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.

kittle Thank you for explaining this. I suppose what I feel is that the NHS pays consultants a very reasonable wage and in return for this they should work relatively long hours for the NHS. Many people have said that they already do this and don't have time to do private work. Good. Others have said that consultants do private work and have every right to do so. (BTW it's conflicting stories such as this that makes me suspicious - there are so many).

Doctors who are trained by the state and paid well shouldn't have time left over (this was my original point jack). If the reason that they do have time left over is because they're too expensive to pay more (as Kittle suggests), then they should be cheaper. If the NHS is in such difficulty and doctors are so worried that patients care is being compromised, why don't all earning over £60 000 plough it back into the NHS? Or all those working part-time go full-time? Given that many of them were trained virtually for free? You can't have it all ways.

When it comes right down to it, whoever liked a pay cut? They're going to be snippy about it. If we're talking about long, anti-social hours with heavy responsibilities for low wages, why aren't we talking about nurses? I don't know how doctors have the nerve to complain in light of what nurses are doing for so much less - without the promise of future glory.

The issue of consultants working privately on the side is more complex than right or wrong - because it leads to an overall picture where two standards of healthcare are being provided, one for the rich and one for the poor.

My grandfather worked long, anti-social hours as a doctor for a relatively modest salary. It's never been a secret that people get ill at all hours and need caring for at all hours, and I don't think doctors have ever expected someone to reimburse them for that inconvenience before. Which is just as well, because there has never been the money to do that and there still isn't.

DimpleHands RTFT (even though it's long)

I think even the OP has conceded that the way a Dr works out of hours is not in any way comparable to the way a lawyer works overtime.

When you have to do extra hours yes, it is 'expected' for no extra pay but I bet you get to choose to work from home, when to have a break and when you've had enough for the night.

I bet you don't do those extra hours at 3am in the morning or in preference to attending a friend's wedding.

You do choose to do the extra hours. You are not rostered on to attend your place of work all night and all weekend. If you don't like it you can walk away and choose a lower pressure, less well paid job. The NHS is the monopoly employer of Drs there is no choice in any of this at a junior level apart from to quit medicine.

I bet you also get a bonus for your hard work and your courses, study and professional indemnity paid for.

I bet your employer even puts on a Christmas party and buys you coffee and pens.

It is not 'being paid overtime' in the sense of work more hours, get more pay. There is a flat rate out of hours supplement paid to those who work the worst hours and this is what the government wants to cut. Thus driving Drs out of acute care.

I and others have explained the complicated machinations of it up thread.

I will concede that we have a better pension and job security. Sick pay and maternity pay are not particularly generous.

Yabvu.

Nurses work long shifts, usually 12 hours three or four times a week. They probably should earn more.

A junior doctor might do 12 days in a row, with no days off, up to 12 hours a day. Would you want that person making a life critical decision for your care? Taking out your appendix ect? You fancy working those hours, missing your kids bed times, birthdays, family events? At least now they are paid for (some of) it.

Given the hours some junior doctors work I don't even think the hourly rate is probably comparable to many other professionals.

mamadoc you explain the nhs really well.
But...

DimpleHands, you said "Work conditions in the private sector are an awful lot harder than they were 10, 20 years ago. As a lawyer, I don't get paid any overtime yet regularly work 20-40 hours over my "contractual hours" every week. This is absolutely expected and if I didn't do it I would be fired. And I don't have the job security or benefits, pension, etc. that NHS doctors have.

I really don't agree with the doctors striking."

You are a lawyer - can't you see the connection between unions - strikes - and better working conditions. Sounds like lawyers need to start unionising tbh

Stopping. I am an NHS consultant who does not do private practice so I have no axe to grind. It's not my bag and I don't care a whole lot about money.

Private health care is not really better in my view. The sheets are nicer, the food is nicer, the other clientele are quieter but fundamentally I can't agree it is better care. In my view it's like private education you're just paying for the frills and the exclusivity.
It's not a 2 tier system therefore. When the shit hits the fan I would rather be in an NHS hospital with better facilities and staffing eg ICU and on site anaesthetist than a private place.

I work slightly part time (well that's what they pay me for in reality I work from home most nights too) so that I can have a little time with my DC. I do not agree that the NHS should 100% own me and I should not have the choices other people have to work part time or do something else outside work even if that something is to make money. That is a pretty ridiculous, exploitative idea.

When the NHS was set up consultants were allowed to do some private practice alongside NHS work to attract them to work for the NHS. Otherwise they could have chosen not to do any NHS work at all.

I have a friend who emigrated to a country with a private and a public healthcare system. He soon realised he could make much more money doing exclusively private so that's what he does. That's what all the experienced surgeons do out there. The public hospital is staffed by juniors and those not good enough to go private. There is a 2 tier system for you.

Allowing private practice retains the best surgeons within the NHS by allowing them to make a little extra typically on one afternoon a week.

“Given that many of them were trained virtually for free?” what?! Have you rtft? They have huge student loans to repay and have to pay out their own pockets for training materials, exams, cpd training etc.

“or in preference to attending a friend's wedding.” iirc there are 3 posts relating to drs having to rearrange their OWN weddings due to inflexibility of shift rotas.

I think it's highly likely that if the actual hours and actual pay were analysed many JDS especially 1st and 2nd years are barely making minimum wage!

But...

I don't understand lawyers?
No probably I don't. So I refrain from commenting on their jobs unless provoked!

When it comes right down to it, whoever liked a pay cut?

You are missing the point that there is no reason for a doctor to work for £60k a year when they can work privately, work abroad or change professions - except we rather need them to work for the NHS. The same is true of nurses - it's not a case of either or.

You can't expect to retain staff if you pay below the market rate for skills and services.

This isn't comparable to other union action where workers have no other choices. This is doctors striking as a last resort before they just leave.

I felt your impressions of life in the private sector were about as accurate as my impressions of lower paidNhs work. No offense intended it is just more grass is greener/ comparisons being odious

You got there before me yes:)

A lot of people are mentioning nurses here, the JDC changes are relevant to this. They are the first step in the chain to huge contract changes across all NHS staff, it's already been said that once the changes to 'unsociable hours' go through they will have to apply them to other categories of staff starting for those on Agenda for Change contracts - this will mean large pay cuts for others including nurses.
Cynically I'm sure they started with the junior Drs because they knew that they could spin the 'greedy drs earn loads more than the average' angle whereas of they'd started with nurses, public sympathy would have been hard to counter.

Wonky yes re nurses. I simply trust them

You can tell me where I am wrong about it if you like. That will be an education for both of us then.

I am married to a private sector worker and both my sibs are private sector workers plus a lot of my friends. I am not the kind of Dr who only knows other Drs. Therefore I don't think I am in complete ignorance but I am happy to be corrected.

The only lawyer I really know is a barrister in corporate law in the city. He appears to do pretty well for himself.

merry It seems that doctors are very emotional when it comes to getting people - and the NHS chiefs - to understand how betrayed and stressed they feel etc etc. But as soon as a comment about some of the very good salaries are made, there's a complete sea change and we're talking about market rate etc etc. Maybe the NHS are trying to take a hard-nosed approach also? Goodness knows, I have relatives who leave lawyers working through the night to have contracts ready when they return to the office in the morning - I expect they feel rather disillusioned and didn't foresee that happening in law school but it's grown-up life, isn't it?

You know what I know about lawyers? Absolutely rubbish at treating elderly people with dementia, car crash victims or cancer patients.

And the NHS is quite clearly not retaining staff or generating the money to pay them (as well as they could be paid privately) anyway - so this discussion is pointless, in a way. Someone has to suffer because it's just not working.

Lol re lawyers! It would fill up the whole thread!

mamadoc
As a self-acknowledged hypocrite, I have paid for private healthcare in the past. Here are the ways it was better.

• Drastically reduced waiting time.
• Consultant had much more time to look at my problem.
• Consultant had many more options to offer me in terms of investigation and treatment.
• Follow-up care was as the consultant felt necessary, not whatever the budget constraints would allow.

"Cynically I'm sure they started with the junior Drs because they knew that they could spin the 'greedy drs earn loads more than the average' angle whereas of they'd started with nurses, public sympathy would have been hard to counter" I don't think that's cynical I think that's reading the situation perfectly!

In addition what I've read elsewhere by JD regarding the JDC and the strike is that a lot of them get this and realise if they don't make a stand the govt will target nurses, hcps, physics etc next! I think that's partly why nurses have been so supportive of the strike.

Merrymouse well said!

maid I audited 5 hospital groups here in NJ. In total it was more than 35 hospitals and they all had the $200k beds that relieve pressure sores. Of those 35 hospitals 15 served areas which are primarily covered by Medicare and Medicaid. I don't know what it's like elsewhere in the country though. I'm sure in deepest darkest Tennessee it is possible that the standards are not as high.

merry I think the two groups are comparable. Big4 have pretty high standards as to who they hire. Everyone has a solid education and after leaving go into junior management positions.

I have already explained why it's not the same as a lawyer.
Is there a safety issue if a lawyer is tired and makes a mistake? Will anyone die?
Will they get some time off when the job is done? For Drs the job is never done, patients will always be with us.

I don't think I can explain any more why it's not the same cf many previous posts up thread

Do you think Drs should have no recognition for antisocial hrs then stopping?

If there was no recognition of it then Drs will choose jobs with lower out of hours commitment and the recruitment crisis in A&E will continue and spread to paeds, O&G and acute medicine.
That's not immoral it's just human nature and common sense.

mamadoc But surely you can see that the state (i.e., the people) have paid for you to receive your training so you do owe them, especially when your salaries are so much higher than anyone else's? At any rate, you don't owe them nothing and if you want to owe them less, I suggest you take a pay cut so that we're paying you less.

And I really do feel that accepting an exorbitantly expensive medical expensive and then emigrating is rather...selfish. Not exactly a last resort. Emigrate first - there are lots of people wanting to go to medical school in this country. The NHS didn't have that cash to chuck away.

So stopping completely ignoring mine and I think other posts about training? Plus drs pay tax like everyone else and contribute to their 'free' training that way too!