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

It says basic salary for consultant drs 2008/9 was:

Min: £60,945
1: £65,305
2: £69,667
3: £74,028
4: £79,001

So, the BMA claims
To put this into context, the estimated take-home pay for the average consultant in England in 2008/09 was £67,752.

If it is true that the average take home pay of a consultant was £67,752 in 2008/9, then that would correlate to a gross salary of a minimum of £104,715 which is impossible since the highest basic salary in 2008/9 was £79,001. I rate this FALSE

Taking inflation (RPI) into account, the average real terms value of that figure by 2021/22 was the equivalent of just £44,096.

Real terms of wages are calculated using the CPI not the RPI, so this is FALSE too.

Between 2008/09 and 2021/22, this represents a 34.9% real decline in the value of take-home pay (accounting for estimated taxation and pension contributions) for the average consultant.

Well, since the -34.9% is calculated as if wages had not changed since 2008/9, used a obviously incorrect take home pay figure and used the RPI instead of the CPI, this too is FALSE.

You'll have to explain further, rubbish... what are you talking about? No barbs were dispatched, nor intended, but you continue to take everything personally, Is this a display of some obscure or possibly ineffable skill set you bring to the NHS? How does it affect the ballot being discussed, in which you'll have no involvement? Me and my mates find our management team very helpful, since ours is well-engaged and good at working together with us workers to keep the trust flying.

They (BMA) should probably have used CPI in their calculations and on the graph. The netsuke of inflation is clear though. They do also state take home pay . For me, I do think that is with tax, pension contributions, NI and probably any tax pension charges taken out. I'm assuming it's up to doctors to supply information to the BMA. How is the information verified, does it include eg indemnity insurance, professional memberships need to work?
It would be good to know how many doctors are in each year's cohort and whether they work part time or more than full time (additional sessions I think they call them). Purely so it can be checked that hours worked is same between cohorts for all the years. This may all have been done (I have just looked at graph not read links).

The chart gave only 4 different values of basic pay for a consultant. Could this "basic" pay be for only the 4 years since becoming a consultant ? I looked at BMA consultant salary payscales on BMA website and there are jumps in pay at years 5-9 since becoming Consultant (and again later). I think basic pay is very different to what average pay will be with possibly....antisocial hours pay, extra sessions, being a consultant for a long time, also there are clinical excellence awards (Discretionary points in Scotland). Certainly if someone asked me back in 2008/9 what an average Consultant doctor (with a few years experience) earnt I would probably have guessed maybe £120,000.

Sorry should be "they clearly state how they measure inflation " .

In which case it is surely immoral also to not give those essential workers a pay rise that is at least in line with inflation each year?

It is really not difficult, the only people at fault here are the Tory government, in choosing not to fund public services properly.

A bit off-topic, but there is an excellent interview with Prof Pat Price in today's Telegraph (Saturday 4 Feb). Her view on the bureaucracy that is holding back the NHS is scathing and horribly credible. She is a consultant oncologist at the Royal Marsden, and a lecturer at Imperial.

Yes, workers should all get a cost of living pay bump in line with inflation.

But that has NEVER happened in ANY NATION in the ENTIRE KNOWN HISTORY OF EVERY CIVILISATION.

So, as much as I loathe the Tories and am quick to cast blame where it is deserved, can’t really blame them for the fact that wage increases have never been linked to inflation.

Yes the BMA doesn’t disclose their methodology nor the assumptions made in their fait accompli calculation there. It doesn’t withstand even the mildest scrutiny. They should have used CPI. They should have explained how they calculated the “average consultant pay” what “take home pay” consisted of- usually it would include pre-private pension amounts. So only the NHS pension contribution deducted. Their figures are a black box and are wildly different from every other analysis that range from a 1% to 10% drop in real terms pay.

Basic pay is definitely not the same as average pay- agree completely. BMA doesn’t disclose whether “average pay” includes NHS wages plus private paying patient income, or NHS wages alone. They must have used assumptions they did not disclose because things do not quite add up.

All in all, I still agree that pay has not kept up with inflation and a decent pay rise is warranted. However, we are all suffering and the lower 99% who are paid less than consultants are suffering moreso imho.

So workers are therefore not being unreasonable to suggest a pay rise close to the cost of living. I am glad with have cleared that up. For a moment I thought that you were under the impression the strikes were unreasonable, when it is plain to see that it is the Tory government that is being utterly unreasonable.

I think the work by the BMA may be sound but genuinely could not say unless someone tells me their methodology (not going to read all the links) . If all the cohorts for all the years were comparable (hours worked/years since becoming consultant/NHS vs private- arguably if more are going private and conversely earning less that is not arguably government's fault....unless due to NHS work conditions/pension issues). I do think there are clearly pension issues and can understand if pension tax payments are effecting BMA recorded take home pay (BMA should state that). All I want is methodology, I repeat it could all be completely okay to me. I do think amounts quoted for take home pay of average consultant could actually be values quoted with lots of the above factors accounted for (just tell me what is being looked at).

The payscales for consultants are set nationally. For consultants who became consultants after 2008, there is an increment every year for the first 5 years and then an increment at 9 years.

All doctors have to pay their professional fees required for work from their own pockets. It's approximately £400 pa for the GMC (cannot work unless registered with the GMC), and I pay about £1200 pa for professional indemnity (insurance for assistance in the event of a legal issue where my employer is not happy to support me) - that is for pure NHS work, I assume that you might pay more if private. There are other professional organisations that people may choose to be part of to access educational opportunities as well, but these aren't compulsory.

All doctors have to pay from their own pocket for the professional exams during training that allow you to progress to consultant. I qualified in 2002, and my professional exam fees were almost £3k in total, which is not reimbursed by the NHS.

Would you like to know what "antisocial hours pay" is? In my previous job I was on call overnight from home 1 night out of 15, and the multiplier for my pay was 1% for doing that. The additional amount I got before tax for doing that was about £75 per month, so around £30pm after deductions for 1-2 oncall nights per month. The maximum multiplier for on calls is 5%, and that is for rotas with very few people in or where there is a very high likelihood of having to come back into work (not simply being called, so it's possible to be called several times overnight).

Yes, it's at home, but it means no drinking in case you get called for advice, being contactable from 8pm at night until 8am in the morning, so having to leave phone on loud, and when you are called, it's for exceptionally sick complicated patients, usually ones you have never met before, and need to make complex decisions and advice, and perhaps even return to work (you have to live somewhere that you can return to work normally within 20 minutes, so if you live further away, you have to rent a hotel room or pay for hospital accommodation).

Well, we know it’s not sound because they used the RPI.
And if they’ve discounted private paying patient income, then the average take home pay comparison could based on different length work weeks from 2008/9 to 2022…..as in if you used to work 40hrs/week NHS plus 10hrs/week private and now the average consultant is doing 30hrs/week NHS plus 20hrs/week private….but the BMA is only measuring average NHS pay, that’s a 25% pay cut from simply working 25% fewer hours billable to the NHS. We do know that this trend of consultants picking up more private hours and doing fewer NHS hours is a thing due to the pension issues.

I agree, the BMA needs to be clearer as in tell us what is being looked at.

No, the strikes are unreasonable imho because it will cause/is causing avoidable and preventable deaths of human beings.

The demand for better pay is not unreasonable, but should not be holding patients hostage to get the demands met.

BMA just needs to say (or someone tell me from reading BMA methodology behind the graph). One person telling me something is not helping me a lot with the "average consultant take home pay" in 2008/9 compared to the last date. I hope BMA take into account with cohorts used years since becoming a consultant and hours worked certainly when calculating "take home pay" I hope they do take into account things like indemnity insurance GMC membership, royal college memberships etc and pension tax bills. For training costs to be a consultant I personally think that shouldn't be included (purely because this is consultant take home pay and it sounds like exams were pre consultancy. I hope you get tax relief at least on lots of these things.

That’s just it, BMA hasn’t published their methodology behind their calculations so no one can tell you. At least, I can’t find their methodology anywhere.

Not paying nurses, consultants and other hospital staff properly will also cause avoidable deaths. A study quoted on Any Questions yesterday had the cost of Tory Austerity as 300,000 unnecessary deaths...

Hardly anyone is aware of how poorly OOH is paid. I’d do far better off financially babysitting like when I was a teenager for just one evening a month than being a consultant of 20 years experience on call on my current rota (1:12).
So glad we are finally looking at industrial action. I don’t know what it’s taken so long to come to this.

Is this the definition of austerity where the NHS budget goes up every year, in absolute terms, in inflation adjusted terms and per capita? Because that is what had happened throughout the "austerity" years.

I have no idea, I think it was a Glasgow university study that was quoted, I'm sure you could look it up if you wanted to.

In assessing whether the NHS has been subject to austerity it’s important to consider how demand for healthcare has changed over the last 15 years. There has been very little apparent planning for the additional capacity required as the baby boomer generation reach senescence. The funding might have gone up a bit, but demand is skyrocketing…

At least Boris got 40 new hospitals built while he was Prime Minister, that'll make a massive difference.

Referring you all back upthread to Prof Pat Price. One of the main issues is the stranglehold of bureaucracy and bureaucratic empire building that blocks the NHS from making use of IT advances. There are so many more streamlined and cheaper ways to take effort and admin out of the systems that are just ignored. And it is ridiculous that qualified GPs should routinely work only 2 days a week. I understand a 4 day week for a very demanding job, but less than half time?

You don’t feel that everyone should have the right to work LTFT if they wish?

MontagueLeo

don’t bother rising to the nonsense of forcing people to work full time or whatever. It’s farcical. Anyone can work as little or as much as they want in this country, thank goodness. GPs, consultants, ‘junior’ doctors can choose to work as little ir few hours as they want if that’s what they are employed to do. it’s their market.