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.

So that may be why my operation has been cancelled.

I honestly think it will also make certain specialties less attractive as I honestly feel in ophth we do have it "easier" than other specialities due to oncalls being not so demanding (though this again depends on where you are working) but then we are expected to do a lot of extra academic work in our own time

I for one do not miss working on the wards! Incidentally ophth is one of the most oversubscribed specialties wonder why?

sugar21 most hospital doctors have their indemnity fees covered by the hospital.

Consulates pay indemnity for private work.

GPs pay approximately 10% of their gross income for work during "normal" GP hours 8am - 6.30pm. Out of hours work for GPs is more expensive.

Oh WitchWay so is MDU/MPS not necessary then?

Gruntled. It's all doctors.

So yes very stupid. They won't increase the number of doctors as that would mean more wages. So instead of Dr a seeing ten patients each day mon to fri he will maybe work weds to sun. See the same amount of patients and have to work at a weekend for no unsocial pay. And yes the hospital will have to pay a nurse, a hcsw, a receptionist, more electricity. The lab will have to put on more staff as there will be more tests to process. The IT dept will have to put on more staff over the weekend as there will be more frontline staff at work, etc.

ok will try to figure this out.
Are you saying that if a JD works in excess of permitted hours their pay goes up by an amount designed to punish their employer? So the money goes to them? instead of them saying no?

How did such a situation arise, that is extraordinary! Surely no one supports that? Or does it work well because hospitals make sure it never happens? Or does their strategising to make sure it never happens create lots of perverse working arrangements?

Then the salary cut thing:
So first year doc is on basic of 23 grand and earns say £7000 from the antisocial hours - grand total take home pay before tax of £30,000.

That doc is fine because their pay is protected (you are I think the first person on the thread to acknowledge this - presumably this was a late compromise from the government to try to undercut the arguments?)

So following year junior doc earns 25000 grand basic but the Saturday antisocial hours are at standard rate not antisocial rate. So in order to earn as much as his/her predecessor they need to earn £5000 from weekend and nighttime hours. and s/he will experience more antisocial hours because Saturdays will be timetabled as a normal day but not experienced as a normal day by the individual because s/he/their family still knows it's the weekend.

Is that right so far?

Thanks for clarifying, crikey seems like my GP is paying £9000 pa.

I'm at the very end of my training. I've worked most of my career in Ireland. During that time I worked 70-110 hours per week, frequently (weekly or more) worked 36 hour shifts without a break as the most senior person in house. I continued these hours when pregnant. I worked while ill as there was nobody to cover for me. We do not want to go back to the old system. I now work in the UK and will only be "junior" for a short time more. I'm happy with my wages, which are incidentally 50% less than my husband who works in the private sector, and has 10extra days holidays a year, no bank hols, no weekends.... I wouldn't be happy to work more unsocial hours, for less money and less time with my child. I'll be supporting my colleagues.

YABVVVU I am a nurse in the NHS and see what the junior doctors do on a 24 hour basis, how dedicated they are and the responsibility they have, this is even more evident at weekends and during the night. I totally support the doctors strike. They should be paid for unsocial hours we need to look after our doctors.

Sorry op ....

You started this thread because of your decorator?

Who actually said the words "but who am i to challenge the likes of them"

Do you live in the 1950s or something?

Oh and Rainbow, sending you waves and waves of empathy. It gets better when you become more senior and can set your own rules, but I remember what an awful mess piecing everything together was. Your consultant - I have no words. Hang on in there...

Thanks, WhoTheFuckIsSimon. That really is utterly insane. If people like lab staff and clerical staff also have to work at weekends, I suspect an awful lot will leave for jobs which allow them to work the same hours as their families so they can be together at weekends. There is just nothing about this that makes any sense at all.

xposted mustbethursday.

So it's not that you get paid according to how many antisocial hours you actually work, it's that there is a sort of giant "model" or "calculator" called a rota that is supposed to even things out (so would you tend to get a temporary pay cut when starting a period of time in dermatology after working a period of time in A&E? because the system "knows" that you are not likely to be working antisocial hours in dermatology.

Whatever the ins and outs of doctor's pay, if they aren't being rewarded by the NHS (in terms of salary, job satisfaction, work life balance) more than they would be in a job with comparable entrance criteria, they won't be doctors working for the NHS - any more than somebody works for tesco's if sainsbury's are offering better terms.

And that is absolutely fine if the long term plan is to get rid of the NHS and have a 2 tier health system.

We started on the thin end of the wedge a while ago, but it's getting much thicker.

At the minute nhs staff such as lab staff and nurses get unsocial pay for weekends.

Believe me if Hunt gets this through he will go after them next. They will all end up working more weekends rather than maybe 1 in 4, 1 in 6 and for less money than they currently get.

And yes, people will leave. People are leaving already due to working conditions and stress. Making things worse is just going to push more away.

I think of doctors and nurses in the same way I think of pilots, policemen, emergency services.

I want them happy, well paid and well rested.

Why this isn't obvious to everyone amazes me.

And when we are all so flexible that weekends have finally been abolished, we can all benefit from the fact that though we'll have to get a Saturday off to see a doctor (just like we used to have to take time off on a Monday), at least we'll be able to see a doctor on a Saturday. Fab!

We take all NHS staff for granted.
In the words of the song " don't know what you got til it's gone "

I can see the situation from both the OP and the Drs POV. I work for the NHS and have recently been a patient as well. The vast majority of frontline staff are dedicated professionals working their socks off. However we are totally demoralised by the constant refrain from the politicians and management that we are still not productive enough they don't want to increase frontline staff even though demand for NHS services has consistently increased year on year We are threatened with downgrading of our posts, stealth changes to our terms and conditions and tupe sold to private companies who then tell us that our jobs which for the NHS require postgraduate level qualifications can be done by someone with 2 weeks training and 5 GCSEs. We are lumbered with joke IT systems which are totally user unfriendly, policies and procedures which often are just beau racy and take up much of our time, layers of management and commissioners who often have no real understanding or experience of working on the frontline and who cost way more than clinical staff, really poorly paid clerical posts which only attracts the unskilled with the result that things such as triaging of appointments are badly done. Then the cherry on the cake is the public are told by the politicians that it's our fault that they're not getting the service they deserve. I could go on but I think you get my point.

As a patient I have had to wait 6 months for an appointment because the hospital "lost" my GP referral, hospital departments refusing to book me in for a scan because they didn't want to pay for it from their budget so fobbed me back to my GP to refer to another department. Having to wait 2 hours after my designated appointment time as my slot had 3 other people booked into it due to need to meet target waiting times and then having to wait 6 months for a follow up appointment due to lack of doctors in that speciality.

If I had to improve the NHS I would firstly look into the procurement process for medicines and supplies so it getsbetter value for its money. Secondly I would consider how much management is actually needed. In meetings I often find it hard to fathom why there are 4 layers of management to only 1 layer of frontline clinicians. Thirdly I would only introduce rigorously tested IT systems - think Apple. Fourthly I would have a quicker process of managing employees who consistently perform poorly out of the NHS and finally the NHS needs long term overview by health experts and not be dictated to by politicians

Our anti social pay has been threatened more than once. I'm front line (effectively) and band 3 so roughly 19.5k a year. That's before tax and not including my antisocial hours
I risk making the wrong choice every day or killing someone or being taken to coroners court. I hear people's last breaths, babies first cries, people finding their loved ones dead, people giving CPR, children choking, things that break my heart
And if they took my anti social that would be for under 20k a year, the average "life" span of the job I do is 8 years before people burn out and leave
I support the junior doctors

Oh and this week I paid £8 whatever for £3000 worth of drugs. That's why I love the NHS even if it isn't perfect!

There seems to be a lot more public sympathy for the doctors than I have ever seen for nurses in the past . I am 100% behind the doctors strike, but it really is very interesting!

*Today 19:01 MissTriggs

Are you saying that if a JD works in excess of permitted hours their pay goes up by an amount designed to punish their employer? So the money goes to them? instead of them saying no?*

Sort of. Twice a year all junior doctors are contractually obliged to complete a monitoring exercise whereby they log every hour worked. This is designed to assess whether or not the rota is compliant. You might imagine then that we do a lot of over reporting to see our pay go up. In reality we all consistently underreport our hours and are unofficially encouraged to do so. Any additional time worked must be justified. The majority of the time this is made out to be a time-management failure on the part of the doctor. There must also be a sufficient return on reporting for it to be considered valid. I have never seen a change in banding happen.
Regarding 'instead of them saying no'. We are never formally asked to work these additional hours. Believe it or not they are borne out of concern for patient wellbeing and colleague workload. They come about because work needs done. If we don't do it one day it has to wait until the next, and patients suffer. If someone becomes unwell at 5.15 just as you are about to leave most of us will not let the nursing staff call the already spread-thinly on-call team who have to go about getting to know the patient while working out what's wrong. Most of us hang around to help the person before 'handing over' a now sick but stable patient.