

…and for full cover at weekends, you’ll need to pay for pharmacists, physio’s, radiographers, theatre staff, pathology staff, ward clerks, porters and so on. The only way to make that cost neutral will be to not pay anything extra for all those groups to give up their weekends, which is a whole new set of industrial discomfiture.

Jeremy Hunt either knows this and doesn’t know how to fix it, or doesn’t know it yet and still doesn’t know how to fix it.

I hate to say #jambafact but that isn’t true.

It would save us all some effort if we just have a tag for when he says something that is true
My vote is this meme

remember it as it will be a long time before it is seen again, if ever

No, what the DH has tried to do is to move from all of the weekend work being effectively worked on “overtime” rates for working a Saturday morning or afternoon, to making Saturday daytime hours “normal rate” and thus releasing additional funding for evenings. As an aside a lot of locum work is currently done by doctors leaving the door of their own Trust and going a few miles to the next one and immediately starting a Locum shift there (which completely blows a hole in the “safety” argument).

This alignment of weekend pay rates simply puts doctors in the same position with pay as many other comparable roles in the NHS or other essential roles like Police / Fire etc – who generally don’t get paid 50% more for doing a shift rostered in the day on a Saturday.

If overall pay were to go up £500-£700m that’s more pay all round – around 15% based on the current pay bill.

The BMA is / was still demanding that anyone working a Saturday morning should be paid 50% more for doing so.

Source for image: http://www.bbc.co.uk/news/health-34775980

As an aside a lot of locum work is currently done by doctors leaving the door of their own Trust and going a few miles to the next one and immediately starting a Locum shift there

Really?

You’d have to be pretty keen for money to finish a 13+ hour shift and then voluntarily drive to another one (and then presumably drive back and go straight into your third consecutive shift the following day?).

I’ve never heard of anyone doing that. I’m sure it happens sometime/somewhere but “a lot”??

I’ve never heard of anyone doing that. I’m sure it happens sometime/somewhere but “a lot”??

Well enough for the BMA to refuse to budge on a DH request in the negotiations that Junior Doctors should notify the employing Trust if they are going to do Locum work elsewhere.

This would mean their employer has a complete view of the hours they are working, potentially avoiding unsafe working hours. So why exactly are the BMA not willing to commit to this given all the endless statements to the effect of the main concern being long hours / unsafe doctors / risks to patients?

i dont know[ though i would also ask for proof this claim is even true from a neutral and reliable source with appropriate quotes etc as you have a jambian grasp of truth and facts]

However i do know that “fact” in no way proves your original assertion.

So why exactly are the BMA not willing to commit to this given all the endless statements to the effect of the main concern being long hours / unsafe doctors / risks to patients?

Because private practice, which is a Consultant thing, not a JD thing. Important to remember that Consultants and JDs are different things, and the battle to get consultants to work more weekends will be an interesting one.

…and the NHS has no effective way of monitoring how many hours anyone works; nurses can work agency shifts on top of their usual hours and there is little will to check this. EWTD comes into play after 17 weeks of averaged hours, supposedly…

My understanding is that the locum clause in the new contract requires that Junior Doctors must offer any extra hours they are prepared to work to their own Trust first (at much lower rates) before being allowed to locum anywhere else.

The FAQ on the BMA website says:

Will I still be able to undertake locum work?

Yes, you will still be able to undertake paid locum work in addition to the hours set out in your work schedule. However, initially, you will have to offer these additional hours exclusively to the service of the NHS via an NHS staff bank – but only at the grade you are currently working at. Under the proposed March offer, you would have had to give your primary employer first refusal on these hours. You will be paid a 22% premium for any such locum work, above the prevailing hourly rate.

You are entitled to carry out additional activity over and above the standard commitment set out in your work schedule – up to a maximum average of 48 hours per week (or up to 56 hours per week if you have opted out of the 48 hour limit in the Working Time Regulations).

So it’s another pay decrease for those who currently work locum shifts.

Also means you get situations where a doctor could be available to put in some locum hours at a hospital near their home, but can’t because it is in a different trust.

Also a very effective restraint of trade situation, which isn’t really going to help smooth things out is it?

The locum Dr agencies need to start donating money to the Conservatives…

I guess it would be naive of me to expect a sensible reply from Jamba to my last post? Suspect he’s left the building… 😉

What this latest debacle shows is that health is far too important to be left to politicians, doctors and their union (BMA). They should be COLLECTIVELY hanging their heads in shame – a bloody shambles where all three obscure the truth for tortured ends leaving the poor patients to suffer.

Forget – the NHS is the best in the world; the Tories are privatising the NHS; this is not about pay etc – that BS is just unhelpful noise and will someone get a bloody grip. Its pathetic.

What this latest debacle shows is that health is far too important to be left to politicians, doctors and their union (BMA). They should be COLLECTIVELY hanging their heads in shame – a bloody shambles where all three obscure the truth for tortured ends leaving the poor patients to suffer

Yes, but the blame for the latest icing on the cake of shambles can and should be laid firmly at the feet of Jeremy Hunt and the Conservative Party.

No, your response is part of/symptomatic of the problem (excuse the bluntness).

All parties are to blame here – in the wider definition of the word – and they have collective responsibility for the on-going shambles.

The whole Tories are killing the NHS BS is part of the reason why the debate never moves on. Health provision in the UK needs fundamental reform, but despite endless change initiatives and money invested, the core issues remain, no they don’t, they get worse. And part of the reason it the crap noise the prevents rational debate.

And by the looks of things, they will get a lot worse too. Pathetic.

All parties are to blame here

But the Tories have been (mostly) in government for the past 6+ years, so I think it’s pretty safe to blame them. If this were 2011, then maybe you’d have a point, but it isn’t, so you don’t.

The Tories are in power. They have the means to fix it. Instead they seem to be doing their level best to make the best clinical staff leave, and disincentivise prospective staff/students from training for a career that frankly looks horrific.