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.

education

A lawyer calling drs selfish?

Oh and I really don't see what the problem is with a doctor who decides to supplement their income with private practice. They should be allowed to do this if that's what they want and their NHS work doesn't suffer for it.

I will most likely have to leave my big4 firm because DH owns a business and I am not allowed to be a director by our independence people. This isn't the end of the world by any stretch but extrapolate this to the NHS issue and if you ban private practice you risk driving that group of consultants out of the NHS.

Stopping--,,I think drs like mamadoc are not the problem

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?

Except it's highly likely that those contracts could have waited, and that if anybody made a mistake it was all sorted out in the end.

People pull all nighters for the most ridiculous ungrown-up reasons and it's debatable whether long hours improve efficiency.

That really doesn't have much to do with the fact that we need doctors (and to keep them we need to pay them properly) and that tired, overworked doctors are dangerous.

I don't see it that way at all.

The state did not exclusively pay for my training. I paid a lot of it myself in tuition fees and then all the postgrad exam fees. It took me til I was nearly 40 to pay off my uni debt.

I am paying them back handsomely and have been for many years by working hard doing an excellent job. AND also now by paying higher rate tax and never using any state benefits not even child benefit.

I see it that the state has a lot more out of me than I ever had out of them.

I could work in the City like my dbro and many of my uni friends and I doubt I'd be slumming it in my terraced house with my 2nd hand car. It's fortunate I don't believe in private healthcare or education as I can afford neither!

I don't want more money but i don't feel I owe the NHS a payback.

People pull all nighters for the most ridiculous ungrown-up reasons and it's debatable whether long hours improve efficiency.

Rofl!

kittle I believe the low spend per capita by the NHS is not so much of a good thing. I think it's more indicative of chronic underspending rather than value for money.

There is a middle ground between the U.S. and the UK. If you look at where UK doctors are going it isn't to the U.S. but predominately to Canada, Australia and NZ. I think those are the systems the NHS should be looking at, not the US. All 3 spend more per capital than the UK.

Well it depends on how you think wages should be set really. In the private sector if there is more demand than supply for a particular group or service wages go up. I imagine they would laugh if you suggested that the prices should reduce just because they were too expensive and they'd tell you to find your cheaper service somewhere else. Simply saying 'but we pay you' wont work if there is someone else willing to pay more. We cant employ people at NHS rates right now and candidates are actively saying they would only work for us for more money. One recent candidate walked after we refused to pay him nearly double the NHS rate and we still cant employ anyone for that post. How is reducing those rates going to do anything but make that worse?

The situation is tempered because of the loyality to patients, the NHS and the idea of provision for all and the vocational aspects of the job. (Not that other professions don't do this either eg lawyers working pro bono).

As for nurses, yes they do work hard. So do many many people, carers, chefs, taxi drivers, bankers, cleaners, lawyers, plumbers. Maybe we should all be paid the same.

However I doubt we'll hear the government taking that line, nor the idea that everyone earning over 60000 should put it back into the NHS tax

Personally, I'm all for redistribution of wealth through taxation and believe the state does a better job than the private sector in providing good quality and value healthcare.

If you want market forces to take over then I personally am highly likely to benefit in terms of income and quality of life as will most doctors. But the country as a whole will pay more and I worry that those that most need support and the most vulnerable will suffer.

I agree want2be. It is underspending. My point was that we get extremely good value for the amount we spend.

MissTriggs indeed!

Good post KittleKattle

My service nearly got taken over by Virgin Healthcare recently. I was very glad it did not but occasionally I do wonder if there would have been free rail travel or airmiles or something.

That's the thing. It's not good value for money when the care isn't of an excellent standard. I live abroad and see/experience the standard of care in other countries. In certain areas such as obstetrics the standard of care provided by the NHS is third rate compared to Denmark, Canada and the U.S. The low level of spending is why this is the case. The doctors and nurses are of a good standard, doing everything they can given the constraints they face. It's just not sustainable and this is a breaking point as money needs to be freed up to pay for PFI contracts.

Rather than cut wages there needs to be a rethink of how the NHS is paid for. That does not mean going private but I do think it means expanding the number of services where a copayment is required. I also think the NHS undercharges foreigners. Charge them proper private rates that are more than what they pay in their own country. The NHS is there to serve british society, not the whole world. It's a huge burden on the system to have to care for those from outside the UK resident population.

I also think there needs to be a rethink around immigration. There should be a requirement for recent immigrants to pay into the system, I.e. pay a supplemental insurance payment for the first five years they reside in the UK. Also non Dom residents should pay this supplemental insurance or pay private rates. My father is a non Dom and insists that he pays private rates when he uses the NHS.

I don't agree that NHS care is 2nd rate.

You need to look at outcomes not subjective experience.

If you check our outcomes I am pretty sure that maternal and neonatal death rates are higher in the US.

The NHS is efficient. It does not spend money on extras that are not evidence based.

It is true that some interventions that are standard in eg the US are not done in the NHS but sometimes less is more. Too much medicine can be just as bad as not enough. US c-section rate is sky high and many of those are unnecessary.

It stands to reason that unnecessary tests and interventions will be incentivised in an insurance based system. NICE is an amazing thing the UK has. It's guidelines are absolutely evidence based so that worthwhile things are done and things that are not worthwhile are not done.

It's not perfect but it is in no way 2nd rate and for the money it is amazing.

People who say it's unaffordable fail to realise that someway or another you will pay. The NHS is funded through general taxation. If you don't like that you can pay through an Insurance system but you will still pay and you will pay more and it will be more unfair to the poor, the sick and the unemployed.

Is it better for some rich people to have better care and someone to park their car for them when they arrive at hospital while poor people's babies die due to lack of health care? Because thats the situation in the USA where overall maternal and neonatal outcomes are worse than in the uk, but those with access to top of the range private healthcare dont have to think about that

Our rates around maternity could be much better - they are bad compared to the rest of europe - but lets not look to the usa, where their life expectancy is less than ours, for answers without having eyes wide open - it is a good system for the rich only

ak-hdl.buzzfed.com/static/enhanced/webdr01/2013/9/10/13/enhanced-buzz-wide-5417-1378832798-28.jpg

Breaking Bad spoof

Tbh the whole thing is weird and there's a lot of double think. I hate the" try to change it and we are so powerful we will earn even more" argument. Clearly all the drs who are in it for the money fall within the cohort of jds at some point so who do I trust? i just dont know and feel that stoppingb put it well

toppingbywoods
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?

Do those same lawyers have to do those overnights on a rota system they have no control over or only when there are spcial jobs on the go. Presumably if they are very tired they can stop for a break/coffee/food. When I was a JD in the eighties I did work the old rota systems when I started at 9am on Sat and finished at 5pm on Monday .Sometimes I had no sleep at all. I couldnt get to the canteen during opening hours because I was too busy. Its not like writing a report- if someone is ill you have to keep going. I cried sometimes because I was so tired. I cried because I had to break such bad news to people. Junior doctors died on duty. We cannot go back to that. I fully support the strike.
I am a consultant now. I am paid well for what I do. I dont do private work .I work many hours each week that I am not paid for. I believe many other jobs are very stressful too, just in a different way . Jeremy Hunts job is stressful but he doesnt care about real people. He is targeting the junior doctors because the conservative government want to privatise the health service but dont want to lose votes so they want a scapegoat. If docs are seen as priviledged middle class wingers it plays right into their hands.
If the general public believe their propoganda that doctors a lazy bunch of uncaring moneygrabbing people they will be delighted . A few doctors are but the vast majority go above and beyond their duties even if they cant always get rare or unusual diagnoses right . Most juniors and consutants I know are heartbroken because they dont have enough time or resources to provide the quality service they could if things were not so stretched .

Maybe when we lose the NHS people will appreciate what they had and how little it cost . Maybe patients will also start to take resposibility. If you are actely ill you need A&E /admisssion. Other things can wait until the next day or for a few days .
My DH is a GP He goes into work on a Monday am at 7.30 to offer early appointments . Hardly anyone turns up. He used to do Sat am clinics-hardly anyone turned up. If they did iy was often with a sore throat

But the juniors aren't arguing for more money. They are happy with what they get now,

The just don't want their future colleagues to earn less.

A payrise should not come with pay protection.

The government should not be removing the financial penalties that prevent employers from over working juniors. That is like taking the tachographs out of lorries and trusting their employers to limiti their driving hours.... Oh wait, that used to be the case and they put the tachographs in for safety reasons.

And if any other NHS staff group believes that Saturday being the new Monday is restricted to junior doctors in my opinion they deluded.

"Junior doctors died on duty" I remember this happening.

The NHS can't exist in its current form. This issue is just the latest in a long line of cuts because there isn't the will to properly fund the system at the political level. When you look at the spend per capital and quality of care in other countries it is far better compared to the UK. When it comes to delivery I've never heard so many horror stories as I do from the UK. You don't hear the same type of complaints about the treatment recieved from German, Danish, Canadian or Swedish mothers.

While some may mock having a service provided that parks my car for me, I think it makes a whole lot more sense than me having to leave someone in need of care at the front door while I spend 15-30 mins parking my car. As it was my son was really sick. He was floppy and not very responsive due to his high temperature. I'm also five months pregnant. So in the UK I would have either called and ambulance and followed in the car with DD or driven everyone together, parked the car and wheeled both kids in the double stroller into A&E. I think having the parking service is a great idea myself.

Another thing is that Ive not said the U.S. is the model to follow in terms of funding. I do however think they have some working practices that the NHS should be copying. For funding I've been clear that I think they should be looking at Germany, Denmark, Canada, New Zealand and Australia.

There is a gap in service with obstetric care in the UK and the stats show that the Us has better outcomes around delivery compared to the UK. The issue in the US is the mortality rate in the 6-12 month age. It's something DH and I have been exposed to via our charity work. The contributing factors are things like poor housing. Much of the housing in the south (where rates of mortality are highest) was found to have mould issues and its very unhealthy for both the very young and the elderly. Yes the rates are too high in this group but for the past 20-30 years they have been trying to tackle it.

So want2bsupermum who are you not going to treat?

Imposition of private healthcare in the Uk will increase the bells and whistles cover to the affluent Middle classes but dramatically reduce the cover for everyone else.

The U.S. has massive discrepancies in outcome data and those who have comprehensive cover are routinely over investigated - there have been lots of articles about this by well respected US physicians.

The European models get more money with more oney the NHS wouldn't be in crisis and we wouldn't be having this discussion.

Yes, the NHs can be frustrating but everyone in society gets high quality evidence based care. That should be something that all countries aspire to.

I have said it once and I'll say it again.
You would have to be a prize idiot to go into medicine for the money.

Why would you not use your excellent brain in banking if you just want to make money? Doctors are generally altruistic people who want to help others but that doesn't mean we somehow owe the NHS our every waking moment or shouldn't expect a reasonable professional salary.

A very few mainly surgeons make substantial extra money in private practice. Most of us are paid a fair wage but nothing extravagant, no extras, significant out of pocket costs and a hell of a lot of stress and antisocial hours.

Most consultants on this thread have said they don't do private work. Junior Drs can't do any private work. It's a red herring.

Standing compared some Drs doing private practice in their spare time to corruption and suggested that I should give my every waking hour to it and take a pay cut so that I can personally save the NHS.

Unsurprisingly I don't agree.
I am happy to pay more taxes for it. I just think it should be shared amongst all tax payers rather than Drs personally take the whole cost.

What part of my posts are you not reading. I've been very very clear that the U.S. is not the model to follow in terms of funding. Germany and Denmark both have a system with 100% coverage of residents via a healthcare payment. You then also pay additional costs depending on your income and services used.

As an example my SIL has been quite sick for the past two years. In Denmark she is paying nothing for her care or prescriptions. My MiL had her first hip replaced and paid a fee for the surgery and medication afterwards. The fee was set based on their income but was an affordable amount.

Hate to say it but there are funding gaps in the NHS and we all know it. The first thing that springs to mind is GBS testing. The UK has also only just given the go ahead for the harmony test. I had DD in 2011 and would have had to endure an amnio which is far higher risk and more expensive than the blood test.

Overall, what politicians are doing to the NHS is wrong. Junior doctors are right to stand up and refuse the new contract. Instead of driving down wages, which we all agree is a short term fix at best, they need to build a more sustainable system.