Supporting nhs consultant doctors industrial action

[Lapland123]

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

@Lapland123

I agree.

That’s a wildly unscientific way to measure deaths caused by strikes. You don’t measure the #deaths on the days of the strikes to determine the #deaths caused by strikes, you measure the 3rd and 4th order deaths caused by delays to diagnoses and procedures caused by the strikes.

Given the nasty tone of some ignorant posters, I’ve come to the conclusion that I’ll need to step away. However I am heartened to see a majority supporting the industrial action. Thank you for taking the time to understand the issues ( too complex it seems for some people to grasp). This industrial action is necessary to allow consultants to continue to work in the nhs.

So one method failed, that’s really not a good enough reason to gamble with peoples lives imho. It’s the military equivalent of going from economic sanctions to carpet bombing.

You have me confused with another poster, I have made no mention of whatever pension you may or may not have.

I have an understanding of the problems, I just cannot support strikes that literally cause innocent people to die. You may view these people as lesser beings than yourself, such that you are willing to sacrifice them on the altar of plussing up your £100k+ salary, but I do not. That’s a perfectly valid opinion.

You and all the consultant doctors have my support, but I draw the line when that support makes me complicit in the perfectly available and unnecessary deaths of other men, women and children.

*avoidable

Surely the consultant will lose out eventually if they are never taking on complex cases - from a deskilling and also interest perspective? Consultants I work with (am dreaded NHS management..) say they find their private work lucrative but boring and enjoy the challenge of the complex cases they see in their NHS practice.

Why would you assume they never take on complex cases? The point is you get to choose your private patient and ones with attitudes that aren't conducive to their own recovery will be pushing the typical tolerance of your average consultant just that bit too far. Anyway there's interest and practice aplenty training up new consultants on complex cases which are most of the ones I'd do for the NHS.

Also a pp said that there would be no doctors left in 20 years time, but potentially with the current pace of developments in AI and robotics there could actually be far fewer doctors needed. If my children decide to show an interest in medicine this is something I would definitely be suggesting they consider.

This is an excellent thing, with the added bonus of admin/manager peeps dealing with patients before and after the machines do. Can't wait, Those of my children who are in the field are already skilling up for portfolio futures that machines, apprentices etc etc would find a little more difficult to deliver, I'm totally for safely automating the drudge.

Speaking of automation, on transport which I discovered after 3 years' absence abroad that other cities had somehow over the pandemic managed to upgrade their systems for substantial resilience and effectiveness AND reduce fares albeit by pence, unlike the massive hikes we have in the UK. Instead we have strikes because nobody seems able to work together or differently with automation, so as a country we're sadly falling behind in so many ways. I digress, but yes AI and robots, that could help tremendously in schools, transport, health, care, etc etc Absolutely can't wait, tis a GOOD thing when used wisely.

A career average scheme is still defined benefits. And pillaged is a ridiculous way to describe it. Previous incarnations of the scheme were based on lower life expectancies and higher gilt yields. All defined benefit schemes are experiencing this and to paint this as an assault on doctors in disingenuous. You can't expect the government to create special terms exclusively for hospital consultants.

For what it is worth I do feel that medics are not being properly compensated for their work, my husband is just about to start a fellowship and will apply for a consultancy within a couple of years so I really do have skin in the game here. But you're not doing your cause any favours by misrepresenting the pension.

The salary linked pension is still there.

If you recall a few months ago you posted about moving to the private sector for a 30% uplift until someone pointed out to you the value of your pension scheme and the huge employer contribution which could well outweigh that 30%. I'm surprised you have forgotten this so soon and no consider it to be of so little value.

@maryso my assumption was based on what you originally said - "Those with any basic capacity will know that it is not consultants who will lose out if the shift to private work continues, and even money will not buy you the skill set you need privately, the private consultant has to agree to take on your case, and why would they bother taking on complex cases even if you can pay the six/seven figure fees in advance."

But on the basis of your most recent post, then people shouldn't need to worry about finding a private consultant to take on a complex case ('losing out') as these will always be done under the NHS anyway 🤷‍♀️

Enjoy your £30k tax bill in his second year of work..... that pensionable salary jump from fellow to consultant is a doozy.

So as an NHS manager, you must be inundated with highly skilled and experienced consultant applicants? As an NHS manager, you have no waiting lists to prioritise? Sp every complex case that comes your way is immediately dealt with by top consultants without pausing? This is amazing because even in tertiary centres we have to queue patients who by the very nature are already at the top of your queue and being referred as a last resort. You may get something out of your strange reality but that's not true of the NHS at the moment. I think we also all know that AI and robots will replace NHS managers much sooner than consultants.

Would fully support you all. You're amazing and we couldn't function without you.

@maryso in answer to your first question, not inundated but generally plenty of applications from very good candidates, yes. A couple of specialties can be trickier to recruit to (currently gastroenterologists for echo/endo, and radiologists) but perhaps we are lucky being a large tertiary centre in a location that people are keen to live in.

Waiting list management is not part of my role but yes, obviously there is prioritisation and the pressures are intense. For complex acute cases though I would say the NHS very much still has people's backs. Anything chronic and/or non urgent then perhaps not so much. This isn't really due to a lack of consultants though (as things stand), but much more about a lack of capacity and flow across the whole system.

And I'm not sure why all the personal barbs in your posts are so necessary - it certainly won't be the bedside manner we'll miss when you're replaced by a robot, will it?

And how do you, I gather not a HCP, know that striking will lead to more deaths than not striking, in the long term?
show us your modelling

It is a fact that in the short term, striking will cause excess deaths. The rest is a gamble.

It’s on the person making the assertion that extra deaths in the short term will be more than offset by fewer deaths in the long term to make their case through modelling or whatever. That’s not for me to prove. You need to convince me to get my support.

But let’s be frank, there is no modelling simulation sophisticated enough in existence that can show you with any accuracy that letting people die now will save more people in the future. I am very familiar with simulation algorithms and modelling software.

In sum, you’re gambling with peoples lives and that is immoral.

OK - how would you change the status quo? Staff are leaving in droves, one doctor in five is leaving medicine within three years of the end of medical school, care is dangerous with hundreds of excess deaths per week, nurses and some junior doctors are using food banks and the govt won't talk about pay.

I'm all ears to hear your non-strike solution. I'll pass it on to the BMA.

Well dear rubbish, it's good to know that your trust is doing so very well. Surprised you can't find enough radiologists though, and gastro, too, when it's quite easy to access them privately. Perhaps your trust is not that attractive an employer despite it apparently being in such an affordable location? Still good to know you're so confident about handling acute complex cases, I note you're silent about the other complex cases.

You're the one who pointed out how helpful Ai and robots will be to replace shortages (which I think cannot come quickly enough and not just in health), and It's pretty obvious that NHS managers' skill sets are easier to replace than consultants, so your taking that fact personally says more about your touchiness than my bedside manner, which has seen me inundated with referrals for decades. It'll be well past my time on the planet when I'm capable of being replaced by a robot, certainly well past my retirement, so unable to please you there either 😁

What's the average salary of an NHS consultant doctor?
From what the OP says, 35% less than it was. I support the strikes.

Lol, touched a nerve.

Majority of consultants I've known and worked with are golden, but I can't pretend I don't also enjoy a bit of a giggle with the CMO and CDs about some of the more prima donna like tendencies of a certain section of the consultant body... Please never change!

www.nuffieldtrust.org.uk/resource/chart-of-the-week-what-has-happened-to-nhs-staff-pay-since-2010

The chart on this link says it is a 10.5% fall since 2010. I'm not sure what the discrepancy is, I expect the unions have used RPI rather than CPI.

And I have just found a paper referring to a new contract for consultants in 2002/2003 which gave the consultants a huge part increase. As I made reference to in an earlier post, the current consultant pay is closer to a reversion to the mean rather. The current pay rates are historically normal after the profligacy of the labour government.

Staff are not “leaving in droves”.

Retention of doctors is above the U.K. workforce average:
”“Most of the larger public sector occupations, including doctors, nurses and midwives, and primary school teachers, have a one-year retention rate above the UK workforce average.”

”Medical occupations had high retention rates for workers aged 18 to 34 years: 96% of nurses and midwives remained, 93% of nurse auxiliaries remained and 92% of doctors remained.”
www.ons.gov.uk/economy/governmentpublicsectorandtaxes/publicspending/articles/isstaffretentionanissueinthepublicsector/2019-06-17

Admittedly the data is from 2017, but this 2019 report is the latest release from the ONS on retention. And since the OP contends massive pay erosion since 2010, you’d expect to see some sort of retention issue by 2017…

My non-strike solution would be to lobby for bursaries for nursing and medical degrees to encourage more students. I’d also keep lobbying for additional NHS funding to go towards more staff (build hospitals, minor injuries units, etc) instead of yet another IT system to “increase efficiency”. The basic problem with the NHS is too few HCPs per capita population. I’d also waive all visa fees, and allow recourse to public funds to encourage trained staff from abroad. A lot of this is in the pipeline or partially implemented.

Don’t forget these are falls in real wages, not absolute wages.

So from March 2011 to March 2021, the salary of a doctor increased by £10,136/Yr. However, due to inflation, this is a loss of £779/Yr in real terms.

So while doctors have had a pay increase of 15% the past ten years, this has fallen short of inflation by 1%.

www.health.org.uk/news-and-comment/charts-and-infographics/how-has-nhs-staff-pay-changed-over-the-past-decade

2017 could as well be 100 years ago. Even in 2018, 15% weren't practicing medicine just two years after qualifying, only about half of them returned. In 2020, over 40% of trainee medics/dentists felt that work had made them unwell.

We have F2 doctors in the practice. Five years ago, most of them went straight into run-through training and the discussions over coffee were all about which specialty they were choosing in the NHS. I think it's been well over three years since an F2 that I've known has gone into further training. I'm giving more and more references to locum agencies in Australia.

In response to a 2021 BMA survey, 43% planned to retire early and 50% planned to cut down on hours after the pandemic.

In the last year, we are nationally down 662 GPs (473 WTE) and 16% of respondents to a recent BMA survey are planning to leave the NHS.

Should I go on? Or could you admit that just possibly, those on this thread who work on the front line of the NHS, might know a bit more about what is going on than you do?

bmjopen.bmj.com/content/12/3/e059397
www.bmj.com/content/bmj/364/bmj.l842.full.pdf
www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/workforce/nhs-medical-staffing-data-analysis
www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis