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.

Ok, so not quite same as me simply writing the pension cheque for the retired doctor in the next street each month?! I had visions of fewer and fewer NHS staff paying higher and higher contributions to pay retired staff as staff left the NHS scheme! I think I'll have to read your post again a few times to work it out

kittle Its awful the way pensions are explained to people. I live abroad but the local MP for my area is George Osborne. I was at a charity lunch when visiting my father in May and raised it with him. I think time value of money (compounding) should be taught as part of GCSE Maths using savings and pensions as examples.

There is a huge pension gap in the UK and the final salary schemes run by the government are wholly unaffordable.

Well, happy to take your word on that then. At the time of the pensions strike I did my best to try to work it out and concluded in a vague fashion we were still getting a good deal. I am aware I'd have to put a lot more in to my pension if I worked purely privately to get the same amount out.

Pension knowledge in the UK and the US is awful. There is zero will to change it because politicians don't want people to know just how bad it is and most teachers are also in the dark as to just how bad it is.

As for doctors salaries, I think they are fine the way they are. The cost of medical care has increased because of developments made. 30 years ago MRI scans were not there and ultrasounds were grainy at best, not the 3D imagery that can check organ detail and blood flow in the placenta. All this costs money.

Hmm yes thats a worry want2b.

I also feel doctors salaries are fine as they are and personally would probably accept a worsening of pay or terms and conditions within reason if I thought that would make the NHS more likely to survive. (I dont really feel that is the governments motivation though and what they are asking makes no sense.) I dont want my children to have to pay for our generation. I also very strongly feel we have to train more doctors and would be quite happy with a bit of increased competition - we have such recruitment problems at the moment. Our trust has tried and failed to get more docs from overseas and locums and agency staff are our prime reason for overspending locally.
Im not sure yet where my own line in the sand is. There were threats to make doctors redundant not so long ago and that was the line for some of my colleagues. It didnt happen as enough people jumped before they were pushed. None of them regrets the move and have told those of us who remain to be a bit less scared of the private sector or moving abroad. On a personal, looking after my family sense, I feel more relaxed as a result. Life would be worse in some respects but a lot better in others. I've started thinking more seriously about plan B if things get worse so if I have to I can do something else or move. On a political level and as a patient with insider knowledge I dont want to lose the NHS. All in all, the balance is still to stay for me.

The Government has rather a large mandate here.

Not really, because they are claiming that they aren't cutting pay, just rearranging it a bit, and that this will enable a 7 day a week health service ( whatever that means) at no extra cost.

At least Mrs T was quite clear that she was closing mines, not rearranging miner's pay so that they were getting a pay rise.

The Tories might believe that the NHS isn't sustainable, but they aren't prepared to admit it.

I am quite sure that in 10 year's time bright pupils will be applying to be doctors and they will be rewarded accordingly. People will always need doctors. The uncertainty is over who will be employing them and who will be their patients.

mamadoc You misunderstood. I'm aware you are not asking for a pay rise. The problem is finding the cash to continue paying you.

mamadoc

My question about the nurses was where were you when they were getting shafted and GPs were being given a ridiculously sweet deal. Since you care about them deeply enough to blaze a sacrificial trail an' all.

In comparison to similar careers it is not that much.

It's shed-loads more than most of us ever see. But it doesn't matter because that isn't the way a welfare state can operate, paying you 'as if' public healthcare was private. If you want market rate you should have gone into law. Or business. You knew how it was. I'm asking you what you suggest the government should do. And you are dodging it.

Stopping - if it's just about affording to continue paying docs why isn't the government looking at renegotiating the PFI contracts which are incredibly bad value for money? Why aren't we imposing contract change on them? It costs us billions, is incredibly wasteful and inefficient, yet there are no moves to even look at getting a better deal.

We accept lower pay...

This is turning into outright deception now. Are you aware that, because of perks like the pension, the public sector is still a better place to be?

I'm not resentful, exactly. I'm in the process of applying to study medicine abroad so I don't hate doctors. But facebook is flooded with posts from doctors saying they have the worst job in the world in every way - and if this thread is to be believed, doctors do have a romanticised notion of what goes on in other professions. This wouldn't play well with the public if it came from any profession. Many of the chief complaints you are making are shared by other professions that don't have the enormous rewards (relative to most people in the country, rather than city fat cats, which is perhaps a fairer way to look at it given the financial circumstances for most tax payers in this country.). In a and e recently, I sat next to a woman who was there with a horrible wound. She was a classroom assistant. It's not just you dealing with aggressive people. In the unit that night, there were nurses and receptions, also there in the middle of the night. It's not just doctors.

Jeremy Hunt was always going to be deeply unpopular but your suggestions for what he ought to do are not exactly coming thick and fast. Saying 'just raise taxes' doesn't really engage with the issues, for instance how feasible would that actually be to do now and how much of the problem would it solve?

FWIW, my lawyer friend still works for (relative) peanuts in his mid thirties. As does my brother. He also works longer hours than his best friend, who has a very nice 9-6 job in oncology, no weekends.

But your friend could choose to stop being a lawyer...there's no shortage of lawyers

Choosing to stop being a doctor (in the public sector) is exactly what you're all threatening to do!

We could lose oodles of applicants to medical schools in this country and still fill the places. I agree that keeping people in the jobs is proving difficult but there is a real problem when the pot of money is simply too small.

Shorter wait times did used to be an advantage of going private but now NHS wait times are much better...especially cancer.
Very much not the case in my personal experience or the experience of others in my circle.

if you are rich enough
I'm not rich. Comfortable, yes a bit. We paid privately because we felt that we had to, having watched an immediate family member wait four months to be diagnosed for a condition that it was obvious she had and that ten minutes on Google told us she would be dead in 3-6 months without treatment. I have been honest in saying what everyone knows, that the NHS is inadequate. I have my own ideas about how doctors are responding to Jeremy Hunt's plans to make it less inadequate. But you're quite right, I'm not going to die unnecessarily to make a point.

Sometimes it does feel like preaching on deaf ears

I think it's difficult to see where we are coming from until you have actually worked as a doctor

Whether people like it or not we are striking and the necessary provisions are being put in place, probably JH proposals will go through lets just sit it out and watch the NHS crumble because it will

We could lose oodles of applicants to medical schools in this country and still fill the places

Applications have fallen by over 10% in the last two years:

bma.org.uk/news-views-analysis/news/2014/october/have-applications-to-study-medicine-fallen

www.pulsetoday.co.uk/your-practice/practice-topics/education/medical-school-applications-decrease-as-negative-publicity-takes-toll/20030395.fullarticle

Can't see that trend reversing this year with all the publicity over pay. Be careful what you wish for stoppingbywoods - if the brightest school leavers stop wanting to be doctors we are in trouble.

stopping. I haven't heard 1 doctor and I know a lot complaining they have the worst job on the world. I have seen a lot of them explain how hard their job is day to day, very different

So Stopping thinks JH's plans would make the NHS less inadequate. You have no idea. Not even worth trying to educate. She has friends already, she "knows".

how many people on here have been on 8am until 8pm....then been 'on call' from 8pm to 8am (yep 24 hours) and had a very busy on call period where they havent stopped all night.....people dont stop being critically ill because the doctor or nurses need a 30 minute break in a 12 to 24 hour shift.....you cant just leave... your 'nowadays professionals are expected to be available all the time' is ludicrous.....everyone needs to sleep, time off with family, holidays.....or do you think doctors shouldnt have a personal life or relationships.....unless you have ever worked in a hospital with sick people and know what goes on you have no idea what it is really like!

Surprised to find people think the state pays for doctors' training.
You pay for a University (tuition fees) course like anyone else. It's about twice as long, and the clinical part has much longer terms so it's harder to have a holiday job. Otherwise just the same.
Once you've finished that you work as a foundation doctor. When you've finished working for the day, you go home and study (in your own time) for further professional qualifications - the studying is a necessity as what you can learn at med school obviously isn't everything you need to know. The state does not pay for your courses or exams (about £1000 for the last one I sat - and that was compulsory).
I think it will be harder than ever to recruit to jobs in anaesthetics, A&E, acute medicine ironically these are the people you really need to be present 24/7 - if anti-social hours are not recognised as such. It's aready a problem.

stopping -a very nice job in oncology 9-6 . Really? You thinking working with extremely ill and possibly dying patients all the time is a "nice job" . It will be rewarding but harrowing and at times very stressful. And Im sure he doesnt always leave at 6 . Get real . And by that I am not saying your brothers job as a lawyer is cushy or well paid-in fact I know nothing about it. But dont pretend you know what his friends job is like.
Good luck with your application for medicine abroad. I have to wonder why you would want to work alongside such a dreadful group of people

If oncology work is such a cushy job (I mean, really), why are 150 consultants putting their name ABx coming out to say the proposed changes to the contracts will significantly adversely affect their speciality. They are having trouble recruiting already.

Stopping- you are applying for medical school? Well I quite genuinely wish you the very best of luck.

I must say I am surprised you want to be a dr given that you seem to really hate us.
Judging by your comments we are incompetent (unable to diagnose a lethal condition that you could figure out from Google), overpaid, lazy and greedy. I suggest that you try to convey slightly less contempt at interview.

It is quite ridiculous to suggest that a senior Drs pay should be similar to a teaching assistant. The level of responsibility, the training time and academic qualifications are much greater. The comparisons I am suggesting with lawyers and bankers are realistic ones. I can absolutely assure you that I personally could make more money for less pain doing something else. I have an Oxbridge degree and a Phd plus a string of post grad qualifications. My friends who have quit medicine are better off than me. I doubt that their management consultancy clients physically assault them either.

I can walk away at this stage after 15 years NHS service to the private sector. I have said on this thread loads of times that I never, ever will but I do have that option. The junior Drs who are going on strike can't. The private sector only wants fully trained, experienced, marketable consultants.

Our pay is affordable. It's been frozen for 5 years. I thought this country was supposed to be coming out of recession now. JH wants to cut junior Drs pay (and later on all NHS staff) so that he can cut taxes because he wants a smaller state. I don't see why junior Drs should pay for Tory tax cuts.

My solution of raising taxes is perfectly reasonable and equitable. It would include raising my own taxes so equivalent to a pay cut but shared across all higher earners not just those mug enough to work for the NHS. This country spends 9% GDP on healthcare. The US spends double that! Other countries praised up thread for great healthcare eg Canada, Denmark and the Netherlands pay 12-14%. If we want great healthcare we should be willing to pay a bit more.

No offence but there are plenty of other professions that require people to study outside of work to achieve qualifications that they need in order to progress - granted the majority of the time the company will agree to finance it but lets stop making out that its only Doctors who work long hours and have to then study for additional qualifications after work too. That simply isn't the case.

There is a 2week maximum wait to see a specialist for a suspected cancer diagnosis. That again is just factually correct.

The only way that you could wait a long time to see a specialist about a life threatening conditions if the GP did not realise it as such and referred on the routine pathway.

The 9-6 oncologist never does any out of hours work then? Doesn't have any ward or hospice patients to cover at the nights or weekends and doesn't participate in the hospital on call rota?

It could be possible I suppose. Like I said there are specialties that people deliberately choose that are more clinic based but I tend to think of those more as dermatology, rheumatology not cancer.

The point is that it is not typical to have a 9-5 job as a dr and that he WILL absolutely have done 10-15 years of full shift work to get there. You cannot train in medicine without doing that it is impossible.

No-one at all is saying that doctors are the only ones to work long hours
No-one at all is saying that Drs are the only ones studying outside work time
No-one at all is saying that being a dr is the worst job in the world.
No-one at all is saying that Drs aren't well paid at a senior level and get a good pension.

All the consultants on this thread have repeatedly acknowledged this.

All we are saying is that:

It is not fair for junior Drs to have a 30% pay cut for doing the same work
Patient safety will be adversely affected if the penalties for breaching hours limits are removed
Recruitment into acute specialties that need an out of hours commitment will be affected if antisocial hours pay is cut and emergency care will be worse not better

Overall medicine is a hard job. As I am sure a lot of things are a hard job:
Entry requirements are high and it is competitive
It is long antisocial hours for 10-15 years at least and career long for some
It requires a lot if study and out of pocket expenses on fees, exams etc
It is very unstable: For the first 10-15 years you move job every 6months to a year
It is very inflexible. For 10-15 years at least and career long for some you will live your life by the on call rota and never make plans more than a few months in advance
It is physically demanding on your feet for long hours on the wards it in theatre
It is emotionally demanding. I think most Drs will at some point have been physically assaulted and surely all of us get verbally abused.

On the other hand
It is emotionally and intellectually rewarding. It feels really good to make people better.
It is high status
It is well paid at higher levels
You get a good pension
You do get sick pay and maternity pay although not particularly generous.

Well boo hoo I have no sympathy because how many Junior Doctors stood by and supported the tube drivers who striked a few months back because they were effectively have the same issue around having to work anti-social hours for less pay. Infact I saw lots of insulting comments thrown in their direction and I bet quite a few of them came from Junior Doctors too - complaining about how they would not be able to get home and it was unfair for the drivers to strike. Yet here the are finding themselves in a similar situation.

This let's reduce everyone to the lowest common denominator is absurd - there are very few jobs comparative to that of a JD.

As someone who does work in a profession touted on this thread as somehow comparably hard I'm cringing at the idea that my job is anywhere near as tough. By way of example:

I work long hours. I've never worked 24 hours.

I always work for a few hours on holiday - I've never had a holiday cancelled.

I often work through lunch and sometimes through dinner - someone brings me a menu and I order delivery on the company account.

I have to study - the company pay the tab and give me study leave.

Clients get frustrated - I've never been assaulted.

I have never had to worry about finding 7am childcare - because I have an amazing nanny (who earns the same as many JDs)

My poor decisions might cost money - no one will ever die as a result.

Virtually all of us are end users of the NHS - is it really acceptable to you that you are treated by someone that may not have slept for 24 hours or has not eaten? That the service is held together by the good will of people who are working themselves sick? Why do people not feel this is totally unacceptable?!