doctors on strike

So, the night after he walks out of the debate, presumably because being at work after 6pm is unsociable, the next morning at 7:15 on BBC News he gets doctors hours wrong and apologises…

Sorry, this is quite complex for early in the morning

🙄

Bless him

Results of the Hunt effect surveys in response to “Increased mortality associated with weekend hospital admission: a case for expanded seven day services?”

What a complete Jeremy he is.

(obviously statistical caveats apply)

The BMA aren’t willing to even talk to NHS Employers and are just using us / the public to negotiate by social media.

The government released the details of its new proposals to the media without bothering to consult with the doctors. Let’s not pretend that they’re negotiating in good faith.

The government released the details of its new proposals to the media without bothering to consult with the doctors. Let’s not pretend that they’re negotiating in good faith.

The BMA have refused to meet NHS Employers (the negotiating body) since June. They are still refusing to meet them.

So how exactly is a “negotiation” supposed to happen?

The BMA have refused to meet NHS Employers (the negotiating body) since June. They are still refusing to meet them.

On points which they consider central to the profession they were told that there was no negotiation.

So how exactly is a “negotiation” supposed to happen?

The leader in the Times today (see below) would seem to be a reasonably balanced appraisal of the current stand off… a lot of people seem to think Jeremy Hunt is actually the negotiator. He isn’t – it’s NHS Employers and the DH.

Not that anyone appears to be terribly interested in the underlying drivers for the new contract (not least the Junior Doctors themselves) but for those who are they are set out in considerable detail here:

http://www.nhsemployers.org/~/media/Employers/Publications/NHSE-DDRB-submission-Dec-2014.pdf

From The Times today:

Barring an unlikely climbdown by the government or the British Medical Association (BMA), England’s hospitals are heading for some form of doctors’ strike. Queues at A&E departments will lengthen. Promises of better care will be broken. Taxpayers who have helped to fund the NHS throughout their working lives may die avoidably.

This is an inexcusable prospect in an advanced 21st-century economy and no one emerges with much credit from the mess that has led to it. Jeremy Hunt is a diligent health secretary with an unenviable task (and an impeccable bedside manner) but he has allowed trust between his department and the BMA to evaporate on his watch.

For its own part the association has been unremittingly shrill in its rhetoric and unreasonable in its tactics. As the 50,000 junior doctors in its membership consider a proposal for strike action over the next two weeks they should bear in mind a few home truths. The seven-day NHS, towards which Mr Hunt is working, is not a luxury but the least patients deserve and the government has a mandate to make it a reality.

An overhaul of junior doctors’ complex and costly weekend overtime rules is one of many reforms that Mr Hunt cannot afford to sidestep. Throwing money at the problem is not a solution. Health spending is already ringfenced with a guarantee of an extra £8 billion a year by the end of this parliament, despite abundant evidence of waste. In these circumstances taxpayers will quickly lose patience with a doctors’ union that appears to prioritise its members’ pay and conditions over their Hippocratic Oath.

The new contract outlined yesterday by Mr Hunt would, he claims, give most junior doctors an 11 per cent rise in base pay. The increase would be paid for with a 25 per cent overall cut in hours classed as unsociable and therefore paying overtime. As a pre-emptive concession to the BMA the point at which overtime begins at a weekend would be brought forward three hours, compared with Mr Hunt’s initial proposals, from 10pm on Saturdays to 7pm.

Young doctors heeding the BMA’s exhortations took to the streets yesterday to accuse Mr Hunt of megaphone diplomacy. Indulging in the very same thing, one called the proposed contract “terrifying”. It is nothing of the sort. It replaces one complicated slab of smallprint with another, but it simplifies base pay and rewards proven progress rather than merely seniority. This is progress. The Department of Health maintains that the contract would deliver a modest overall pay rise for most junior doctors, although as things stand many of the pay safeguards offered would expire in 2019.

In defence of junior doctors it must be said that they already work longer weekend hours than consultants, and it is a shortage of specialists and support staff that is mostly responsible for poor care in hospitals at weekends. Junior doctors’ long weekend shifts are, however, a factor behind this pattern, and the new contract addresses it.

Mr Hunt has allowed a showdown with junior doctors to develop where none was necessary and he should have been clearer, sooner, on the details of the new contract. Yet his errors pale beside the association’s gratuitous yearning for confrontation. It demands negotiations without preconditions while holding patients’ health to ransom with a strike threat. Enough already. It is past time for the BMA to sit down with Mr Hunt and strike a deal.

Allister Heath talks sense in the Torygraph today, not least the words that cannot be spoken – the NHS is broken beyond repair, with the crisis being both structural and inevitable.

Hunt is merely the latest politician shuffling the proverbial deckchairs…

We need to stop deluding ourselves, and begin to debate openlywhat a world class health system fir for the 21C would look like

Well put!

From the Guardian today:
http://www.theguardian.com/politics/2015/nov/04/jeremy-hunt-pay-rise-offer-to-junior-doctors-is-nothing-of-the-sort

would seem to be a reasonably balanced appraisal of the current stand off.

run that by me again?

the NHS is broken beyond repair

In what way? It’s good value and has excellent outcomes.

What a complete Jeremy he is.

Oi !!

Another good reason (if one were actually needed) to not read The Times.

Or indeed j5m !!

It’s good value and has excellent outcomes.

Good outcomes apart from the 25% of people who are dead with cancer within 6 months of diagnosis due to the fact the diagnosis was too late. We’ve got some of the worst cancer outcomes in Europe and we’re not much better on Chronic Disease or mental health.

Yes, we’ve covered that UK cancer survival rates are lower (though steadily improving).

Are you going to ignore all the things we are good at?

The BMA have refused to meet NHS Employers (the negotiating body) since June. They are still refusing to meet them.

So how exactly is a “negotiation” supposed to happen?

It won’t because a) the government has consistently said that it won’t back down and b) when it made a revised offer, it didn’t bother telling the BMA.

Good outcomes apart from the 25% of people who are dead with cancer within 6 months of diagnosis due to the fact the diagnosis was too late. We’ve got some of the worst cancer outcomes in Europe and we’re not much better on Chronic Disease or mental health.

Overall, the NHS is consistently rated better than most other European countries.

So better facts than The Times

Why Jeremy Hunt’s ‘pay rise’ is not what it seems:

My basic pay as a junior doctor is £10.85/hour.

I get an extra £5.42/hour for frequently working nights and weekends.

Per month I earn £1886 from my basic salary and an extra £943 in supplements for working antisocial hours.

This totals £2829/month.

With Jeremy’s 11% pay rise my basic pay will increase to £12.04/hour.

But I will no longer receive extra payments for working antisocial hours.

My new monthly wage would be £2092.

I would lose £737/month.

Jeremy is trying to sell it to the public as a generous pay rise, conveniently 1% higher than the 10% rise our selfless politicians decided to award themselves earlier this year.

He still continues to refuse to acknowledge or listen to our genuine concerns about the new contract with regards to safe working hours and patient safety.

I do not want to strike but Jezza isn’t leaving us with many other options.

If only he would stop spending his time trying to create spin and press headlines which paint us in a bad light and make true efforts to re-engage with the BMA and restart negotiations.

*******UPDATE*********

Since writing the post I’ve received an email from Health Education England with a 4 page letter from Jeremy Hunt attached. It provides further information on his newest proposal.

With regards to antisocial hours pay I would still receive my supplement of 50%. However the hours considered as antisocial would be greatly reduced. The 11% pay rise is supposed to offset this to ensure my wage stays the same.

I’ve crunched the numbers and under this system my pay would be £280/month less – not quite so drastic, but still a pay cut and not the tidy rise Jeremy would like the public to believe.

Making conditions worse for employees will not improve the NHS, if you think things are bad now J5M it’ll get worse by Dr’s leaving or less applying.

The OECD assessment was not exactly a ringing endorsement!

now where’s the iceberg?

My basic pay as a junior doctor is £10.85/hour.

I get an extra £5.42/hour for frequently working nights and weekends.

Per month I earn £1886 from my basic salary and an extra £943 in supplements for working antisocial hours.

This totals £2829/month.
So that’s (1886/10.85=) 174 hours of basic pay. And (943/5.42=)174 hours of supplement.

Does that mean they’re only working weekends and nights?

Or is the £943 the basic rate plus the 5.42 per hour enhancement? In which case that’s an extra ~60 hours per month?

Or is the £943 the basic rate plus the 5.42 per hour enhancement? In which case that’s an extra ~60 hours per month?

Presumably. Or do you think junior doctors make less than minimum wage to work weekends and nights? Even Jeremy *unt wouldn’t suggest that.

Or maybe he would … 🙁

Does that mean they’re only working weekends and nights?

their banding supplement is paid in proportion to the amount of anti social hours they do but is paid on the whole of the salary. That doctor’s in a 1A banded job so they’ll be doing a lot of anti social hours.

Anyone who describes Jeremy Hunt as being ‘diligent’ clearly is a troll of the lowest calibre.

So that’s (1886/10.85=) 174 hours of basic pay. And (943/5.42=)174 hours of supplement.
Does that mean they’re only working weekends and nights?

I’ve added an image that explains it a bit better.

Presumably. Or do you think junior doctors make less than minimum wage to work weekends and nights? Even Jeremy *unt wouldn’t suggest that.

Or maybe he would …

thats not how minimum wage works though. you could still be paid £5.42 at the weekends and you would still be over the minimum wage for your hours so don’t put it past him ha ha ha ha

just5minutes means woefully biased in favour of Tory spin to the point of being lies and propaganda- ie like his posts

Two people in need of urgent medical attention died last month after they did not go to hospital at a weekend because they wrongly believed there would be too few doctors on duty and that they would be at risk of dying, research claims. Almost a third (32%) of the 40 patients studied, who all held off seeking NHS treatment for that reason, suffered “long-term, irreversible morbidity” (an increased chance of dying) as a direct result of their delay, their doctors say.

In addition, more than four out of five (82%) of the patients had a worse outcome than if they had sought help the day their health deteriorated, while the delay could have proved life-threatening in 90% of them, the study found.

Despite all his propaganda about there not being any doctors at weekends, Mr Hunt says in his latest letter to junior doctors:

I know you already work across 7 days and perform the lion’s share of weekend work, but the purpose of these proposals is to enable hospitals to roster more staff at weekends, as there is currently around three times less medical cover at weekends as during the week. We are not suggesting we need exactly the same levels, because there will always be elective work that is not done at weekends. But we must make sure that we can always promise the right level of medical..

That seems a completely different story from the one he has been selling in the media!

The whole letter is interesting though. His new tactic seems to be to offer junior doctors a Prisoner’s Dilemma. If they agree to the changes then he’ll promise that their pay won’t be cut and only the doctors that follow them will suffer.

UK cancer outcomes are poor compared to some European countries, biggest factor is late diagnosis, we need better screening programmes,better awareness of symptoms, etc but all that costs money and we spend less as a percentage of our GDP on healthcare than all those countries
We also have big problems with lack ofexercise and obesity in this country compared to Europe, and many people don’t appreciate that obesity can be a huge multiplier of cancer risk.

Paying doctors less money to work more hours will only reverse the huge improvement UK cancer survival rates have seen in the last few decades

biggest factor is late diagnosis, we need better screening programmes

thats not a doctors job though. poor rates of diagnoise can be down to poor screening like not doing the bowel cancer test but it’s also down to crap doctors and people that don’t go to their GP as well.

biggest factor is late diagnosis, we need better screening programmes

Whose job is health education? Politicians?

*Engage Propaganda Mode*

That’s right folks – it’s an “11% pay offer” and the greedy docs want more from the “gravy train”.

Media misrepresentation at its best/worst.

😐

The Doctor is Out

Sun 100% correct as usual.

We “dictate” the amount of “overtime” we work?!?!

GrahamS – Member

*Engage Propaganda Mode*

With propaganda machines from both sides going into full spin mode the question is …

Who is telling the truth? If both sides claim the truth you see what I mean?

🙄

Oh, and you’re most likely to die in hospital on a Wednesday, not at the weekend.

Not until Jamby has said he agrees with what they said can it be considered to have reached this level of accuracy

legolam – Member

Oh, and you’re most likely to die in hospital on a Wednesday, not at the weekend.

Why is that the case?

The truth (to rebut the “facts” in the Sun article):
There is no such thing as overtime for junior doctors
We don’t dictate the hours that we work, we are given non-negotiable rotas to work
You are more likely to die in hospital on a Wednesday
The BMA would like to negotiate the full junior doctors’ contract – the government would only like to negotiate 1 point out of 23 negotiation points (regarding travel and relocation expenses, which the DDRB suggested should remain roughly the same as at present)

Why are you more likely to die on a Wednesday? No idea. Maybe it’s a statistical quirk? Maybe it’s because more complex procedures are done in the middle of the week?

It’s certainly not because there are fewer doctors on a Wednesday, although the new contract will necessitate reduced medical cover during the week to give better cover on the weekend.

legolam – Member
You are more likely to die in hospital on a Wednesday

Okay the truth.

But why on Wednesday that is my question?

edit: just saw your reply after I posted …

Just one other point that is being missed – some rotas have 50% vacancies – even in big city hospitals.

More doctors at weekends will just mean less in the week. IF we assumed death were rates were different they will probably rise in the week due to far less staff.

And no it’s not numbers being suppressed- government dictate medical school places