Page 11 | Supporting nhs consultant doctors industrial action

Lapland123 · 2023-01-31T13:54:01+00:00

I hope this has public support. Consultants have seen the largest pay erosion in public services- now 35 % pay erosion since 2010. Add the pension debacle, where we are asked for real money now for a theoretical glitch in how pensions are calculated. The ‘real money ‘ bill now can be 6+ months of your take home pay annually. Yes, really. Vacancies exist in multiple specialties and the day to day job is more and more difficult in the context of vacancies throughout the nhs I hope we have support for industrial action due to this government’s disgraceful erosion of our pay though we are working harder than ever

Battlecat98 · 01/02/2023 08:34

AdelaideRo · 31/01/2023 20:31

@edwinbear I would accept a lower pay rise this year if virtually every year for the last 20 years the government hadn't rejected the advice from an independent body about my pay to give me a much smaller pay rise.

Cumulatively this has resulted in a 35% drop in pay over the past 15 years.

I'm fed up. Everything in the hospital is basically left to the consultants. No junior doctors because they are hacked off with working for free/ very little - the consultants will do it.
No admin support (too expensive) to type letters. Never mind the consultants can type their own. But they can't have any additional paid admin time. No money for that.
No porter to take urgent specimens to the lab - never mind the consultant will do it as they know that if they don't the specimen might not have the urgent tests done on it look for cancer .

The good will is ending. I"m done.

I'm going to start cancelling any operation that is going to run beyond my planned end of day. No more staying late because the family have travelled to the hospital/ made arrangements etc.

And I'm actively planning my route out of the NHS. For the money I get paid I'm sure I can do something a whole lot less stressful that doesn't leave me waking up in the middle of the night scared for my patients.

I and the majority of my teaching hospital colleagues do no private practice.

I work more than full time but I also only work 4 days a week. Because my regular working day is 11 hours long (and I often finish late).

As a NHS nurse I completely agree with you. The workings of the NHS now is impossible, we to, have to pick up everything that cannot be done by anyone else. But, we regularly get castigated because something went wrong and that is our fault.

The stress is unmanageable, always late off of work, it's now expected if we didn't stay patients would be even more unsafe. I support all strikers. This government has deliberately caused all of this devaluing of public services.
I agree with you regarding not staying late and not doing extra surgery, we need to try to work to rule. If we did this the NHS would have bigger problems. The good will of the staff is gone. The experienced staff are leaving. I have just returned from 2 months off due to burn out. Of course on return nothing has changed, the stress is off the scale. I am looking to leave. The NHS will loose a highly experienced nurse and I know more will follow.

FixTheBone · 01/02/2023 08:34

edwinbear · 31/01/2023 23:10

I guess anyone on a final salary pension scheme has a vested interest in getting the salary on which it’s based as high as possible.

Final salary scheme ended years ago.... some consultants still have some of their pension in that scheme.

ShoddyCustomerCare · 01/02/2023 08:40

I absolutely support their strike action. We need everyone to step up and support. We need these highly trained, chronically undervalued professionals to run our services, which we depend on. Unless everyone has thousands sitting about which they could use for private health care? Not me, certainly.

Those pissed off that they already have what, on the cover, looks like a high salary need to give their heads a shake. They have worked and worked for that salary and it is being stripped from them in various ways mentioned upthread. No wonder they are leaving for other countries where they receive a salary reflective of their contribution to society.

You want 115k? Go put in the fucking work, then I bet you would be complaining about being robbed of it when you are in their positions. The grass isn't always greener and we need empathy to support and retain our highly skilled professionals, not indignant and often ignorant jealousy.

Same goes with all sectors striking. Solidarity. ✌️

LeanIntoChaos · 01/02/2023 08:40

The thing is, it's market forces. I work 10.65pas as a full time consultant. Just moved from registrar. Really worrying about a tax bill. No idea how to work out how bad it will be. I have a mortgage and 4 children....I just cannot pay it.

I do private work, it's plentiful in my specialty. I can earn half my monthly wages in 4 days in the private sector. Even accounting for tax.

I cannot afford to pay the tax bills. Therefore, I will have to drop my NHS time and pick up more private, as I don't have to pay into my pension privately, and it reduces my NHS wage.

I don't need to strike for more money, I can get that by working privately or moving abroad. However, I will strike because I want to continue to work in the NHS and it's becoming less and less possible for me.

I do care about my job and my patients. This is a vocation. I'm prepared to be paid less for NHS work, but I cant suck up tens of thousands of tax bills. I literally do not have it.

paintitallover · 01/02/2023 08:54

The real focus is the new plan junior doctors -theyve been sold out.

ChungusBoi · 01/02/2023 08:57

jgw1 · 31/01/2023 14:05

What I don't understand in all of these pay disputes is I thought that the Tories were fans of markets.
Currently it is very clear that in many job markets the pay is not enough to attract people. So what you clearly need to do is cut pay.

Spot on.

There is a global market for medical staff so pay and conditions need to improve if we are to retain and attract enough staff to UK hospitals.

edwinbear · 01/02/2023 08:59

@MushMonster I'm an economist by trade. The harsh reality is that as a nation, we can't afford to be paying anyone any more money at all. Currently we are £27.4bn pounds in debt - overdrawn if you like. That's the highest debt figure since records began in 1993. From the ONS:

"Initial estimates for December 2022 show that the public sector spent more than it received in taxes and other income, requiring it to borrow £27.4 billion, £9.8 billion more than the £17.6 billion forecast by the Office for Budget Responsibility (OBR)".

www.ons.gov.uk/economy/governmentpublicsectorandtaxes/publicsectorfinance/bulletins/publicsectorfinances/december2022

That figure is £16.7bn more than Dec 2021 and £21.1bn more than Dec 2019. As a nation, the private sector (the profit sector if you will) does not generate enough income, or profit, to fund the public sector (the cost centre). If the UK were a Plc, we'd be bankrupt, as our spending is greater than our income. Now, clearly we're not a Plc, we can't go bust. But we do need the private sector to generate more income to fund the public sector. In the short term we can borrow more money to increase pay for low paid, public sector workers, but fundamentally, the private sector needs to be creating more wealth/profit/income to meet the bills and we need tax policies to encourage that. Alternatively, we need to spend less on the public sector - tjose are the only two options.

I'd fully support the UK becoming a bit more more overdrawn to fund reasonable pay rises for lower paid workers, but becoming more overdrawn to pay people on £100k a 35% pay rise? That needs to wait until our bank account looks a bit healthier.

monitor1 · 01/02/2023 09:15

edwinbear · 01/02/2023 08:59

@MushMonster I'm an economist by trade. The harsh reality is that as a nation, we can't afford to be paying anyone any more money at all. Currently we are £27.4bn pounds in debt - overdrawn if you like. That's the highest debt figure since records began in 1993. From the ONS:

"Initial estimates for December 2022 show that the public sector spent more than it received in taxes and other income, requiring it to borrow £27.4 billion, £9.8 billion more than the £17.6 billion forecast by the Office for Budget Responsibility (OBR)".

www.ons.gov.uk/economy/governmentpublicsectorandtaxes/publicsectorfinance/bulletins/publicsectorfinances/december2022

That figure is £16.7bn more than Dec 2021 and £21.1bn more than Dec 2019. As a nation, the private sector (the profit sector if you will) does not generate enough income, or profit, to fund the public sector (the cost centre). If the UK were a Plc, we'd be bankrupt, as our spending is greater than our income. Now, clearly we're not a Plc, we can't go bust. But we do need the private sector to generate more income to fund the public sector. In the short term we can borrow more money to increase pay for low paid, public sector workers, but fundamentally, the private sector needs to be creating more wealth/profit/income to meet the bills and we need tax policies to encourage that. Alternatively, we need to spend less on the public sector - tjose are the only two options.

I'd fully support the UK becoming a bit more more overdrawn to fund reasonable pay rises for lower paid workers, but becoming more overdrawn to pay people on £100k a 35% pay rise? That needs to wait until our bank account looks a bit healthier.

Remind me how many billions this govt have pissed away giving dodgy PPE contracts to their mates and on Liz Truss' little experiment with the economy?

edwinbear · 01/02/2023 09:26

@monitor1 I don't disagree, but we can't get that back now, it's gone and we're left with a stonking great overdraft we need to pay back.

Endlesssummer2022 · 01/02/2023 09:30

edwinbear · 01/02/2023 08:59

@MushMonster I'm an economist by trade. The harsh reality is that as a nation, we can't afford to be paying anyone any more money at all. Currently we are £27.4bn pounds in debt - overdrawn if you like. That's the highest debt figure since records began in 1993. From the ONS:

"Initial estimates for December 2022 show that the public sector spent more than it received in taxes and other income, requiring it to borrow £27.4 billion, £9.8 billion more than the £17.6 billion forecast by the Office for Budget Responsibility (OBR)".

www.ons.gov.uk/economy/governmentpublicsectorandtaxes/publicsectorfinance/bulletins/publicsectorfinances/december2022

That figure is £16.7bn more than Dec 2021 and £21.1bn more than Dec 2019. As a nation, the private sector (the profit sector if you will) does not generate enough income, or profit, to fund the public sector (the cost centre). If the UK were a Plc, we'd be bankrupt, as our spending is greater than our income. Now, clearly we're not a Plc, we can't go bust. But we do need the private sector to generate more income to fund the public sector. In the short term we can borrow more money to increase pay for low paid, public sector workers, but fundamentally, the private sector needs to be creating more wealth/profit/income to meet the bills and we need tax policies to encourage that. Alternatively, we need to spend less on the public sector - tjose are the only two options.

I'd fully support the UK becoming a bit more more overdrawn to fund reasonable pay rises for lower paid workers, but becoming more overdrawn to pay people on £100k a 35% pay rise? That needs to wait until our bank account looks a bit healthier.

Economist is not a science and no economist has a deep understanding of every sector in a complex economy.

edwinbear · 01/02/2023 09:35

I don't think you need a deep understanding to appreciate the UK currently spends more on the public sector than it has coming in from the private sector. That's GCSE level economics.

YankeeDad · 01/02/2023 09:36

@FixTheBone @Changechangychange Thanks for correcting me. It is even worse than I thought.

I had been of the mistaken belief that new accruals under final salary schemes were finished, and that any new accruals now related to average salary schemes, which would not lead to the same dramatic single-year jumps in pension entitlement.

While it is entirely fair for people to pay tax on their income, it is just not fair for people to get charged a huge lump sum of tax in the here and now, based on the actuarial (=estimated) present value of an annual payment that they may or may not receive a decade or more in the future, depending upon how long they live and what further rule changes the government makes, such as for instance any increase in the retirement age. Yes, there is a "scheme pays" method to get around the immediate cash flow issue, but the terms of that scheme are onerous (it is basically a very expensive debt for the consultant), the consultant cannot change their mind once signed up for it, and the terms of the scheme are subject to future change by the government. It is like taking out a mortgage where you are not allowed to refinance to a different bank, but the bank reserves the right to change the interest rate at any time, and possibly also to extend the maturity so that you pay the interest rate for longer. Since the liability giving rise to that debt is already unfair (=present tax owed for future, uncertain benefit), the whole approach to "scheme pays" just adds insult to injury.

It is also important to remember that the pension is not a pure entitlement that is just handed over to the consultant: yes, there is a large employer "contribution" (with the government in effect transferring its contribution from the left pocket to the right pocket since this is an unfunded government liability), but there is also quite a large employee contribution, which is why the take home pay for a consultant is only about 50 percent of their gross pay even before these pension tax charges are taken into account.

The more I learn about this, the more I am grateful that consultants are not leaving the NHS even faster. Not because they are greedy, but because they do not want to be financially screwed over as a reward for their hard work.

Honeybee8409 · 01/02/2023 09:37

It doesn't matter what people like @Jazz12 or @edwinbear think. The BMA will cast a vote and consultants collectively will decide if they think its a worthy cause to strike for. No point ranting and raving on mumsnet.

YankeeDad · 01/02/2023 09:40

LeanIntoChaos · 01/02/2023 08:40

The thing is, it's market forces. I work 10.65pas as a full time consultant. Just moved from registrar. Really worrying about a tax bill. No idea how to work out how bad it will be. I have a mortgage and 4 children....I just cannot pay it.

I do private work, it's plentiful in my specialty. I can earn half my monthly wages in 4 days in the private sector. Even accounting for tax.

I cannot afford to pay the tax bills. Therefore, I will have to drop my NHS time and pick up more private, as I don't have to pay into my pension privately, and it reduces my NHS wage.

I don't need to strike for more money, I can get that by working privately or moving abroad. However, I will strike because I want to continue to work in the NHS and it's becoming less and less possible for me.

I do care about my job and my patients. This is a vocation. I'm prepared to be paid less for NHS work, but I cant suck up tens of thousands of tax bills. I literally do not have it.

You have distilled the issue perfectly.

If the government fixes the pension tax issue, it will also lessen the pressure to offset the 35% of real wage cuts that is so often cited. There are ways of doing this that should not increase the NHS wage bill at all, and that might even reduce it.

I hope this will get sorted soon.

Pandaphonium · 01/02/2023 09:44

For the consultants the solution apparently seems to be to insist on even more money or they’ll withdraw their labour.. But this isn’t about money..

It is about money because its a job. I'm not sure why some people seem to have trouble understanding this, people go to work to earn money. And yes just like anyone else consultants can leave if they feel the conditions, pay and being taxed on a theoretical pension which they will then be taxed on again in the future isn't reasonable. They have no moral obligation to stay, its the NHS and ergo the public who need to access healthcare that suffer when the shortages get even worse. The more I read about people's bitterness, resentment or ignorance the more I am all for privatisation.

paintitallover · 01/02/2023 09:46

Currently we are £27.4bn pounds in debt

Interesting. Similar to the £30bb blown by Liz Truss.

monitor1 · 01/02/2023 09:47

edwinbear · 01/02/2023 09:26

@monitor1 I don't disagree, but we can't get that back now, it's gone and we're left with a stonking great overdraft we need to pay back.

Not for NHS staff to pay it back. The gov could go after those PPE companies. They could take punitive court action against MPs who gave contracts to their mates. I don't really care how they do it, but if they can't balance the books then they should admit that Brexit was a disaster and step aside for someone a bit more competent. Though who that is, I'm not sure, looking at the current crop in opposition.....

FixTheBone · 01/02/2023 09:50

YankeeDad · 01/02/2023 09:36

@FixTheBone @Changechangychange Thanks for correcting me. It is even worse than I thought.

I had been of the mistaken belief that new accruals under final salary schemes were finished, and that any new accruals now related to average salary schemes, which would not lead to the same dramatic single-year jumps in pension entitlement.

While it is entirely fair for people to pay tax on their income, it is just not fair for people to get charged a huge lump sum of tax in the here and now, based on the actuarial (=estimated) present value of an annual payment that they may or may not receive a decade or more in the future, depending upon how long they live and what further rule changes the government makes, such as for instance any increase in the retirement age. Yes, there is a "scheme pays" method to get around the immediate cash flow issue, but the terms of that scheme are onerous (it is basically a very expensive debt for the consultant), the consultant cannot change their mind once signed up for it, and the terms of the scheme are subject to future change by the government. It is like taking out a mortgage where you are not allowed to refinance to a different bank, but the bank reserves the right to change the interest rate at any time, and possibly also to extend the maturity so that you pay the interest rate for longer. Since the liability giving rise to that debt is already unfair (=present tax owed for future, uncertain benefit), the whole approach to "scheme pays" just adds insult to injury.

It is also important to remember that the pension is not a pure entitlement that is just handed over to the consultant: yes, there is a large employer "contribution" (with the government in effect transferring its contribution from the left pocket to the right pocket since this is an unfunded government liability), but there is also quite a large employee contribution, which is why the take home pay for a consultant is only about 50 percent of their gross pay even before these pension tax charges are taken into account.

The more I learn about this, the more I am grateful that consultants are not leaving the NHS even faster. Not because they are greedy, but because they do not want to be financially screwed over as a reward for their hard work.

Agree, and thanks for taking the time to have a closer look at the issue.

I don't think any consultant is wanting to be unreasonable.

If we want to go as far as what should be equitable and fair, 35% pay increase today would put us back on terms with 2007, and I don't recall many people saying that consultants in 2007 were being paid extortionate salaries, but as you and others have correctly pointed out, such an increase would ruin many consultants due to the current pension tax situation.

Inflation linked payrises from now on, or, at least adhering to the DDRB recommendations, plus fixing the pensions would be entirely acceptable to most consultants I expect.

The senior judiciary had the exact same pension problem, and, it got sorted, removed from the tax rules that cause the unpredictable, punitive, unaffordable and unfair tax bills.

No consultant is asking for a tax free pension, but it could either be payed for by deductions from gross salary i.e. tax paid up front, or upon drawing the pension. Linking the LTA to inflation would help as well, in order that the total maximum value doesn't decrease by 10% per year.

The issue is, there are a limited number of reasons that strike action can be legitimately undertaken - we could for example go for strike action over deforestation in Brazil, but the real terms salary drop is a quantifiably big negotiating stick, that we can threaten to strike over, in order to get what we really want, which is a secure pension that isn't being constantly devalued, and that doesn't have the perpetual shadow of an unaffordable tax bill hanging over us.

edwinbear · 01/02/2023 09:58

Though who that is, I'm not sure, looking at the current crop in opposition.....

@monitor1 you and I are agreed on that, at least. I'm dismayed that we don't seem to have anyone - either politicians on either side, nor civil servants in the Treasury, who seem capable of working through the nations income and expenditure and coming up with a proper, workable, plan as to how we can create more money as a nation, to start paying off our debt, whilst funding our public sector properly.

FixTheBone · 01/02/2023 10:02

couldn't go on strike action..... the last paragraph should have read

BrokenBonesStixStones · 01/02/2023 10:03

I support getting consultants and all nhs staff getting more pay, absolutely but I can’t support a strike as I fear it could cost lives

Endlesssummer2022 · 01/02/2023 10:12

edwinbear · 01/02/2023 09:35

I don't think you need a deep understanding to appreciate the UK currently spends more on the public sector than it has coming in from the private sector. That's GCSE level economics.

If you understood economics beyond GCSE level then you would understand that debt at a national level isn’t a problem if the economy is growing and the debt can be serviced which is the case in large, complex economies. Every economy is in debt. It is not the same type of economics at household level and I wish publications like the Daily Mail would stop explaining the countries finances in such a simplistic and inaccurate way.

Instead if stealing consultants pensions and taxing a shrinking working population to death, the government should be trying to grow the economy.

monitor1 · 01/02/2023 10:14

BrokenBonesStixStones · 01/02/2023 10:03

I support getting consultants and all nhs staff getting more pay, absolutely but I can’t support a strike as I fear it could cost lives

Sigh. Have you read the thread? this has been dealt with. Lives are being lost every day due to staff leaving due to intolerable working conditions. This will worsen. Long-term, striking will save lives.

monitor1 · 01/02/2023 10:15

and pray tell how you support increased pay and better conditions if govt won't talk and you won't support a strike?

Southwest12 · 01/02/2023 10:15

I totally support both consultants and the junior Drs striking.

So much is written about the backlog of apts and surgeries and what needs to be done to fix that, but if the pension issue isn't fixed then how can the backlog be sorted. Why would someone do an extra clinic or extra list if they are effectively paying to be at work. No one else would accept that.

I've got friends who are consultant surgeons and others who are trainees and when I stop and think about what they actually do, as in the technical side of operating and having someone open on the table, I'm always blown away.

As a patient I am behind them and will join them on the picket line.