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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

AIBU unreasonable to say everyone should know about the junior doctor's contract the government is trying to impose?

322 replies

Addictedtocustardcreams · 18/09/2015 07:27

The government is seeking to impose a new contract on junior doctors. By junior doctors I mean all those in training I.e. Not consultants and GPs. Starting salary for these doctors is £22636 plus a supplement for additional & antisocial hours worked.
The contract seeks to re-classify normal working hours so that 9am on a Tuesday will be the same as 9pm on a Saturday night (so normal hours Include up to 10pm 6 days a week). This will lead to a pay cut of 10-30% for all junior doctors depending on which specialty they work in. They also propose to remove certain safeguards over lack of breaks & working over contracted hours.
They also propose to entirely scrap a pay supplement for junior doctors training to be GPs. This was designed to make pay equivalent to that of a doctor in hospital training who receives the pay banding I mentioned above. There is already a recruitment crisis in general practice. One in ten posts in England are unfilled in a recent survey. Many training posts are unfilled too.
You might think this doesn't matter to you but we are all patients sometimes. I know people who won't be able to afford their mortgage if the contract is imposed and they plan to emigrate. What will happen to the NHS then?

OP posts:
YoungGirlGrowingOld · 23/09/2015 08:51

It seems completely reasonable to me to compare doctors' working hours with other professionals where the entry requirements are similar. The only point where I differ from Grazia is the point about law being better paid. That is only true in certain areas of law - the corporate finance and commercial parts. I recently read that the majority of lawyers earn between 25 and 30k. Those are professionals with the same length of training as doctors whose working hours are probably close to/greater than those of junior doctors.

The problem is that (if the debates around my kitchen table are anything to go by!) most doctors believe that, had they chosen law, they would be at the sharp end of the profession earning 100k plus and therefore want/expect their salaries to reflect that. First, not all of them would make it in corporate finance (based on numbers alone!) Second, they fail to take into account differential working hours/pension/other benefits when making the comparison (and the vast majority of lawyers can only dream of benefits like the NHS provides). Third, that area of law requires absolutely crippling hours - forget the EWTD and concentrate on trying to stay alive-type hours. In my first seat as a trainee, I worked 84 hours without sleep to complete a transaction as did most of the lawyers, financiers, accountants on the team....no complaints, I loved it, we all necked champagne and had a happy client at the end, but it was fucking brutal even at age 25-odd. It's not just a case of "working the odd weekend" as a PP said - we are trained to be available when our clients need us. Those clients could be in any time zone. I have not had an uninterrupted holiday in 10 years, and that is one of the reasons why I am now thinking of getting back to "normality" which will obviously - and fairly -mean taking a massive pay cut. Doctors seem to expect both and I think that is what grinds, particularly as they are paid from the public purse (which is basically empty).

It's also quite ironic that doctors apply the thumb screws by saying "oh well if you won't pay me properly I will just FO somewhere else - your loss!" We need to train more doctors and it's actually doctors' organizations who are the most opposed to that - keep the supply scarce and name your price. It's consistent with the pasting I have received on here for telling the truth about DH's working hours (home by 6pm every night, earlier on Friday, occasionally works evenings, on call for the weekend every 6 weeks or so requiring 2 ward rounds and not going too far away, eye wateringly fantastic pension, sees the third largest number of patients in the hospital despite nice hours and has received clinical excellence awards so plainly not "coasting" etc). It's all true, but to hear his colleagues complain, you would think they were being sent down t'pit every morning! As a consequence I take all the sob stories on here and elsewhere with a large pinch of salt.

Grazia1984 · 23/09/2015 09:24

It sounds good few of us have both doctors and lawyers in the family and are one or the other of them. I suspect my brother and I (doctor lawyer) are very highly paid because we are at that small percentage end of things who did well. I accept some lawyers and doctors are not well paid and indeed I know some small firm regional lawyers where they are drawing £10k a year and paying their staff more than they are and legal aid etc has never been well paid but then agian that's the state paying you.

I certainly feel sympathy with young doctors where the rules change as here. You enter on one basis and then things change. It applies all over adn sometimes the other way round. GPs got massive improvements in their financial deal a good few years back. My chidlren's father teacher (nearly left because his net salary was the same as our childcare) and then suddenly again a long time ago teacher pay went up a lot so he carried on full time.

My advice to my children (2 of whom is a lawyer and one a postman (degree in ancient history) so far) is pick work you enjoy, pick work where you have the chance of earning alot, pick work which enables you to control yhour own fate so if possible work which means at some point you can work for yourself in part or in whole and financialyl always spread risk - have both spouses working, have extra sources of income, protect yourself so if one source fails you have another (one reason I have loads of clients rather than relying on one or two big ones which is dangerous).

I certainly have no problems with junior doctors publicising the impact on them of the changes. At the front line for me I go to the doctor about once every 10 years and our GP surgery is wonderful, open every day of the year, new clean, good systems. I am a bit supporter of the NHS but it is certainly a difficult beast to get right.

Is the supply of doctors scare? I thought we were training more than we can give jobs to.

Xanderpask · 23/09/2015 09:33

Times have changed re mat leave, and contracts. Yeah for mums who want to can return to work if they want. I like to think of it as progress, we retain skills in the workplace, we have invested in, I realise it's s luxury but a small part of the 47 years I will potentially work for the NHS, don't see it being justifiable as a reason to pay less which is what we are discussing.

But just so you know Maternity leave for doctors exactly the same for anyone in the NHS. If you commit to returning to your role in 12 months you can get 8 weeks full pay, 12 weeks half pay,20 weeks statutory. (As you may be aware NI pays 40 weeks statutory to the employer no matter how long you take many return at 6 months )

As you say it's about the tax payer paying enough for the right people to do the right job in this country.

So whilst we may have competition to do medicine we have a relatively high drop out rate and for whatever poor workforce planning issues we don't at present have the enough people filling in middle grade rotas currently. We pay less than elsewhere in the world but the principle of the NHS mean people like to experience it and have it on their CV, so they do come for a while. I have many learned friends who have gone back to India as the NHS is revered there and they then charge a premium for their experience. one of my consultants takes a flight every 6 months to actively recruit to a 24 month slot in the NHS to fill the gaps in our rotas the competition to drive down our pay is not there. Let's be clear if those skills were available already to us from within the EU they wouldn't get visas for people from outside.

Train more doctors is a good plan, med school places are decided by the government not Drs, it's going to take 15 years for their skills to become available to my rota though so not helpful now.

So yes, the tax payer needs to consider this.

drive.google.com/file/d/0B_H7id69DOeYN0FrVlRFekFDZTR4cFRLcWwwVi1MRUljd0Mw/view?pli=1

They need to consider that the BMA have been told agree to this before you can come to negotiate, that is not negotiation.

They need to consider if this is the plan of an employer who wants the NHS to be at breaking point so we can end it and people can profit or is this the plan of somebody who has interest in retaining the skills it needs ?

wonkylegs · 23/09/2015 10:09

Young girl - your husband sounds like he's an exception rather than the rule though where working hours are concerned as that is certainly not the experience my husband has, nor his colleagues. I accept that my husband works in a hospital with staff shortages so the pressures on the rota are heavier than they should be but lots of hospitals are being faced with this problem and it means that for all levels of drs and healthcare staff the pressures are increased.
I also suspect that your husband is in the generation of consultants less affected by the changes to pensions and contracts. Certainly my husband was affected by this and it means that the rewards of working at this level are definitely not as generous as they once were. Yes hes not badly paid compared to the population as a whole but we shouldn't be comparing with the general population that's not a like for like comparison.
I am angry with the way the government have gone about this - they have been deliberately antagonistic towards all health professionals (Hunt attacked their professionalism prior to the summer recess), they have misled the media over the position with the BMA ( they are not refusing to negotiate they have been given nothing to negotiate, saying accept this because we're going to impose it anyway is not negotiation) they have refused to discuss, defend or debate this in anyway and have just put out the same statement. They refuse to implement safe staffing standards when they have been told time and time it's a problem and then grab hold of policy's which will reduce safeguards for staffing. One of the biggest problems the NHS has is the problems with spiralling debt due to PFI contracts, have they even attempted to address this in any way, renegotiation of contracts ?..... No of course not but we've been told that drs (& I'm sure other healthcare staff will follow) must accept new contract terms because it's only fair and the only way. It smacks of one rule for the workers and another for the corporations.

YoungGirlGrowingOld · 23/09/2015 10:19

The thing is Xander I actually have a great deal of sympathy with the juniors who are understandably aggrieved that the goalposts have moved. One of the problems is that they do themselves no favours by trotting out the same old lines..."UK doctors are paid less than anywhere else" for example. Absolutely, demonstrably untrue. Yes, I am aware of the OECD study and also that it mendaciously ignores private income and pension benefits, which are astonishingly generous. DH's pension is the equivalent of receiving his salary again - if you don't believe me, please ask an actuary. (I am not complaining, because I will benefit enormously, but I can also see it is unsustainable.) His private income meant that we enjoyed 4 foreign holidays last year - we save it in a holiday fund and splurge when we can. Those same opportunities are available to junior docs once they complete training. I think most people would suck it up for a few years, given the potential rewards.

I truly hope you are right, and that it is part of a plan to reform the NHS and emulate one of the better European models. I can't see how anyone who has been in to a NHS ward recently can believe that is the best we can offer as a wealthy country. (God help us if it is!) I am not sure whether it is the end of the NHS that doctors are mourning or the end of their collective pay bargaining that it would herald. Either way, I don't think any government has the balls to tackle the issue head on. The NHS will eventually collapse but unfortunately I think things are going to get a lot worse for staff and patients before anyone puts it out of its misery.

YoungGirlGrowingOld · 23/09/2015 10:27

wonky you may be right about DH, but he became a consultant in 2013 and is not yet 40 (quite!) so hardly an old codger.

I think there is misunderstanding on both sides. There is a lot of ignorance amongst the general public over what junior doctors actually are and what they do (lots of responsibility and "senior" in many respects, not just wet-behind-the-ears, straight out of university) but also by the medical profession over what aspects of their package are stonkingly good (and what expectations are in equivalent careers).

I don't agree that there should not be a comparison with the general population. Of course there should (!), particularly when all of those salaries (and pension contributions) are paid from the public purse. What is the alternative?

Xanderpask · 23/09/2015 10:55

Young girl the issues of the NHS as you say are because we have people leading are only interested in 5 year sound bites, and the issues that will make a difference to the voting public, the majority of whom fortunately have limited interaction at work age unless they need to book a GP; which is how we come to the issue of why we have a health secretary making sound bites about being able to make choices in elective 7 day care rather than focussing on the fact that we have not got the budget or workforce to fund 5/7 day elective service as well as we would want; and areas that aren't popular. We need joined up integrated physical health and social and mental care. But the average tax payer wants his money to spend on what he sees are his problems now, sadly not what his healthcare needs are in the future. The biggest single reason for declaration on bankruptcy in the USA is healthcare. I have relatives who had well paid jobs and good medical insurance who have lost their home and declared themselves bankrupt as the contributions to insurance after the unexpected birth of their 26 week twins ran up to $450,000 for NICU, the total bill being millions. Yet this care is available to everyone for nothing in the UK. It's same principle the government argue in regards to austerity about not waiting for the rainy day to fix the roof, you have to convince people to invest in it. Focussing on Dr's wages which are not excessively high per hour for what they do, distracts from the real debate that we all need to have about what shod happen. Instead of pussy footing around to achieve the targets of the latest set of politicians.

The NHS for emergency/urgent care if you have an advocate for you works very well.

Semi urgent care is the worst, elective, their has been a political motivation to invest in and there have been some improvements.

Grazia1984 · 23/09/2015 11:11

Yes, I don't want the US system. We are a smaller nation and can afford an NHS and people like I am still buy into and use it which keeps it good in a sense. I would buy private non urgent serivces if I need them as I get older (which for me is cheaper than BUPA etc). Interesting legal case by the way just recently www.gov.uk/cma-cases/conduct-in-the-healthcare-sector on the huge issue of private insurers forcing down prices in a way I think is unfair to doctors, although patients and the competition authorities does not agree.

I don't think it's fair (although life is never fair) to change the rules for younger doctors as they made a decision to do medicine on one basis and then it changed although we have always had that. My father joined the new health service in about 1950s and stopped working when he was 77. My brother will similarly have seen and will see big changes. Lawyers too particularly those who picked legal aid work will see large changes across a 40 year career so I suppose some change is inevitable. Try to spread risk. Even if it';s a hassle do different things. My father did some lecturing as I do in law He marked exam papers as I have have in law. He was mostly employed by the NHS but also had a private practice and on a tribunal until 70 and court work. Spread risk and you tend to get more protection (but hard when you're working very hard in your primary job, I know).

Xanderpask · 23/09/2015 11:16

Incidentally in regards to the pensions argument. My husband has a private sector final salary pension worth more than mine currently. (Double) despite similar contributions. We are only paid pension on average earnings now. Which means despite paying in equal amounts female Loose out if worked part time or on mat leave, so i don't see it as extra plus point to retain me as a doctor. ( to explain further As a junior currently that is based on the basic salary rather than actual earnings. Which is why the significant difference in mine and my husbands as his is final salary & based on his whole salary. So yes Myself and husband have similar contributions yet contrary to the rumours ... his is worth double mine. The NHS fund is self sufficient, in fact it often creates a surplus, which feeds into the public purse. Yes it's good, However, it is not as good as many others in public service and I have indicated It is not as I have indicated as good as my husbands private company scheme, It's certainly not good enough to justify the need to reduce pay by up to 40%.

YoungGirlGrowingOld · 23/09/2015 12:19

The NHS pension fund is in surplus currently because the massive increase in staff under Brown (probably much-needed, but different point) are still of working age. The shit will only hit the fan when they retire. The same applies to teachers. So the surplus point is a massive red herring. The unfunded public sector pensions issue is a massive elephant in the room for any government and the only reason it is not being tackled is political expediency - nobody wants that particular unexploded bomb going off on their watch. As I said upthread - ask an actuary, because that has been a real eye-opener for DH. Either way, the days of cushy pensions are over for all of us. Final salary pensions are long gone. We cannot and should not just print money to pay public sector wages and pensions.

And I don't know anyone who advocates the U.S. healthcare system - certainly nobody on this thread has done so. It's a rather disingenuous tactic used by those on the left to scare those who might not know much about alternative healthcare delivery. "Think you're poor now? When you have to pay for your hip replacement, you'll probably starve!" I have experienced several different systems and when it comes to quality of hospitals, nursing and organization, the NHS is by far the worst. (I still can't believe how many people are expected to share a bathroom, or how smelly and dirty the wards are, in our local general hospital - although the standards of cleanliness are somewhat higher at the specialist unit where DH works). However, the standards of training of the doctors is amongst the highest if not the best. We need to find a way to take the best bits of the NHS and get rid of the poor performing aspects. Part of that will require pay and pensions reform, no matter how unpalatable. It would be absolutely wrong to keep inflating doctors' salaries while patients' services are pared back.

Xanderpask · 23/09/2015 12:38

thanks grazia, its a nice idea to spread the risk. But this is difficult in medicine, as a junior. ( I already interviews med student for free, teach under my nhs contract on days off for no additional money ( no budget for it ) teach on paid for courses in annual leave for hotel and travel expenses only.) The only thing i can earn from privately is air ambulance insurance work repatriating ventilated children to the NHS when they fall ill abroad . The work is irregular and indemnity costs so high that unless i can guarantee i will be available to collect the child on the day it is stable enough to be repatriated its not a reliable source of income to get me through training, and justify the indemnity costs. Unlike some allied healthcare professionals we can't pick and choose my days on and off to work, we work through 7/7 24/7 so can't commit to another job to support me to the top.

If you, or anyone else is interested in trying to pressure to government to have a real debate on the NHS, and not just the pay issue, please look at NHS survival.

Most doctors have no idea on the bad influence on an individuals health GE and political parties despite the sound bites, the people most at risk can't fight for themselves, we have to fight for them. Honestly around general election approvals for medicines, equipment, everything just stops for months, they come back to parliament a couple of weeks then recess, honestly months have been lost this year on progressing peoples health... its a nightmare.

Honestly I'm on maternity leave at present so I have been going to volunteer NHS commissioning patient consultation group meetings, baby in tow ... to understand it all better. The last meeting they were putting a tender in and there was an interest because of political motivation to ensure the service was more accessible to people with mental health issues. Sadly the "business leader consultant" writing the business proposal had lots of ideas but no clinical understanding. By that I mean, they are designing a service to offer this, but do not appreciate the fact that the service has to be designed to be as safe as possible for all so the algorithms used take a while to go through. The service does not know the caller is mentally ill, it has to assess physical health first before coming to that conclusion. So throw as much money into trying to make it do this, get the best consultants in to tender for the contract at great cost to the NHS but your mental health patients will no fit the algorithm, they will not like the questioning. It will no suit them, this is why mental health crisis teams with their own contact numbers have been developed and they should access services they know well. ( The issue really is with what we can do to support people with mental illnesses in crisis and how they can access good services and improve them not with the 111 service, which is about signposting normally well people to urgent but non emergency care but needs to interact with the crisis teams ) but these people writing the business case don't have clinical experience, there is no real clinician consultation until tender about innovation, and there were certainly no patients with mental illness, and i suspect they would struggle to anyway there to explain that ....) ...madness waste of precious resource in austere environment.

Xanderpask · 23/09/2015 13:57

Younggirl, the point is massive pensions aren't there, not that i think they should be; hopefully the actuaries will have got this proposal correct.
Per spend percentage of our GDP we are efficient.

We are not talking about inflating pay, or printing money, we are talking about cutting current pay by 10-40 per cent and hiding behind the pretence that this will solve the issue in the healthcare service, I don't think it will, but the ensuing issues may make things bad enough that all of those in good health consider it a priorty to discuss.

Healthcare will never be profitable in every area, it can't be.

I'm not supporting the USA scheme, like everyone else would after have an ethical issue advice is given for profit over health. But my anecedote is true as is that .... sadly it is also the case that poorer health is usually seen in those who can least afford to pay or contribute toward care.

As others have said it shouldn't be the sacred cow, but we do need to have the balls to tackle the issue, and not just hide behind the idea that staff are well paid and deserve a pay cut because we can't afford to pay them what we said we would for their contracts before they are completed.

what do others do?

www.kingsfund.org.uk/sites/files/kf/media/commission-background-paper-social-care-health-system-other-countries.pdf

what do we want?

cutting pay isn't in my opinion a good long term solution.

YoungGirlGrowingOld · 23/09/2015 14:13

But the pensions are there - DH has one. In what other job can one retire on 55 or 60 on 50k plus a year?

My understanding is that the Tories are attempting to make good on an election promise to enhance out of hours provision (which I think we can agree is currently pretty woeful). This means that the overtime benefits currently offered to doctors will not kick in at the same time. Is this correct?

If so, it's hardly a pay cut, is it?

I have read the Kings Fund report and find it very interesting (although all think tanks have their own bias, of course). The simple yet unanswered question for me is why not one single country apart from the UK delivers healthcare through a NHS system with (effectively) a central employer?

I think we agree there needs to be more money. It just isn't going to come from the taxpayer given the current financial straits. I think it would cause less harm in the long run to face up to this now, introduce a social insurance scheme with co-pay and let government focus on paying the premia for those who (as you say) can least afford to contribute towards care. Of course this won't happen!

This will also have the benefit of leaving medical staff free to negotiate contracts with private providers if they are unhappy with the current terms.

Floraclare · 23/09/2015 14:33

YoungGirlGrowingOld - you can't enhance out of hours provision, without more doctors - daytime services are already stretched and if you remove doctors from the day, you are just moving the problem.

And I wonder if your husband has an overworked team of junior doctors beneath him, which allow him to be home at 6pm each night? I hope after being one of the last doctors to get that kind of pension, I hope he is supportive of his juniors who will receive so much less. Perhaps he should give some of it back to help pay off the UK debt?

Junior doctors are not asking for a pay rise, they just don't want to see their pay hugely cut - and their rights at work and to have a family, further eroded

Floraclare · 23/09/2015 14:38

And it is not just lawyers and bankers who are earning more than junior doctors (which I also agree is not an appropriate way to describe highly trained professionals) - I know many a person in PR, advertising, sales who are earning around the same - if the changes are forced upon us, I would need to leave the South East as my wages would no longer cover the mortgage on my two-bed flat, especially with the added cost of childcare

Grazia1984 · 23/09/2015 14:38

Very few people in the private sector have final sal;ary pensions and indeedm ost people in the UK amazingly work for employers with 5 or fewer staff and most of them have just about no pension. I am a lawyer with virtually no pension for example but happy to work until I die. My sibling will retire from the NHS at 50 in a few years on £50k a year and has been advised to earn as little as possible from now on from the NHS as his pension is just about the maximum before the new rules start penalising it from a tax point of view - obvioulsy that is only relevant to people my age with decades of work behind us (and most people don't get more than 6 weeks on 90% pay when on maternity leave - I didn't even get that(. Anyway this is not doctor/lawyer nor even then and now comparison. The bottom line is if the pay is reduced too much people will do something else - I know doctors who have gone into pharma companies for example and risen up the management or formed their own commercial company, another who imports or exports pharma products, a few who went into law.

easterlywinds · 23/09/2015 15:02

You can't retire at 55 on a pension of 50k plus. The average 50k figure is for retirement at 65. A consultant retiring at 55 would only achieve 60% of this, although this is still a decent pension.

YoungGirlGrowingOld · 23/09/2015 15:03

Actually Flora his registrar is about to go on maternity leave for a year, leaving him with no support until the next rotation. One of the lawyers in my team is doing the same (albeit only 3 months because our mat leave policy is less generous) so we are in the same boat there - difference being that he will not be expected to bill and make up the difference in his registrar's time and fees himself, whereas I will with my associate.

This whole debate becomes so disingenuous - I tell the truth about DH's hours, and doctors on here have accused me of being a troll, a fantasist, a Tory party stooge, and now you have suggested DH must be shafting his junior colleagues. None of that has an iota of truth. For some reason, there are a lot of doctors who don't want people to know that some of them currently have a pretty good deal Hmm

It reminds me of the FB post that went viral on FB when the junior doctor was complaining about being paid £1.20 an hour (or something) for being on call when it turned out that he was only calculating based on the additional uplift on his salary that already contained an unsociable hours element. If you have to misrepresent the truth in order to make your argument sound convincing, you probably don't have much of a point.

Xanderpask · 23/09/2015 15:10

Grazia for any employee standard statutory pay is 90% for 6 weeks and 33 weeks of SMP which is £140 per week (or 90% wage if lower now) so yes has improved but many friends on better.

Younggirl growing old, as you will see from above,it is a pay cut, and worst still a pay cut for those who do the most unsociable hours whilst people in unbanded jobs get a pay rise.

I disagree out of hours services in my area of work are woefully inadequate. I would ask why you think that? Adult medicine different to paediatrics and neonates i appreciate.

re pensions senior people may still have good pensions, we are and still will be paying for them in years to come as thats how the scheme works now, and i'm happy for that.. but still the juniors and anyone who was on mat leave in april have switched over to april 2015 scheme which is probably rightly no where near as generous. my pension after 12 years as it currently stands is a 1/4 or not a 1/5 of your husbands, and less if i retire before 68.

Xanderpask · 23/09/2015 15:15

younggirlgrowingold not accusing you of anything quite enjoying the debate and trying to show you why this contract is bad for patients and juniors and doesn't set out to help the tory idea of improving out of hours service by cutting the pay of those giving it

Xanderpask · 23/09/2015 15:21

i also haven't accused you of misrepresenting your husband, your husbands team and he will fill the gap as much as they can for his registrar as its part of their contract in regards to cross cover. The statutory pay is recoverable to your company as well as the nhs.

There are just many different jobs in medicine and some of us at the hyper acute end are working extremely hard, when in work, not going to receive big pensions, but if you put in the position that we are paying our child minder more than we earn, then there is a hard decision to make

YoungGirlGrowingOld · 23/09/2015 15:26

Yes you are paying for it, I do appreciate that, but you are paying nowhere near enough for the annuity you will receive.

I can't comment on pediatrics or neonates but 2 elderly family members (one on each side) have died from cancer in the last few years and in both cases their decline has resulted in emergency admissions "off peak". Despite being in hospitals at opposite ends of the country, they received equally appalling "care" that was straight out of some hideous Daily Mail theme park - abandoned in trolleys, shouty nurses, rude doctors who spoke no English, blood on the walls/floor/bed, patients with dementia wandering about - it was a real eye-opener for me. The only time when I received decent, timely care was when I dragged DH in to A&E and demanded that he find out why none of the SHO's bothered to read my relative's notes. Their attitude (of complete disdain) changed instantly and one said "I didn't know you had a doctor with you" as though if I gadn't, that somehow would have made treating my relative like shit okay. They are both sadly dead now, but I still get ragey thinking about how medical staff treated them both.

So yes, anecdotally I strongly feel that OOH care needs a metaphorical rocket up its arse. So I find it hard to get terribly excited about people who are already quite well paid, and will in future be stonkingly well paid, getting paid slightly less for a short period of time while they are "training".

Floraclare · 23/09/2015 15:50

YoungGirlGrowingOld - I can't see that anyone has called you a troll, but your husband's relatively easy working life and amazing pension is not representative of the experience of most junior doctors. And by the same argument, I guess you won't get terribly excited if the new Consultant contract decides to knock 40% off his take home pay and drastically reduce his pension? :allinthisogether:

We would all love to see better OOH care - and I understand how awful it is when family members don't get the care they need. One of the hardest thing about being a doctor, has been not having enough time, staff and support to give each patient the care they deserve. Making overworked doctors work longer hours for less pay, is not going to lead to an improvement in patient care - and is just going to lead an increasingly demoralised and burnt out workforce.

YoungGirlGrowingOld · 23/09/2015 15:56

Of course that would tick me off Flora but I am a realist and it won't kill us to use his private income for the mortgage or food instead of holidays. (We are childless and I fully appreciate this makes a big difference too).

I agree with your last point as well. I suppose I have become very sceptical about the NHS model in view of the poor care our family has received. But you are right that making conditions worse will not change this. The problem is that nothing will except (much) more money and (much) better management. And there doesn't seem to be much danger of those things happening!