to wish doctors weren't going on strike

[MissTriggs]

After 5 months of misdiagnoses, being sent to the wrong person, explaining why suggestions weren't helpful, holding my GP's hand and fighting to get to the right person I'm now booked in to have the test I need on 2nd December, the day after the strike.

If my test was on 1st December I'd be pretty upset

I then read a post on here from a junior doctor claiming s/he could make more money "as a manager at Greggs" and that tipped me over the edge.

I saw lots of posts from doctors saying they already work weekends but it turns out they get paid extra for this at present.

I think doctors have no idea what it is to work in a job where you can be sacked easily, where you don't know whether work is coming in from day to day, where your employers have no interest in getting you back to work after a career break and where you either have no pension or the value of your pension can fall from year to year and be worth nothing.
I also think they don't realise that, whilst a generation ago doctors might have been unusual in working antisocial hours, nowadays all professionals are expected to be available all the time.

I might be wrong, but I don't think I'm being unreasonable here.

what does junior doc's timetable look like? Does a fortnightly one arrive? If they are above directive levels (post-changes) are they supposed to say "I'm not coming in for that shift, sort it out".

The BMA strongly recommend that all Drs have their own indemnity insurance. Given that more Drs are reported to the GMC by their NHS trusts than by any other single body, I think this is pretty important! I would be really surprised if the majority of Drs don't hold their own indemnity in some form. Particularly as NHS litigation indemnity only covers Drs for clinical negligence and not disciplinary or criminal matters.

I stand by to be corrected on this!

right, have indulged self enough on the thread. thanks to those who took time to answer politely.

Take home message for me is that the junior docs' advocacy could do with a reboot as I don't think the message is getting across -let's hope a settlement is reached for the sake of the patients.

MissTriggs the same is true of medicine as law

Plenty of women at junior levels but far fewer reaching consultant especially in 'acute specialties' eg surgery. Because of the sexist assumption that women are responsible for childcare and men are not women are forced to chose more 'family friendly' specialties that are generally lower status and lower pay.

Another delightful feature of this new contract is that automatic pay increments for years served will be stopped and pay will only increase on progression to the next grade.
Progression to the next grade is based on time served and on passing exams and assessments. You can't accelerate by passing the exams early.
It follows that if you are off on mat leave and work part time your pay will quickly start to lag behind your male counterparts who usually have no such worries.
It will also reduce your pension under the career average scheme as a double whammy.

My great hope is that this will be solved by more men opting for shared parental leave and part time work to level the playing field but that remains a pipe dream.

hope your pipe dream comes true x

To whoever ask do about defence fees. As a three day a week GP mine is £7000. after tax relief that works out as about six weeks that I work for free in order to pay it.

Lollypop If all your work is covered my hospital indemnity, then technically no, but all doctors are wise to have "Good Samaritan" cover in case they are sued by someone they stopped to help in the street, for example. No idea what this costs, but it is not much, in the overall scheme of things.

Working out of hours as a GP is now so expensive to cover with indemnity insurance that a lot of GPs refuse to participate, as it makes no financial sense. Local to me is an OOH scheme that offers to reimburse GPs for additional indemnity costs - I can see this sort of thing becoming more & more common.

Junior Dr timetable is generally issued at the start of the 4 or 6 month job (often on your 1st day if you are lucky a few weeks before) for the whole 6 months ahead. It is almost impossible to swop or alter it as it is so complicated.

It is carefully calibrated not to 'breach' on paper. If you worked those exact hours it should be fine but in fact you usually work quite a few more for free with early starts and late finishes. I do recall proudly turning up 10 mins early for my first consultant ward round in my first ever medical job expecting a pat on the back only to find that it was 'the done thing' to get there at least 30mins prior so as to be familiar with all the new admissions overnight, blood results, x-Ray's etc in order to present this to the consultant on his arrival at 8am. Needless to say 'time off in lieu' is not a concept recognised in medicine.

The problem arises where someone goes off sick or a post is not filled then usually pressure is exerted on the remaining Drs to cover that shift by invoking the 'cover in an emergency' clause that most contracts have. This can often result in a domino effect where one goes off long term sick, the others have to cover and get sick and start dropping and finally the whole thing falls over.

The problem arises where someone goes off sick or a post is not filled....

aha, so all calculations done on basis of no-one being off sick.

I get it.

more staff seeming like a better idea by the minute.

I'm a consultant and fully support the juniors strike. In my specialty whuch has always struggled to recruit we now have so few juniors that the strike won't make a huge difference from many ordinary working days. We have huge gaps in the rotas and have had to employ very expensive locums who can just charge whatever they like. Market forces and all that. There have been times where we have had to run a 4 day a week non emergency service with only emergency cover for the other 3 days because we couldnt get enough doctors. We have lost at least 5 colleagues to other countries in recent times. If terms and conditions get worse then we will struggle even more and have to pay even more for locums who frankly aren't always that great massive understatement even though they are charging way more than even a consultants wage for a junior post. And dont get me started on what the consultant locums expect. The idea that all this is going to help 7 day working is laughable.
I think the basic salary for a junior at 8 years is about 40000 btw MissTriggs. Banding payments range from 20%-40% extra for most juniors through to the very rare band 3 jobs which are 100% extra.

I support the strike - but I wish it were not necessary. PP have made good points.

Well yes to more staff. But how to pay for them? The UK public aren't clamouring to pay more tax.

And how to recruit? We don't train enough doctors, IIRC. So overseas recruitment?

Are you paid when off sick? Plenty of people outside the public sector are not paid for the first 3 days and then paid at the low SSP rates.

We've tried overseas recruitment and failed to attract anyone.
If we dont treat our juniors doctors well we will have to pay more. Whether thats by taxation or insurance. Happy and adequately paid nhs doctors are cheaper than the alternatives.
The situation in my specialty is a sign of things to come I fear.

Yes we are paid when off sick. Doctors have very very low sickness levels though at a similar level to the self employed.

Another corker my taxes pay your wage quoted from a delightful customer a few days ago when he was speaking about the pay dispute

Yes, I pay taxes too so I guess I'm paying my own wage AND your treatment

Thankfully this doesn't seem to be the general consensus!

kittle are you in anaesthetics by any chance? This is very familiar situation

presumably there is no shortage of graduates?
but then too many people drop out at critical points?

ie you cannot simply increase no of med. school places.

I did some management consultancy for a major engineering house a while back (sorry, I know you don't like management consultants - if it helps, I did promise myself to do the job without learning any consultant speak). Anyway, it turned out that what the key staff wanted was:

1. time spent discussing their work with senior colleagues and alumni
2. a sense that their work was understood by those who had influence with the CEO
3. financial security.

What they did not want was the things I was brought in to announce they wanted including:

1. bizarre performance pay schemes

2 "google time" (which is when you get Tuesdays off to invent what you like).

1. massive pay hikes

And what demotivated them more than anything else was complex targets/schemes/incentives that smacked of being led by the FD.

All v. interesting. Well it was for me. Charged far too little though - should work for NHS.

should work for NHS - as a management consultant I mean.

Oh and I managed to stop a woman being sacked.

£60000 outside London at 8 years qualified is a great salary compared with law/accountancy etc- (London is different) and the pensions/sick pay are a dream land to most of us - plus at 8 years people are just at the age where they start to appreciate this. So - why are they leaving? I don't buy the "better pay in OZ" argument. What is being done to them to make them leave?

Deo- yes there is sick pay but it's not massively generous. There is a period on full pay but it reduces to Half and then to SSP quite quickly. I don't know much about it as I've never been off sick more than a couple of days in my career so far. Partly good luck I realise but also my threshold for taking a day off sick is very high in common with most Doctors.

Similarly maternity pay is 6 weeks full and then something like 18 weeks half and then statutory.
Many of my friends in private sector jobs had 6 months full pay and 6 months half pay.

What is being done to them to make them leave?

It's the lack of autonomy, sustained campaigns in the press against doctors, constant top-down interference, increased expectations & risk of suing from an unrealistic public...

Thanks WitchWay
OP it's not just about money you know I don't know why people are so bothered about figures at the end of the day junior doctors are worth their pay and it may not even be enough when you factor in the hours some do outside their contracted

I'm not detracting from other professionals in NHS and other sectors

This strike is about much more than just pay

Hmm,

From this thread it seems the big disadvantage of being a doctor is the lack of autonomy/interference and high consequences of mistakes described in this thread. Partly the nature of the work, but clearly much more than that.

There are other respects in which it is a profession with better conditions than other professions - I don't want to start another argument though so won't list them.