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

In a nutshell - my take home NHS pay was £62495 last year - a good amount.

I then received a brown envelope which told me due to factors out of my control, I owed the tax man £32000 of pension tax. So my not so bad £64K / £5300 pcm suddenly became £2600 pcm.

Not quite so healthy and rich now - no entitlement to any benefits, support because the first figure is what it takes. Add in my malpractice insurance at £900 pcm - life is suddenly not so bloody rosy.

That is what the pension tax is about - monies I have never recived I am paying tax on - wtf is that about.

That is absolutely nuts and needs to be sorted ASAP.

@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).

Yes I support. It's an example of a profession where we need to pay competitively to fill vacancies. This is not theoretical - the empty posts are there now.

Funny how when the market says "more pay required" in this instance, suddenly the Government are all socialists who think doctors should think about the good of society.

The pension fuck up is disgraceful - of course they're going to cut their hours or retire early as a result, as we all would in that position.

Lowest paid staff getting more will count for little if there is no clinic leadership and expertise to run services.

Couldn’t care less what your salary is. That’s not really my business.
If you feel the need to strike, then I support you wholeheartedly.

It’s not a vocation, it’s a job.
Doctors pay tax, a lot of tax, so are also contributing to their own salary.

With so many minimal/low wage workers in the health and social care sector, I'm afraid I can't get on board with nhs consultants salary not being as high as it should be. Equity is important here, not equality.

Yes I support the doctors and consultants getting a pay rise.

It is one of the most important jobs in our society, the responsibility is huge and the sacrifices they make to get to these positions are huge and ongoing.
If they are not compensated properly they will move to other countries where the pay is more in line with the demands of the job.

Well yes, but this is going to be a problem for you - it's too complicated for easy headlines and tbh most people won't be able to get their heads around the issue.

Realistically, the Daily Mail will be running stories with an emphasis on million pound pensions. The details will be way down the articles, if they're covered at all

Not a reason to add more dead bodies to the pile.

Strikes result in yet more unnecessary deaths by lowering staffing even further.

Strike before there are no consultants left .

@lookluv, I am the first to support fairer pension taxation for NHS consultants (see my previous long missive) but I suspect that you might be giving selective information here. You said that your NHS take home pay is £63k, but if your pension tax charge is 32k then I strongly suspect you have substantial additional income from other sources, such as private practice or perhaps investment income.

A pension tax charge of 32k would require pension capital value growth of at least £71k in excess of the annual allowance, and your annual allowance does not get tapered below £40k unless you have threshhold income above £200k. With an untapered annual allowance, pension capital value growth would therefore have to be £111k in order to generate that level of pension tax charge, and I don’t think a person on £130k or even £150k pensionable salary would be getting £111k in pension capital value growth.

I’m happy to be corrected in case I am getting it wrong.

Really heartened to see a lot of support here

I expect fully that the Daily Fail will mislead as usual

This is everyone’s business, as lack of consultants staying in posts in the NHS will come for everyone ( unless you die swiftly and suddenly at home)

If it’s not already crystal clear, being a doctor is not a vocation, and neither is being a nurse. They are jobs.

If the jobs were as they were a decade ago, we would not be in this position.

I don’t know any consultants in the NHS who are paying for 3 skiing holidays, or indeed, any skiing holidays- please read the numbers above, and facts about pension theft, before writing such nonsense.

If this is unsuccessful, and the recruitment and retention continues to fall, I expect many consultants to work in private practice instead of the NHS. Expect we’ll afford skiing holidays then, if you’re still bleating on about that.

This is one problem, but not actually the main one. The main problem is far too complex to convey in a single forum post, but....

The main problems are to do with annual allowance and pension growth.

Because of the way Final Salary (now ended) and Career average schemes are calculated, any increase in pensionable pay increases the value of the total pension pot. This is unrelated to the amount payed in in that year , and means that by earning any extra pensionable pay, or having a pay increment, a tax bill can be triggered. This is often in the region of around 10s of thousands of pounds which either needs to be payed up front, or, taken out of the pension pot, as a loan which attracts interest until you retire. This is often unavoidable. A consultant working a standard 10pa contract, with no private or additional work will almost certainly get hit by this when they pay increment, at which point, the only options are to reduce pensionable hours I. E. Work part time, or to leave the pension scheme, which reduces the value of your pension, and may affect the scheme benefits such as death in service and spousal pensions.

The financial hit is unfair, but the worry is as bad. Many professional pensions experts get the calculations wrong, and I've personally spent hundreds of hours trying to understand the issue.

I never heard of this. I must have missed it on the news. So they are asking you to pay all that extra money on taxes in one year? Also... I think the money for the pension comes out of the gross for the month before taxes, so what is this pension tax thing? It does not make any sense to me, at all.
As you say, with around £2000 pcm, it is a struggle, especially with a big mortgage. And prices just keep rising and the stupid amount needed for gas and electric bills these days. Most people get around that figure, we are all struggling while someone else is pocketing your £30000 and as much as they can take from the rest of us.

You've got it wrong.

The growth is based on, for most consultants, a combination of two pension schemes, a final salary, and a care scheme.

I don't have my exact numbers to hand, but as a year one consultant my pensionable pay jumps from 48k registrar to 73k consultant, which increases the value of the final salary part by 65% plus whatever contributions have been made plus an inflation factor, plus a multiple for the extra year service. My growth was 96k for that year, thankfully I had carry forward as minimal growth for the previous years.

Additional clinical responsibilities, excellence awards can all be pensionable and add to the problem.

You can be working tour day job, no private work or other income, everything through PAYE and be nowhere near the AA taper (which was partially fixed by increasing it) and still get absolutely stung by this.

Look up Tony Goldstone on twitter, who has led the way on this and makes some of the details more easily understood, but I'll admit, I struggle.

Evidence from the last strikes was that the death rate decreased as there wasn't any planned activity happening...

@FixTheBone so from what you’re saying, a 35% pay rise as OP suggests, is merely going to compound the problem no? Given the higher the earnings, the higher the potential tax liability. Better to get rid of DB Achebe’s all together and move everyone to DC.

DB schemes….

Spot on. And if people think they're overpaid, sign up for the job and have a go.

I taught a surgeon who came to (swimming) class on the back of an 80 hour week. It was his way of winding down... 😂Granted, some of that was not... surgeoning? but it is pretty exhausting.

I'm all for striking.

The issue is partly about pay, I know it sounds entitled, but a two doctor family shouldn't have a bathroom and bedroom that they've not been able to renovate on the ten years since they bought their house for £180k, that what pay erosion has done to us - a ten year plan that we've had to cut back and cut back year on year until we're at the point where the overdraft gets used every month...

The main issue, as above is pensions tax rules, which we cannot legally strike on.

In an ideal world I'd want 35% pay restoration and infkation linked increases, but we all know thats not going to happen.

As a compromise, I'd probably take fixing the Pension issues and 5% increase in pay for the next 15 years.

I totally agree that NHS need more doctors. More nurses. More support staff.

I don’t understand how paying NHS consultants more money suddenly takes away all the stress and improve working conditions? Some more money and suddenly they find the current situation acceptable!?

@noworklifebalance It is meant to be a vocation. It has an specific oath for it and all.
If a consultant does not have a vocation for their job, let's face it, we are all better off with them getting a job in banking or whatever.
It is not all about money in this life. There are plenty of things much more important than money, and a good working ethics and care and love for your job are in my list.

Bollocks. You can’t measure deaths caused by strikes by consultants by # deaths on the strike days themselves. The deaths come later as knock on effects due to delayed procedures and diagnoses.