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.

Hi OP.
Firstly in the spirit of honestly I am a 39 year old junior doctor.
Secondly, it is a hugely complex issue, not helped by government spin and dubious media reports.
Thirdly I'm sorry you have had bad experiences in the NHS. Obviously I cannot comment on your circumstances but I think every JD has been in the position of not being able to provide the care we want to because we have too much to do. And we hate that because it isn't fair to patients and it can be dangerous.

It is impossible to explain the whole row in a post but some of the main points are

1. Contract removes current penalties (fines) for hospitals who overwork their Drs. So though govt says reducing hours they are removing penalties ( like reducing speed limits but removing fines and points). Tired Drs make mistakes.
2. We don't chose the hours we work and the "extra pay" reflects the fact that an a&e Dr works way more evenings and weekends than, say, dermatology or radiology. We already can't fill a&e, obstetrics, anaesthetics jobs so this change in pay will affect the busiest and most vital specialties the most. Drs are already leaving and we cannot afford to lose any more
3. Govt say they are trying to make 7day NHS. We already have this for acute stuff but not elective eg dermatology appointments, knee replacement. Govt want to provide 7 day service with no extra Drs. That means more hours per Dr or reduced Dr numbers during the week. All Drs would agree that 7 day emergency service vital and that there is room for improvement in some areas but we cannot afford 7 day elective. We are already run off our feet weekdays. Also Drs don't run the hospital. For 7 day service need nurses porters radiographers phlebotomist etc. would be incredibly arrogant to think we could manage without our colleagues. Also one of main weekend issues is inability to discharge because no social services available. So every Dr in country could work every sat and sun but we cannot make the NHS work without all the other things

None of us wants to strike and we hate the idea of it but I and many of my colleagues truly believe that the NHS as we know it is finished if we don't stand up to this. Also all emergency care will be covered by consultants so hospitals will be safe on strike days. What will happen is clinic appts and routine ops will be cancelled which I know can be devastating if you are waiting for these.
This is not all about the money though my family cannot afford a pay-cut. This is about the future of the NHS for me and my family as patients, not about me as a Dr. Drs in U.S. Get paid a lot more than we do. But I never want to be in a position where I have to offer substandard care cos someone doesn't have right insurance or money to pay. If you have questions please ask and I can understand your frustration. But please ask yourself if this was an 11% pay rise is it likely that we would do this to ourselves? Your working environment sounds horribly unsupportive but I feel we all of us deserve better than that. And honestly if you need to go to hospital as an emergency on strike day the care will be there.

As a nurse I 100% support the doctors . How would you feel op if they doubled your work load and halved your pay !

Living abroad has opened my eyes to how badly the doctors and nurses are treated in the UK. I took DS to the ER last night. I have already seen the bill which was $15k but the insurance company will negotiate that down to about $3-4k. Our copay will be $300-400. I don't mind paying this because we pay much lower income taxes compared to the UK and the difference we save as we know to expect these charges.

The care at the hospital was amazing. I drove up to the front door and a porter took DS (2.5 so a toddler) in for triage. There was a person who took the car and parked it for me so I could run in after DS with DD (2nd porter came along with a wheelie bed for her as she was fast asleep). I got into the ER and was directed to the triage area where there was a lady printing out forms for me to sign. DS's pediatrician had already called ahead and emailed over his details.

The triage nurse was very concerned about his temperature which was 104F and DS was out of it. Care started right away with two nurses wheeling him into a room to weigh him and confirm his height. Two specialists came in to assess him and within 15mins of arriving they had him hooked up. The lady from the front desk had seen I was pregnant so asked if I was ok plus said they had a spot for DD in the 24 nursery attached to the hospital.

That sort of care doesn't happen in the NHS because there isn't the money for it. I would have spent 15mins trying to park the car at the other end of the car park. Had to get both kids into the stroller and wheel it up. Getting there I would have been waiting at least 20min to see the triage nurse. The A&E doctor would have been dealing with a couple of drunks and filling out paperwork before coming over to DS and taking a more detailed history because nothing would have been communicated before our arrival.

The nurses and doctors were all very professional with none of them exhausted. They have tools to help them cut down on the paperwork. Last night all the doctors and nurses were using their own tablet to record everything that is updated so everyone can easily see what care is being given, or not.

The NHS boasts how they can provide the same outcome for significantly less money. Well I would prefer to pay the extra and have the better care.

But I thought they got a pay rise?

You have clearly swallowed Hunt's bullshit.

I support the strike and I have an appointment in the 1st December which will probably get cancelled.
I work as a senior health professional and I see the kind of stress junior doctors are put under for less money than me. I wouldn't do it.

Scottishlady

junior doctors are paid extra for working antisocial hours currently but generally they have no say in which hours they work.

thanks that is helpful. what I'm picking up is a combination of high responsibility with lack of autonomy (which must have knock on effects on the workplace dynamic). I don't know how much of that is an inevitable part of the job and how much is the distorted "system".

To compare, I had to go abroad after the first of my wedding guests arrived and before my wedding - but there was a sense of it being my decision/or at least it was in the power of fellow professionals to stop it happening. I can see it would have been worse if I'd made that trip because of a "rota" handed down by a financial manager.

Blueteapot,
Thank you for your reply.
I think I am starting to see ways that might help get the message across but am not sure if I want the rude replies!

I was going to say that doctors aren't paid by the hour for unsocial/overtime hours (which reading your OP is what you think - understandable, but not the case), but I see Blueteapot has already explained the banding system.

Another hidden cost of the new contract for junior doctors is even without the loss of bandings, doctors wouldn't get the full take home increase of an increase in basic salary as they will need to pay NHS pension contributions on it - the banding they get now is not counted as pensionable salary, so not counted either in taking pension contributions or when they calculate pensions. So they'd lose an additional 9.2% (or thereabouts for most current juniors) of that pay "increase".

It's not great that they have to strike, but it is necessary. Doctors don't strike lightly. The new contract is not acceptable.

Turnip, Blueteapot, I hear you but this is not the message that is coming across on the radio station I listen to or the newspapers I read.
What you say below is far more compelling than what I hear from reps on the radio.

"To me, hospitals are places run by doctors

HAHAHAHAHAHA! Comedy gold, that. I work in a speciality with a reputation for bullying and undermining. No control if a bed for an elective surgical patient gets allocated to a patient with complex medical needs, even if the surgical patient has cancer. No control if the specialised unit gets closed down because the nursing staff are told they have to look after an additional bay of patients. My rota changes on a daily basis, sometimes I get no notice at all. I've worked shifts where my first toilet break is 13 hours into it. Get home after not falling asleep at the wheel to hear of a health secretary spreading lies and misinformation and accusing the profession of not working hard enough.

Or to give another example: two sets of offices. One is on a top level floor, carpeted, air-conditioned with desks, comfortable chairs, working computers, a water machine and fully stocked kitchen. The other used to be a storage cupboard, 2 chairs shared between 15 people and a computer that frequently breaks down (which the team were moved to without any notice). One office is for management, the other for a team of surgeons. Match the offices to the teams."

"It's not "a lot of people", it's everyone in the private sector ie the people who work to earn the money to pay the Doctors' pensions."

I pay quite a lot of tax and pay quite a bit into my NHS pension, which is a pension fund that is currently self-funding. No one in the private sector pays for it.

Rebanding- autocorrected to rebranding. That was another huge waste of money, changing the NHS logo

Hic - who let that happen? Someone must be completely out of control.

Anyway, no junior doctor (I was one for a long time, I'm not anymore) wants to strike, but no junior doctor wants to get a 30% pay cut (yes, looks like current junior doctors will get pay protection but not the doctors coming after them) and the new contract is unsafe. The fact that most of the NHS, the nurses, the midwives, are behind them just shows the strength of feeling for us all who actually work in it every day.

Here is a good video from some junior doctors about why they are striking:

www.telegraph.co.uk/news/nhs/12004506/Junior-doctors-explain-why-they-are-striking.html

moving to more clinician led management

I'm not sure if this is controversial - I hope not. (For ref, I work in a university attached to a major hospital, my husband works for that hospital trust).

I think there is a place for non-clinical staff in the hospital management structure. Bright, innovative, managers with (hopefully) specialist training in creating healthy, happy working environments, perhaps enacting appropriate efficiency measures, advocating for their clinical staff when necessary - these would presumably be real assets?

The issue is the dichotomy between "management" and "front line", with both pulling in opposite directions under very different pressures (financial .v. service provision). The premise is that managers are working for the government, and doctors are working for the people, with the aims of each at odds with the other.

I don't want clinicians to spend time identifying which administrator in XYZ department can go. My experience of such meetings/committees/working groups/whatever is that clinicians don't want to do this either and I've seen some great clinicians make terrible managers. Equally, I don't want "admin" managers to work only to the bottom line.

The chief exec and chairman of my trust are both career managers. That seems wrong to me, and there should be someone with clinical work on their CV. Whether that should be a working clinician though, I'm not sure.

Lower down the hierarchy, my department (Pediatrics) is headed by active clinicians who can't even get a PA!

TL;DR - I don't necessarily think that "hospitals run by doctors" is the ideal thing to aim for.

Turnip, Blueteapot, I hear you but this is not the message that is coming across on the radio station I listen to or the newspapers I read.
What you say below is far more compelling than what I hear from reps on the radio

There is a lot of Tory spin going on in the media. Take for example the fact that you thought he had offered us a 'pay rise' - that's because of the way it has been spun on the media to the general public

Hi Dino,

the pension discrepancy is, as most people know, that public sector employees have the huge benefit of career average or even final salary schemes whereas these are unavailable in the private sector.

That is a huge huge benefit. It should be valued accordingly when people are considering whether they work in good conditions.

Bluetea,

there is a lot of spin full stop!

advocacy has its place but also creates confusion.

There is a less complex but comparable area that I do understand and it took a long time to grasp it (another "system"). Unfortunately I can now recognise 90/100 of the stuff that's said about it on both sides as spin! Very few things that are said take the debate forward.

for instance Bluetea, I think that the doctors' reps have been representing the "basic" salary as the "salary" whereas you've explained that the real salary is complex but always involves time paid at higher rates.

When reps say that the starting salary is X but then the public learn it is X plus Y it doesn't help.

A useful mean annual salary estimate of X plus Y would be more useful info.

Otherwise the 11 percent raise comes across as just that - an 11 percent raise!

anyway, good luck with it all.

YABVU. And very shortsighted.

I fully support the strike. The contempt the UK government have for their NHS staff is appalling. These incredible people are already overworked and underpaid. Do you have any idea of the amazing job so many of these folk do on a daily basis, OP? Could you work for days on end with very little sleep, with the burden of patient lives on your shoulders, and do so happily with shitty rewards and very little respect or thanks from the bumholes in charge? They don't deserve what is being forced upon them. And when our NHS is totally crippled because all of our doctors and nurses left to go work somewhere with far better working conditions, we'll be very sorry indeed.

I think you sound pissed off at all the wrong people, OP. I genuinely don't mean to armchair analyse you but I think you're frustrated and anxious about your health, and pissed off about your own working conditions. Which is all very understandable. But junior doctors are not the cause of your problems. Rather than begrudge them their opportunity to make things a little better for themselves and our precious national health service, why don't you try supporting them instead?

Think of it this way:

If the only thing between you and the pearly gates is a junior doctor, what would you rather? A fairly paid, well rested person who feels valued and takes great pride in representing the NHS? Or someone who is clearly exhausted, overworked, and questioning why the hell they didn't choose a different career path instead - one with better pay, less stress and more appreciation for the fantastic job they do (I get this working for Tesco, for god sake) - whilst they're busy trying to save your life?

Jannak thank you for your thoughtful response.

In my own case, a privatised system would have been of little use - mine is a "join the dots" challenge for medics - so I haven't ended up thinking that's the way forward.

I do however think my GP needed access to something like mumsnet-for-GPs with lots of retired specialists posting helpful replies. That would have saved many thousands of pounds of NHS costs. What she needed was to post "help - mysterious history/presentation" and she'd have had an answer in moments I suspect....

Ask your GP to post on doctors.net? :) (there is one, although I've not logged in for ages - had much useful advice from the forums there)

OP

Have a

It's amazing how many supposedly educated and informed people swallowed the 11% pay rise spin when JH himself was extremely clear it was ridiculous maths - he said that the majority of drs would receive an 11% pay rise but the overall pay envelope would remain the same. Even a primary school child can work out that sum doesn't work and that he was spinning a headline to fit his narrative. Today he's been criticised for his interpretation of yet more NHS data (time taken to see a consultant on the weekend), the more that man talks the more I think he is incapable of telling the truth.

There are forums like that- doctors.net is the best eg. But overall gps are less well supported than hospital specialists. I work in an area where we deal with rare paediatric diseases and we have national meetings a few times a year for our mystery cases. But there is also a wealth of expertise in my dept so we only get stuck on the really weird and Wonderfuls. GPs on the other hand see all the rare stuff before we do and have very little support. It is one of the toughest jobs in medicine, I think. There is a new group called resilient gps that is a sort of GP support network and another called GP survival. Hopefully social media will provide support especially for those in smaller practices. I hope things are working out for you and getting better

I can't believe you guys are falling for this
OP is stroll asking very ignorant questions if she really wants the real answers then do the research the information is out there

I will be striking to save the NHS and ensure the proper safeguards to protect patients and doctors remain/put in place it's not about the money

In someways I think maybe some of the general population are complacent maybe the NHS needs to go let everyone pay private insurance and let the two or even three tier system evolve then you will here all the stories in the media but the doctors won't care as their working conditions and pay will probably be much better!