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.

So discourage people to join an already overstretched & underresourced workforce? Genius.

I'm not saying I'm unsympathetic to doctors' pay erosion argument, but I think important to clarify that they are really not earning only £15 per hour for 15/20 years. Source - www.nuffieldtrust.org.uk/resource/exploring-the-earnings-of-nhs-doctors-in-england

This is what is needed. Junior doctors' student loans to be on hold as long as they continue to work for the NHS. 9% in their pocket and it would keep them in the UK.

University is ridiculously expensive and being a junior doctor is also expensive. This is the only solution. It would also encourage more young people from ordinary backgrounds to apply.

The problem with making comparisons with other countries is in AUS it seems a high wage but the cost of living there is also very
so all in all it’s not the good wage it looks

I'm not saying I'm unsympathetic to doctors' pay erosion argument, but I think important to clarify that they are really not earning only £15 per hour for 15/20 years. Source -

They are expected to work long hours and aren’t paid overtime.

This reduces their hourly rate.

These are expectations to get through their training.

Same with teachers working long hours with no overtime payment.

I other industry would expect this.

I work 35 hours overtime is double.

If I worked the hours JD do I would be on 84K a year.

I'm not sure the amount of unpaid overtime is actually that extreme - junior doctors generally get paid for the hours (ie shifts) that they work, with a bit of staying later to finish up sometimes. The most recent NHS England staff survey data suggests around 43% of all staff are doing up to 5 hours extra a week unpaid. I think that's pretty standard (good in fact) for professionals? 10% saying they do 6-10hrs and 4% 11hrs+. (www.statista.com/statistics/883433/nhs-england-staff-working-extra-unpaid-hours/). I'm an NHS manager and put myself in the 6-10hr bracket for that survey, which I didn't think was too bad.

Obviously JDs will also be studying, but again that's in common with other professionals and they do get some paid study leave for this.

Or a Gastroenterologist!

BUPA were actually investigated by the monopolies commission for this behaviour. They won’t allow patients to see a Consultant who dares not to sign up to BUPA rates - which as you say haven’t changed in 25 years. Dh is the last Gastro still doing any private work in our whole County (approx 350k people). He’s going to stop this year, it’s simply not worth it financially and he’s exhausted and burnt out anyway. The two private hospitals in the County will no longer be able to offer any Gastro service.

The amount that the government “save” by paying less is totally undone by the hit to the economy from the strikes. How much tax income and productivity has been lost from all the people unable to work due to health complications they would not otherwise have suffered? How much unnecessary disability and sickness pay are we shelling out due to having such an unhealthy workforce? The same goes for the rail strikes. There isn’t even an economic argument for not resolving the strikes in the workers’ favour.

https://www.healthstaffrecruitment.com.au/news/medical-professionals-pay-hours-overtime/

Looks grim at 240,000 AUD starting point plus double time for extra hours.

How much tax income and productivity has been lost from all the people unable to work due to health complications they would not otherwise have suffered?

Its like saying you don’t know what I do until I stop doing it.

These figures aren’t included in the doctors salary discussions - perhaps someone should put a figure in how much doctors save the economy?

Then we will need a private/public hybrid and/or compulsory insurance type model to fund these sorts of salaries. But it will take a brave (or foolish?) government to propose this whilst the UK is so culturally attached to the NHS.

There's already been uproar, particularly within the NHS, at Wes Streeting starting to allude to how things work in Singapore...

I wouldn't believe that too much, we often had waay more staff working during hours monitoring weeks (and bosses trying to push us out the door on time) on the old contract n very few actually declare overtime as results in meetings to discuss why you were late.

I strongly remember just after I started work that the reason I finished 3h late was cos I was lazy and inefficient, not that our rota was 5 drs short! Hence I never declared what I actually worked again, as expecting some acknowledgement I instead left in tears

And we get 5 days private study a year regardless of how many exams we are sitting in the year. Hardly generous

It's at least 3k maintenence ontop of the 9k tuition fees as its against university policy to work at all during term time.

I'm on the cheap 3k fees and having paid 600ish pm for nearly 10y only just finished paying it back

www.theukcatpeople.co.uk/post/how-much-does-it-cost-to-become-a-doctor-in-the-uk

@Destiny123 the staff survey is completely anonymous though, so I'm not sure why people would choose to under report on that?

They need a pay increase but I think they need an improvement in working conditions more. This could be delivered at less cost than the requested payrise.

Simple things like rotas provided in advance so lives can be planned, changes to shift patterns so they aren't working dangerously long hours, improvements to the system of training so doctors don't have to move around so much to complete their training.

If the government wanted to end this strike they would look at these sorts of changes alongside a more modest payrise plus a commitment to future increases.

The government don't want to end the strike though. They want to break the NHS so they can dismantle it without uproar and sell out to the US insurance companies.

Hang on a minute!

why do taxes need to be increased?

Hunt has just reduced the tax take by £20 billion, with more to follow, inc a 6bn cut in IHT thresholds rumoured.

20bn would pay for free care for the elderly for many years or would double the pay of carers and still leave enough to fund social care.

We in the UK have plenty of money but our governments make decisions that our ultimately not in our best interests i.e that £450 cut in NI would enable the individual to see a consultant for 2 x 20mins appointments.. wow big deal.

The government don't want to end the strike though. They want to break the NHS so they can dismantle it without uproar and sell out to the US insurance companies

100% ^this.

No other explanation, the cost to settle the Docs dispute is tiny in comparative terms, a slightly larger pay offer plus 3 years of talks on restoring pay in Scotland solved the issue.

The government don't want to end the strike though. They want to break the NHS so they can dismantle it without uproar and sell out to the US insurance companies.

I just don't believe this is true (and for the record I am most definitely not a Tory!). How would it even work? What interest would US insurance companies have in eg urgent and emergency care, frailty, mental health? The things that suck up such a disproportionate amount of the NHS resource. Where would the profit be for them? And how would the government even begin to square it with voters? I feel like it's a line that gets reeled out a lot (and to a degree is helpful to the government as they are able to deny it in good faith), but it also enables people to avoid facing up to the real issues and what we might actually may need to contemplate doing about them.

Not convinced it truly is (although it's meant to be) as the reminders for me to complete it miraculously stop as soon as I complete it (and they're barcoded etc) so wouldn't surprise me if people were scared to...but tbh the vast majority of my peers never complete them as its just even more paperwork to do in our own time. I didn't do mine this year as it came out after I'd only been working in the trust for a few weeks so didn't feel I could add much opinion on the place yet

As part of that deal would the NHS also pay for all of the training expenses I had to fork out of my own pocket?

What you're suggesting is a double edged sword. Trainees also provide around 60-80% of the service provision in the NHS - if you're going to bind them to a training contract, that involves them being paid just to train, then it's going to cost a lot more money, and need a lot more doctors that aren't trainees providing the service.

Can you not read the graph just above your post? It empirically has been eroded more than other NHS staff.the only group that have taken a bigger hit is consultants.

Well they need to stop asking for 35%. If they get that much. Then the rest if the NHS should get the same. I think k the strikes are having very little impact now. (Certainly in my area) Elective surgery has continued. And less doctors are striking as they can't afford not to work for so long. The only issue we are having is getting the TTO's and discharge letters done.

They are most definitely having an impact in our area. Our A&E has closed completely for the duration of the strike, all emergencies now have to go to the hospital in the next town - which puts massive pressure on them. And consultants have cancelled clinics and procedures to man the wards.

It's because of pay erosion and pay restoration. It's not going to be the same for different HCP depends on past pay agreements pay scale and union. Are you a nurse?

Look at the graph. The 35% is restoration to previous previous REAL levels i.e. a rise only to recover compound inflation. Junior Doctors' pay along with Consultants' has been eroded more than other groups in the NHS. So the rest of the NHS shouldn't get the same.