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

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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?

teachers

Don't know any other doctor/teacher partnerships Punk

This has made me bizarrely happy :)

I didn't like to say blackclouds but yes. I could have
a)taken my A-levels and done an wgineering degree on a salary from an enineering firm and started on 40K aged 21
or
b)Done a PHD after my intercalated BSC and stayed in academia
or
c)Taken my medical degree in to the city and earnt 80K aged 23
I choose to stay in clinical even hospital medicine. Now I'm too old and knackered to do anything else. But I could have...

FFS an enineering degree

engineering even

No, you should say it. it is the truth, after all!

DH had to get a minimum of AAB just to get on the course - and a shed load of voluntary work!

Nobody's tried to give teachers a 20-30% pay cut, as far as I've heard - if they had, I'm sure everyone would be up in arms about that as well/instead.

My FB feed is full of angry doctors talking about this, but I feel like we're talking in an echo chamber - we need to stop talking amongst ourselves and get our message out to the public in order to get some support against the government's systemic destruction of our profession.

If the current reforms go through, I am looking at a 20-30% pay cut. As a doctor in what will be my 8th year post-graduation, responsible for the sickest patients in the hospital at night, I will potentially be earning less than one of the new Physician's Assistants, fresh out of their 2 year post-grad training course. Oh, and they won't have to move jobs/house every year in order to progress either, or pay thousands of pounds in examination/training fees.

This is not 'just' about pay; it's about sustainable, safe working and creating a longterm motivated and safe workforce.

No doctor I know is too worried about pay - we know we are well paid (not as well as your lawyer or dentist or ManU football player, but people tend to not go in to medicine for the money, believe it or not), but it would be nice to be valued for what we are: hard-working, conscientious and often going the extra mile. The constant dr bashing is just demoralising, and I fear that people will only realise what they've lost when the service they've become used to is gone.

Have you ever wondered why the majority of GPs are now female? Because many male junior drs don't want to go in to a job that has little kudos, isn't paid as well as hospital consultants, demands long hours AND has little in the way of career progression - perfect for the wimmin then. Which IS a feminist issue, but that's not the point, the point is that that tells you a lot about how the job is perceived.

It's still the best job in the world though and a privilege to do

Yy that we have to stop talking among ourselves.
I despair how apolitical and passive a bunch drs as a profession are.
Weird.

Blackcloud - I have a Msc and have spent 5 years in further education. I've volunteered for the past ten years too so I know what it's like. I want to have my own care company so I am getting more experience whilst I have a young child as it is what I am passionate about. I am not saying because it's unfair for one it should be unfair for all, I think you have misunderstood me. I simply meant it is wrong for everyone doing work like this whatever job they do. If people oppose it for doctors I urge them to oppose it for all jobs.

You've answered your own question in a way though Fratelli - the care companies are mostly privatised and as such the emphasis is on profit, hence lack of travel time and so on. It is a disgrace, I agree.

But it is ultimately the illegal decision of the companies and not of the government.

Under my current contract as a junior doctor (GP trainee), when I return to work from maternity leave as a part time trainee (working three days a week), after childcare costs I will expect to have £1155 per month as take home pay. Incidentally, that works out as £96.25 per day I actually work and if those days are 9 hours long that works out as £10.69 per hour.

Under the new contract being imposed from August 2016, for doing exactly the same job I can expect my part time take home pay after childcare costs to be £644 per month. That is about £53.67 per actual day worked and an hourly rate of £5.96.

£644 per month to contribute to the running of the household, the mortgage, food, petrol, insurance, phones, electricity, gas, water.

But more than that, a portion of that £644 per month goes on my professional indemnity with the MDU, membership of the Royal College of General Practitioners, the British Medical Association and accreditation by the General Medical Council. These add up to about £1000 per year and three of them are non-negotiable (RCGP, MDU, GMC).

More than that again: I have exams to take if I ever want to actually qualify and work as a GP. Taking those exams will cost me over £2000, and that's assuming I manage to pass first time.

This is not sustainable.

We aren't kicking up a fuss because we are having a pay freeze, or are only getting a 1% pay rise. We are upset because we are having a pay cut. Not a "pay cut relative to the rising cost of living", but an actual, real, significant pay cut. For doing exactly the same job as we are doing right now. In fact, many hospital junior doctors will end up working many more antisocial hours than they do right now, as the new contract removes the financial incentives for Trusts to limit the hours worked by junior doctors, and considers evenings and all day on a Saturday as “normal working hours” and therefore to be paid at a normal rate of pay. It is a rota co-ordinator’s dream, I’m sure.

We sacrifice a lot to be your doctors. In the 6 years since I’ve qualified, I have missed three weddings of friends, worked four Christmases, missed countless friends’ and family’s birthdays, hen parties, summer BBQs. I’ve had jobs where my holiday was prescribed to me - I was told when I would have holiday and I was given only four weeks’ notice of this and was unable to swap. My other half couldn’t get leave at the same time. No-one in charge at work seemed to care. I wasn’t able to attend my grandfather’s funeral when he died suddenly last year, as I was supposed to be on night shift and couldn’t arrange a swap at short notice. I didn’t get to say my goodbyes.

In my time working in hospitals, I have done my best. My utter, absolute best. I have been there beyond my shift on more occasions than I can count. I have held the hands of dying patients and comforted their families; I have excused myself from the ward to howl in the toilets when patients have died unexpectedly. I have talked, negotiated, cajoled and called in favours from specialty doctors, theatre co-ordinators, social workers, nurse specialists and more in order to get the best for my patients. I have swung into action in A&E to help save the life of major trauma patients, or a child about to die of undiagnosed diabetes. I have been the unfortunate soul who walks with their head bowed into the relatives’ room to give bad news. I have gritted my teeth and behaved professionally when patients have taken up our precious time in A&E with problems that are better dealt with by GPs, pharmacists or even common sense. I have sprinted across the hospital to answer the emergency bleep to many cardiac arrests. When a fetal heartbeat fell dangerously low during labour, I have assisted in the Caesarean section that delivered the baby in less than 10 minutes and may have saved its life. I have been spat at and scratched by patients. I have had sexist remarks made to me by patients. I have been shouted at by patients frustrated by how long they have waited to be seen. And I have kept going back for more. Not for the money, but because I love it and I can’t imagine doing anything else with my life.

I may have to use my imagination soon, though. Under the new contract, I may not be able to afford to finish my training. What a waste of the taxpayer’s investment in me through my 5 years of medical school and 5 and a half years of post-graduate training.

I am heartbroken.

Nutter

Whatever you do, get your qualification, please do.

The stuff I've seen in my Facebook feed is totally disingenuous though - comparing junior doctors first year salaries with salaries of other professions, neglecting to mention that Drs salaries much rise higher and faster than virtually any other professions.

Ultimately it's a well remunerated career and has been pointed out unthread, for GPs at least, there is very little accountability.

Laurie, nobody in their right mind could deny that it's a well-paid career.
But you have to get there first. And survive - mentally, physically and financially.

And GPs are not accountable? Don't make me laugh.

Nutter - I am so sorry to hear of everything you have been through, but I am not remotely surprised as I have seen it with so many of my friends. I really do wish you the best of luck. This is such a stressful time and so unbelievably unfair considering the years of hard work and dedication you and 99% of the others have put in. It really upsets me how few people see to respect this.

To the previous poster - although I agree with the sentiment, I think the problem is that Nutter (and many others) will find themselves literally unable to carry on as they just will not be able to afford to. It's all very well other posters saying about how good the salaries are once you hit consultant, but that is so far down the line and you have to jump through so many hoops to get there, and many doctors will have accrued so much debt by this point .

I think this contract change is an appalling one and we all really ought to stand against it for the good of the NHS and our own health

I work in the NHS and know what a difficult job doctors do and just how hard they work, study and push themselves but I do think they have lost a lot of sympathy from the public and from other professions with the way they have stood aside, raking in the money in previous years, while other professions like nursing, pharmacy, healthcare, etc were screwed over. Hopefully this might be the push to get the health professions united that the NHS needs

All the posters trying to compare teachers workload and responsibility to that of a junior doctor...come on I have enormous respect for teachers (I certainly couldn't do their job) but it's not a valid comparison. You simply cannot compare an evening spent doing lesson plans or report writing to a night shift in A&E or performing surgical procedures and I don't know many teachers who are expected to work for 36 hours without a break, which I have seen Junior Doctors do many a time.

As a Nurse who has had her (already crap) pay frozen for 5 years I admit I haven't always found it easy to sympathise with my medical colleagues. Just the other day I had to bite my tongue as a Locum Consultant Psychiatrist was complaining to me that her pay is "scandalously unfair" . In the case of Junior Doctors though I feel that what's happening is deeply concerning. The pressure and the working hours are truly ridiculous and the risks to patients are massively increased due to their utter exhaustion. Obviously tiredness is par for the course but you shouldn't have people's lives in your hands when you haven't slept for two days, that's just common sense and in other high risk industries it wouldn't be considered acceptable. Aviation for example has very stringent guidelines about how long pilots and ATC's can work without a break and no one has a problem with that!

Yes, there's the big pay off at the end of the road when you reach Consultant or GP level but it's a long and hard slog to get that far. Those from working class backgrounds without the support of wealthy families may not be able to complete their training. How many talented individuals will simply emigrate and take their skills elsewhere or choose another path altogether? As someone who holds responsibility for some very complex and vulnerable children, I want to work with great doctors from all backgrounds, not just a priveliged few who could afford to become doctors.

Calm..that's a bit of a sweeping statement

The truth is as doctors there is a closed shop run by the government which is the NHS. They can treat us badly because there is no other training or work available to us in training years. They know this. If we were lawyers we would be millionaires because of the hours we work and the skills we have. We are worth more than 100 pounds per hour but we don't get paid that amount (which we can get as locums ) because we are in regular training jobs. Drs want to stay in the NHS and treat sick people but if the conditions are poor they will leave ... No one can make them stay, it's not compulsory!!
Drs have been exploited by the govt for years because if they paid us properly for our true worth , it would be very very expensive. However, the Torys are trying to reduce our pay, our morale, our worth and it's basically unfair and doesn't match the expertise we have. We don't have to explain ourselves .....it's just we are trying to do so to get backing to oppose the govt before the Drs leave in despair and the Health System collapses. Then people die.

Because that's what we do...we save lives. That seems to be forgotten .

"The Torys are trying to reduce our pay, our morale, our worth and it's basically unfair and doesn't match the expertise we have. "

I don't think calm was disputing this. He/she was simply saying that this has been happening to other professional groups within the NHS for years now and there is a perception amongst some members of those groups that Doctors have only spoken out now that it's started to happen to them.

I have supported my colleagues when they've been facing disputes/cuts - I can't go out on strike with them but certainly show my support on social media and so on. Not sure what else I should be doing? I really don't think this should become a mudslinging competition between different public sector jobs.

And we are talking about a THIRTY PERCENT pay cut! Never mind what GPs earn, whether consultants spend all their time playing golf (they don't), if this was happening to anyone there would rightly be outrage. They've been feeding the media all these stories about deadly weekends etc in order to butter the public up to accept massive cuts like that. And with the way UK training works, if we don't like it, there is pretty much nowhere we can go without leaving the country or quitting the career that has taken my entire adult life plus a large portion of my teenage years (in preparation). I think that justifies being a little upset.

I am an auditor and on an 80% schedule work about 45 hours a week. It is about my limit as I have 2 DC at home. 99.9% of my peers have had to complete a Masters (I'm in the US so its CPA), pass exams that are not exactly easy and just worked our arses off. During busy season 8-16 weeks we work 100-120hrs/wk. My client this year is doing an accelerated filing so from year end we have 60 days to issue our opinion. All of our work has to be perfect and much of it can't be done until the client has closed their books. Our salaries are much lower than what doctors are making with the same number of years of experience. We don't get any overtime pay yet we are expected to be on call 7 days a week.

Just because my industry sucks doesn't mean other industries should. I think this new contract is badly thought out. I am fine with saying regular hours at 7am-10pm but lets get real on overtime. Everyone should get 1.5x pay when working more than 45 hours a week. I want to hear about what hours junior doctors will be expected to work and what costs that they currently incur are going to be covered. Given that all of my friends who are doctors and not in London move all the time for their training contracts I think moving costs should be fully covered along with any student debt remaining after 10 years.

I have advised my friends who are looking at leaving the UK to go to Canada. Already here in the NYC area there are more and more British doctors and they are nearly all white, middle class males. They are qualifying here much faster compared to the UK and getting paid an awful lot more, even after paying for their insurance.

I'm a junior hospital doc, qualified in 2009, working on a senior registrar rota, non-resident on call. I'm one of relatively few doctors who is likely to get a pay rise (in the short term, at least) from the new proposals.

I would still vote against the new proposed contract, and I would be prepared to strike to prevent it being implemented.

Why? Because it's not just about salaries. The wider terms and conditions are also being decimated, and the new contract is devastating for recruitment and retention, is likely to lead to a reduction in quality of service and patient safety, and detrimental to junior doctor health, wellbeing and relationships.

I've a list of concerns as long as my arm, but my main one is this:

There are NO safeguards in the new contract to prevent hospitals routinely overworking their doctors. (Currently we have a system of "monitoring", which in my experience HR play fast and loose with, but which provides some protection).

Let's say a ward actually needs 4 doctors to get through the normal daytime volume of work. You'll probably find that currently there are maybe 3 doctors, who will be missing their breaks, staying a couple of hours late each day, and getting the work of 4 people done. In spite of this, it'll probably pass the monitoring, somehow, it always seems to come at a time when there are fewer patients than normal, or more consultants present on the ward.

In the new scheme, HR know that their conscientious junior doctors will stay until the work is done and the ward is vaguely safe. They know that there will be no financial consequences for the Trust, even if their doctors are routinely staying several hours over their finish time. If the 3rd doctor leaves, or is off-sick, the same work has to be done by 2 people. There is no incentive for the trust to provide a locum to ensure safe cover. The 2 remaining doctors will miss their lunch. They will try to get through the work faster. They will stay even later than usual. They will be tired, dehydrated, error-prone. Your relative in Bed 4 will be reduced to a tick list of tasks to complete; there will be no time for compassionate care.

If the exhausted doctors wish to raise this issue, they have to individually jump through a series of administrative hoops called "exception reporting". The final arbiter in this is planned to be the Trust's grievance procedure - hardly independent. The junior doctor is likely to be told their time management or teamwork is defective in some way, and it'll be flagged up as a problem at their ARCP (appraisal). There is minimal chance of a Trust accepting that the fault lies with poor staffing.

It is, frankly, a nightmare scenario. The recruitment and retention issues are here, now. Many, many hospital doctors work on understaffed rotas. It's incredibly demoralising - to feel that we can't do the job as well or as safely as we would like to, because there aren't enough of us to do the work at a safe rate, to reflect, to discuss cases, to double-check as we go along.

We can't allow recruitment/retention to get any worse; the NHS is about to implode as it is.

Please support us in rejecting this contract. We're doing it for you and your relatives who might find yourselves under our care at some point, as well as for our own sanity.