Doctor strikes - how can a resolution be reached

[mids2019]

https://www.theguardian.com/society/2024/jan/06/settle-nhs-dispute-or-thousands-with-cancer-could-die-early-say-health-chiefs

It appears that there a real tangible reductions in cancer care due to industrial action. If introspection is now critically affecting patients how do we remove the crisis. Are juniou r doctors pay demands realistic and if they can't be met do we accept that we will have future disrupted service.?

I feel of the juniou r doctors get a significant pay rise nurses will soon start striking again so this is a real headache for government with ultimately patients losing out.

Dh is a Consultant, he tells all his juniors to emigrate. He became a consultant in 2004, he loved working in the NHS then. But then the Tories got in and everything changed. The last 13 years have destroyed that love he had for his job. It’s so sad.

The UK has no wish to train enough professionals in any field whatsoever. And this is deliberate policy as universities charge much more for overseas students, so prefer to train overseas students.

Of course I get it. It costs significantly more than what undergraduate doctors pay in fees to bankroll a medicine degree. It is the case for many of the more challenging high-contact time degrees, particularly STEM ones. If you considered an Imperial engineering degree, it would be a lot more expensive than the fees paid too. Look at Oxbridge, the cost of a low tutor to student tutorial based teaching model costs a lot more than the fees paid by the student. This is all viewed as an investment for the benefit of the country as a whole - healthcare, engineering prowess, academic leadership etc etc.No-one tells an engineer or an academic that they can't leave the country or they have to pay back their degree costs! Neither are engineers hostage to a single monopolistic employer. They are free to move around and bump up their salaries as they go from employer to employer.

You are comparing post-grad study which is your choice to further your own career with an undergraduate degree to equip you to be able to do the job at the entry level. You are not talking about the same thing. Presumably your undergraduate fees were capped at £9k too?

Out of interest who should set salary increases for doctors? Should it be a ministerial decision or should it be an independent salary review board and if the latter who should staff it.

I ask because ultimately it seems to be the Secretary of state that finalised any settlement but I presume more juniour ministers are involved in the talks. Would a change of government helo?

As the conservatives are responsible for the decline real terms wages since 2010 can we assume all doctors vote Labour?

No they don't. The overseas fees help to subsidise the cap on fees for UK students.

I'd rather have an insurance based system like other countries. Atm tax payers pay a shed load of tax for a rubbish system, can't even get an appointment.

If taxes were lower, to compensate for the NHS no longer being publicly funded, we could afford to pay for the insurance.

Some could afford to pay for insurance and many couldn't. What happens to them?

Easy, pay them what they deserve, treat them better.
Look at other cost cutting measures that will actually work, but making the people who work for the NHS suffer is not ever going to be an adequate way of cutting costs.

I do think that Dr's should have their insurances and fees etc that were mentioned on another thread should be met by the NHS unless they are taking up private work.

I think not just Dr's, but everyone who works in a hospital should have access to free parking too. It's terrible that people are paying to park in hospitals, to work for the NHS

The Tories want to ruin the NHS look what happened with PPE, billions spaffed up the wall to mates.

once the NHS is privatised, it’ll be a free for all amongst the mates at the top.
And actually doctors will be paid much much more. But the public will get poor access and treatment unless you can pay extortionate private healthcare premiums

A bit part of the problem here is that people keep thinking of doctors as wealthy. For doctors who are consultants now, this might be the case, but for people who are JDs now, it really doesn't look appealing.

Remember that a medical degree is 6 years, so longer than most. Some people do a medical degree after doing another undergraduate degree, so this makes 9 unpaid years. And due to the way medical degrees work, having a job while studying can be really, really hard, or impossible.

Then comes the poorly paid JD years. It isn't just a few years. It's possible to be a JD for 15 or 20 years. This might include a PHD or overseas fellowship time, which is often very poorly paid or unpaid.

There are also a lot of costs associated with these years. Fees associated with training tend to be steep. JDs also get very little choice about very frequent moves, and the costs associated with these add up quickly, especially if the JD had a partner or children.

Finally, you become a consultant. Yes, some specialities earn a lot, particularly procedural specialities, which skews the average. However, people are coming to this later and later. Many doctors also have to retire early ish as the physical demands of oncall etc get really hard as you get older.

@WhereGlasses as I mentioned, people thought medicare would be different in AUS, turns out they have the same issues seeing a GP as we do and also have to pay for the meeting in a week or two after repeated calls to their practice. It's not that different for the patient (who can afford $100+ a visit - you're stuffed if you can't btw) but the doctors are hopefully less stressed.

It's possible to be a JD for 15 or 20 years

I wanted to highlight this part -

Leave med school at 24 with 6 years Uni fees and loans, average £10K a year so £60K. Earn £15 per hour for the next 15/20 years - plus inflation.

Compare that with DD - we’ve paid accomodation £15K over 3 years plus she worked instead of a loan - in Uni 3 days a week so plenary of work availabe.

She’ll be earning straight from u I in a standard 9/5 job, no out of hours, no weekends, holidays when she likes. No debt.

She will more than likely out earn doctors by the time they are all 30 years old.

Nobody is holding a gun to their head and press ganging them to go to med school.T here are far many capable , bright youngsters applying than there are places for despite all the above.

The govt is clearly running it to the ground.
I really wish Labour would at least make the obvious connection and permit terminally ill people to save billions in medical and hospital treatments by dying with dignity. I carry a donor card and have my will in place, most people I know don't want to be a vegetable at the end of their life and a burden. It is odd to me how such a popular solution keeps on being ignored. Palliative care costs are huge if you consider appx 50% of terminal people use them (and more should have access), let alone NHS stays and GP visits in the last year of life, plus the impact of care burdens on families causing issues with their work and family lives.

Are you drafting a recruitment poster for jobs in Finance?

@ilovebreadsauce Well, in previous posts, you are practically proposing holding a gun to peoples' heads!

And no, there aren't "plenty of capable bright youngsters" wanting to get in. Currently recruitment for medicine targets the top 0.05% in STEM for medicine. By definition, there just aren't that many people with those attributes. And if you happen to have those attributes, there are plenty of other professions that are gagging to recruit you. Yes, there are other people who are bright, but surely medicine is a really important place to recruit those who are next at a scientific type of thinking?

*best, not next

@Scarletttulips Exactly. You also have to consider that if you do something like being an electrician, you can start saving really early in life. If you don't start earning until you are in your mid 40s, then there is very little capacity to invest/ save / benefit from compound interest.

I live in Australia. Lack of access to GPs hasn’t been something I’ve experienced.

You can choose your GP so some clinics are more popular than others but i or my children needed to be seen we could do so, in a timely manner. Maybe not by our “preferred” doctor though. Some GPs have areas of interest ans those with a women’s health focus are often more popular.

Possibly/probably inner city Sydney over the holiday season is much harder though, and more expensive.

Bearing in mind that GP and prescription costs are reduced for those with a health care card (low earners, those with chronic conditions).

I didn’t grow up in Australia and was sceptical of its hybrid system but I like it. I had perimenopausal intermenstrual bleeding, saw my GP and had bloods and a scan requested and done within a few days of her review. They were done by private providers and “basic” tests are usually bulk billed (government pays the private labs/radiology providers). No need to wait for a blood test time, can literally just turn up and get it done.

this morning one of my daughters has woken, gasping with abdo pain. Not like her at all. If she doesn’t settle with basic pain relief we have a few options:

• after hours GP
• local public hospital where there will be a wait, but not hours and hours
• local private hospital, staffed by ED consultants. If she needed to be admitted their paeds ward is well-established, with good nurses. We have private cover if a private admission is required
• local WISE clinic (walk in specialist emergency). Also staffed by ED specialists. They don’t have an attached hospital to admit to, but have observation options.

The Public hospital is great but we’d probably choose the private hospital because of better wait times to be seen, better parking that’s free and the knowledge that, if she does have appendicitis or something, her operation will be performed by a consultant.

So that’s the future , better care if you pay and go private, that’s what doctors are striking for as well as fair pay and working conditions.

I will add as well that people often use a mix of public and private. They may choose to see a private specialist for continuity purposes but go public for acute presentations. Private specialist consultations are also partially funded by Medicare. A lot of people with a chronic condition pay for outpatient private specialist appts but don’t have private cover. “Going private” for an issue is quite culturally normal in Australia. GPs will give you a choice.

Medications that are government subsidised can be prescribed by public, private doctors alike.

of course it’s imperfect and of course demand>capacity but alternative referral pathways in primary care enables patient choice and reduces some of the pressure on the public system.

My husband is ex NHS trained and he would never go back. Having said that, I don’t think a partly government-funded hybrid system would work in the UK, because culturally it doesn’t seem as though any out of pocket cost, for any part of health care, would be acceptable.

i was out the other night for a work dinner and one of my colleagues, who works in a fairly niche medical speciality, said he went to a specialty-specific international conference and was struck by how down-trodden his UK colleagues were. These were doctors he’d known for years but apparently they were all very flat, with many just holding on for retirement

I wouldn’t do a five year degree with straight grade A’s for a level and gcse on those conditions. I’d get my highly educated Arse into banking and retire by 40 instead.

I dint think medical degrees are free are they?

It’s not better care in private though. Not at all. There are terrific staff and services in the public hospitals Sometimes it’s faster to go private, not always.

Is it not better to have alternative referral options, to bring waiting times down?

Something that is better is the private labs and radiology services. I can’t imagine having to wait to see a GP for weeks, then wait for a blood test appt and wait for an appt for an USS.

You’ll be hard pressed to find an anaesthetist now if you’re insured with Bupa.

BUPA haven’t given their medics a pay rise in literally 25 years. I wonder if their shareholders have had increased dividends? I wonder if their premiums have gone up?

hundreds of anaesthetists have resigned from BUPA.

I'm in Oz and this isn't my experience at all. I can get a GP appointment at a bulk-filled (free) GP within 24 hours, sometimes even same day if I want to just turn up and wait. Or I can go to my GP of choice, with the Medicare rebate it costs me $35 per visit (under 20 quid). When my son had a burst appendix his care in the Children's hospital was exemplary. The hospital had a free gaming arcade on the top floor, and kids had their choice of gaming handset or dvd player, my son didn't want to leave! My husband had an accident at work a few months ago so Workers comp paid for private care, it was like a five-star hotel with full room service (and lots of UK staff). We also pay about $70 a month for Extras cover which pays for various medical benefits including two pairs of glasses and an eye checkup each per year, also an annual dental scale and clean, among other things like ambulance cover. I have to say I was initially a bit wary about moving away from the NHS system but it just works better here. I also have experience of the Irish system which isn't great either IMO.