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.

olecranon quite

I think you might be misremembering a few things. There was a GP pay deal made which increased GP salaries more than expected (shortly followed by a huge spin campaign on overpaid lazy GPs, grrr). This was because the govt at the time weren't aware how many of their fee for service arrangements the GPs were already providing. The GP pay rise reflected the work they were already doing instead of being an inducement to work more.

The punitive hours payments were negotiated when I was a junior a decade or so ago. Work diaries over 2 weeks were filled in. Any shift pattern with too many shifts longer than acceptable, too many antisocial hours, too many hours worked altogether - resulted in an increased salary for the juniors until the shifts were redesigned within the limits deemed acceptable. Staff were pressured (probably still are) to record their hours more creatively than truthfully to ensure the roster was documented as compliant with the contract to reduce the payments. Antisocial hours are being redefined to be outside of 7am-10pm Mon-Sat - so working at 9pm Sat becomes as acceptable as 9am Tues.

I fully support the strike.

"Do you want to be treated by a doctor who falls asleep when they sit down on your bed to talk to you as one actually did to me in 1989?"

no! (I've spent enough time with medics who are not fully "with it" over the last five months already).

I thought the dispute was about Saturdays (which they already work they say) no longer being treated as overtime. How will they be asked to work longer hours?

thank you Hic.

It sounds as though that was a short-term windfall for doctors followed by long term negative consequences.
Surely their union must bear some responsibility for negotiating such a deal without thinking through the consequences?

miss there is concern that docs will end up working longer hours, because the govt wants to remove the system that punished hospital management if they worked too many hours.

It's one of those situations where the official hours stay the same, but in practice there's nothing to stop hospitals totally flogging them

'For women, medicine is a far better career than law or business because the NHS allows them to work part time and wants them back after they've had babies.'

Wow! The OP was ignorant. Okay, that happens. But then when people who are doctors try to tell you how much junior doctors are being fucked over by this government so that soon enough, you will wait forever for your test unless you can stump up and pay for it yourself, and you come back with more utter tripe.

But lots of GPs work part time don't they?
And explaining (as Hic is doing) is better than just asserting I think....

I wish they weren't going on strike too - but I feel they have been left with little option. The government have blatantly ignored their concerns re: patient safety recruitment/retention, training and fair pay/working hours and have instead tried to use spin to try to convince the public that doctors are greedy part-timers who are being unreasonable. They (govt) have been and are being deliberately obstructive to negotiations - fucking hell, how many concessions have they given tube drivers to avoid strikes, and yet they won't do the same to stop doctors walking out!? The level of responsibility doctors carry is incomprehensible to most of us, and they should be fairly treated to reflect that.

My due date and induction date are right around the time of the planned strikes, and if God forbid that does affect me or my baby, it won't be the doctors I will blame!

Basically they are being forced to consider working weekends and to 10pm to be part of a 'normal working day' instead of 'anti social' which will make a huge impact on their pay levels. I have a friend who is a surgeon, she's been working for the NHS 10 years, she's hoping to become a consultant soon. She works her backside off. She has 2 small children which obviously she had to take time off for. Her male peers are a few years ahead of her now because they didn't have the same consideration (her choice, I understand that). She's working away from her family this year and only seeing them weekends because that was the job given to her by her local hospital trust. Doctors in hospitals work bloody hard hours already.

I fully support them striking for better pay/work/life balance. I pray to god I or a loved one don't need a hospital during said strike but I fully support them.

I think I need to step away from this thread. To have a chance of survival the nhs needs to retain doctors. If the very people who use the nhs cannot see the value in doctors being paid appropriately and have working conditions which protect both doctors and patients then Hunt will continue to dismantle it.

so the pay structure is complex Chiller?

I can see it's a job with a relative lack of autonomy compared to business (working 80 hours a week in business would tend to involve quite a lot of autonomous decisions about when to stop and start).

GP is slightly different, this contract is for Drs who are training to become GPs or consultants, but aren't there yet. The process can take more than 10 years! You're right though in that all these issues are interconnected: morale is low in the nhs because we do the job to help people. Because of mismanagement and underfunding, we often can't, which feels awful.

YABU

There has been no pay rise, in fact pay has been frozen for the past 5 years. Doctors already work nights and weekends, what is changing is that the government want to stop paying them for this work. Junior doctors wish they didn't have to strike, as well, but the government wish to impose a contract which will make working conditions even worse than they already are, resulting in exhausted doctors and putting patients' lives at risk. The proposed contract is not reasonable and would result in the end of the NHS due to doctors being forced to go elsewhere. We already have a recruitment crisis in medicine, particularly in areas like A&E and general practise. How do the government think that beating doctors harder is going to help??

Yes very complex! And you're right, Drs have no autonomy over working hours or even the structure of their working day.

WTF?

"Better for women because they can work part time after children"

Have you ever tried to find childcare that starts at 0630 for a 7am start?!?

If the very people who use the nhs cannot see the value in doctors being paid appropriately and have working conditions which protect both doctors and patients then ....

then those who do understand need to clarify and explain perhaps?

"Which they already work they say" - yes, doctors already run a 24/7, 7 days a week service. Weekend working currently falls in the time period of antisocial hours but with the new suggestions it won't - and won't be remunerated as such.

Shifts are already long, oddly patterned (to fit within the bare limits of legality so hospitals have to employ and pay as few as necessary) and havoc to fit family life around. This will make things so much worse.

Doctors will leave the NHS in droves. Private companies will take over. Doctors ironically will then be paid better for working fewer hours and probably have a much better life! But most doctors I know still in the uk are striking to save the NHS from privatisation even though they'll be better off out of it - because they value its principles and because they really do care about patients.

thank you for your thoughtful replies Chiller.

Do you feel the management systems are at the root of the trouble?

I can't help wondering, from what people (well, the polite people) say so far whether it wouldn't better to have LOWER pay but BETTER hours. (sorry for capitals).

YABU.

Junior doctors are paid a base salary and then a percentage on top called 'banding' depending on the number of out of hours shifts their rota requires. An 11% increase in base pay is proposed, but with the removal of pay banding, which will effectively add up to a large pay cut (eg 30%) for junior doctors. The term junior doctor refers to all of us below GP / consultant level, and as such as others have say we are talking about people who can be in their late thirties, with families etc - not just those who have just left medical school.

Make no mistake, we already run a 24/7 service covering evening / weekend / nights on-call and are quite happy to continue to do so. The government propose to reclassify evenings and weekends into 'normal' working hours to pay these times at base rate. There simply aren't enough junior doctors around to staff the rotas that would result from this increase in 'normal' working hours and to do so in conjunction with removing safe working hours limits would result in huge compromises in patient safety. Similarly, imposing such a drastic cut in pay will do nothing for the ongoing recruitment crisis and further undermine future NHS patient care.

Make no mistake, the proposed pay cuts are a huge kick in the teeth, but they are nothing compared to the patient safety issues that the government intend to impose upon the NHS (with a long term view to privatisation) and that is why junior doctors in England have voted for strike action.

"to fit within the bare limits of legality so hospitals have to employ and pay as few as necessary"

interesting the way you describe "hospitals" as something quite different from doctors. To me, hospitals are places run by doctors, just as law firms are run by lawyers.... Who is running these hospitals?

I work for the NHS, in Scotland.

A junior doctor can graduate at age 23 or so, and be placed onto a ward.

In my hospital, a first year doctor can expect to work a set of nights - alone - looking after up to 200 seriously ill adult patients, including patients on two surgical high dependency units. They are supported by around 4 senior nurses who will travel the wards to cannulate, take an ECG etc.

They don't earn more than £30000 a year, in fact most are on the average starting salary in the UK. After your pay comes in, you need to account for student loans, union fees, gmc fees, normal household bills, travel to work, uniforms (suits need dry cleaning, etc) , extra training, tax, national insurance..

If it wasn't for extra pay at antisocial hours (i.e 3am) most couldn't afford normal living expenses.

I've seen doctors collapse in bed at 5am only to be woken up at 5.15am not to get to bed again until 11am, after working 24 hours.

I've seen a doctor banging his head off a wall as he was so tired..

Have worked with people who have worked 12 hours, do 12 hours on call, and ware still expected to work another 12 the next three days.

Better working conditions dont 'just happen'. How can you moan about the poor working conditions in un unionised jobs without seeing the connection??

WTF?

"Better for women because they can work part time after children"

Have you ever tried to find childcare that starts at 0630 for a 7am start?!?

to be honest, yes, but in a profession where most women are pushed out after childbirth. I think it is sensible to recognise not just the downsides but the upsides of any profession.

I can't help wondering, from what people (well, the polite people) say so far whether it wouldn't better to have LOWER pay but BETTER hours. (sorry for capitals)*

Sure, so the government are going to give hospital trusts enough money to pay two junior doctors instead of one?

Whilst they simultaneously remove the working hours directive to allow hospital trusts to force longer hours on existing doctors?

Those two things don't match up.

The government wants the same single doctor to work longer hours for less pay.

Is that what you want?

Is this a competition to write a goady opening post and then follow it up with most ignorant questions / statements you can think of?