All the doctors I know are leaving. Are we going to be screwed for healthcare in 5 years time ?

[Gigihadr]

Our NHS now has some of the worst health outcomes out of 19 wealthy nations compared in an international study.
But in 2010 the NHS regularly ranked 1st or 2nd in most international studies.

The UK is under-doctored, we have a 3rd fewer doctors per 1000 people than Germany or Spain

Our government response to the doctors we have left has been to erode working conditions and pay, ensure they have record levels of inflation and rocketing student debt

They are moving to better paid, better resourced systems/employers (they are a competitive international commodity) and I can’t blame them for that.

AIBU to think we are utterly screwed? why are we just sitting back and watching this slow motion car crash ?

As with many things this depends greatly on a)your specialty and b) where you live.
I never did any private work in my entire career and many (most?) of my colleagues didn't either. There's no private hospital in our town, never mind next to our hospital and not a lot of Range Rovers in the carpark either. No, none of us was struggling to pay the bills but the life of an average Consultant in a small town DGH, especially in an acute specialty, is very different to that of someone in a lucrative field like Plastics, Orthopaedics or Opthamology in a big city teaching hospital.
There isn't a huge demand for private practice where I worked as very few of the population we serve has the means to pay for private care. Plus as a PP said, the rates of pay from the major insurers aren't that great, particularly for a specialty like my own, and by the time you have paid for your indemnity insurance and probably someone to do your accounts, you need to do quite a bit of private work to make it financially worthwhile. Given the hours I was already working in the NHS I wasn't inclined to spend all my spare weekends at work as well. The stereotypical Consultant who leaves the NHS work to his or her junior staff and spends all week on the golf course or raking it in at the private hospital may exist in some places, I wouldn't know, but in my experience it is not a lifestyle that your average DGH Consultant would recognise. Yes, a few of the Consultants in our Trust do quite a bit of private work, notably the eye surgeons, but most don't and I don't think many of those that do would describe it as extremely lucrative.

@BelleMarionette Your point about the appalling treatment is down to the profession though isn't it. By the way I totally totally agree with you. The training pathways and culture are antiquated, not fit for purpose and seem to lead to adefensive unreflective and in some cases outright bullying culture in far too many specialisms in too many trusts...

I wish I could upvote this.

this is the situation in a nutshell.

I'm going to be applying for graduate-entry medicine this year. I have a degree and master's in Biology and was thinking of studying to become a PA, but after reading things written by junior doctors on scope creep I know I wouldn't feel comfortable with the level of responsibility given to a PA after just 2 years of studying.

I'd rather try and get into medicine and, if I'm not successful, go into nursing instead.

Yes, I worked in cancer care, and there was only one - of at least a dozen - oncologists (the only man, funnily enough) did private work, and just one of the five (all male) thoracic surgeons I worked with. One surgeon told me his wife wouldn’t let him, as his NHS schedule meant any private work had to be done at the weekend and she wanted him home with her and the kids, to enjoy their already comfortable-enough life.

In some cases, but it also comes from other staff. Quite often HR is deliberately vile towards staff. As a newly qualified FY1 I was also abused by the nurses. Some places have a toxic environment.

A fellow junior doctor, who had worked in another profession prior to medicine (accounting) said that this sort of behaviour would have never happened there. Socially, other professionals I know have some grips with their jobs, but none experience bullying.

There’s a mass exodus from many professions- the rise in cost of living and the crap work life balance highlighted through covid has led people to realise these types of jobs just aren’t worth the stress!

I agree, that's my experience too. Never known so many people of all different trades/professions giving up and either retiring or changing to different jobs with less stress, shorter hours, less commuting, etc.

Covid, COL and stealth taxes are really hitting the squeezed middle and lots are saying "enough is enough".

Even trying to get my car serviced/MOT'd has been problematic with several garages offering their first "slots" in 6-8 weeks time "due to lack of staff".

Our long term self employed joiner has just given up and is now driving a lorry instead - he says it's double the money, fewer hours and no stress!

A couple we know who had a B&B have closed it down and now both work in supermarkets where they're paid more!

Really depressing to think where we're heading.

Wasn’t it called the great resignation?

But yeh Covid response has a lot of responsibility for general quitting

I think a large part of this is due to Brexit. We aren't recruiting from the EU, and those already here from the EU have often left due to feeling unwelcome. Who could blame them?

The trouble with the mass exodus from the NHS is that people die. Not enough staff so care is unsafe.
But hey, we are about to magically find £14 billion to bail out a private company that has paid dividends to their mates of £54 billion.

Safe job.
Govt floor under wages.
No clients.
Can be a high earner anywhere in the country, not just London.
Fantastic pension. Not as good as it was but way better then private sector.
Doctors always eat.

Shockingly few people died in 2020 and 2021 when HMG shut off half the NHS.

It's not going to take 5 years!!

Using the car crash analogy the question is, will the air bags deploy? If so we may have some hope of rebuilding something from the wreckage. If not those worried about the cost of living now will find things an awful lot harder when they have to fund any health needs on top of everything else. Those that moan about the cost of vet bills will have their minds blown at the cost of healthcare.

Impact on death rate is not necessarily immediate.
Delayed diagnosis of cancer with reduced life expectancy is the big headline - the impact of which may be a year or more down the line.

It breaks my heart. All I have done today is apologize time and time again for the amount of time people are having to wait, chasing down the two Dr's we have to cover a whole maternity unit to make plans and review those needing reviews. I've seen people walk out and then I've had to write defensively in my notes to make sure they know I asked the woman to stay and be seen but she couldn't wait another couple of hours because she had to get home to her other children. I've had to deal with women stressed and anxious because they never see the same community midwife and they have ptsd from their last birth that they never managed to get counselling for because the waiting lists are so long. I have only been in the NHS 12 years but the decline has been steady, and then totally escalated post covid

Wait and see what the government answer is-lots more untrained staff doing doctors jobs, plus private for those who can pay. They are utter shits.

It’s just intolerable, for staff and for patients. What a state we’re in, as a country. A global laughing stock, yet Tory supporters are still bleating on about Covid being the sole cause of all our problems. Oh, and Ukraine. Nothing to do with their political choices, not at all, dearie me no.

I’ve just checked my hourly rate on my payslip - band 5 nurse - £17.68 ph, against my DDs F2 doctor’s pay - £16 per hour. She has reached breaking point this week - walked out/gone off sick, after nearly 2 years of excellent work and being one of the most resilient people I know. How has it happened that junior doctors are so poorly paid? BMA - what have they let happen - why??

Well, just read that medical degree length is going to be cut to 4 years. It’s a bloody joke. Just devalues medicine and god knows how it will all be crammed into 4 years. Healthcare is getting more complex not less!

Other gems from the just published NHS long term workforce plan;

• Doubling medical school training places to 15,000 by 2031, with new schools and more places in areas with the greatest shortages;
• Increasing GP training places by half to 6,000 by 2031;
• Almost doubling the number of adult nurse training places, with 24,000 more nurse and midwife training places a year by 2031;
• Allowing staff to 'earn while they learn', with apprenticeships that lead to a full degree but more-on-the-job training;
• Greater reliance on 'associate' roles that can help with less demanding tasks, freeing up senior colleagues for complex cases;
• Expanding training for clinical psychology and child and adolescent psychotherapy, with places rising by more than a quarter to 1,300 by 2031;
• A renewed focus on retention with better opportunities for career development, improved flexible working and pension reforms to keep 130,000 staff working in the NHS for longer.

id imagine 99% of this is unachievable rubbish. I can promise you that midwifery training places can’t be increased. Nationwide there’s already too many students, they’re not getting enough time on labour wards and a significant proportion aren’t achieving the 40 births they should get to qualify. Hospitals are currently looking at telling universities they need to reduce their numbers! The NHS can’t knit up pregnant women for the students to practice on and with the falling normal birth rate I can’t see what they can do.

Unless the nmc do what they’ve done for nursing and say x amount of practice hours can be done in simulation rather than the hospital. Which would be insane. We already have newly qualified midwives who feel not confident and end up leaving soon after qualifying as they’re not prepared for qualification. So I don’t think playing around at delivering babies on mannequins will help.

sorry, I know this thread was really about doctors but I think it’s just indicative of the govts push for numbers at any cost. As long as there’s a good headline saying how they’re going to solve the staffing crisis they don’t actually care firstly about whether it will actually happen or not and secondly if it can happen is it a good idea!

Nhs worker here. Our health isn't 100% our responsibility though. Genetics is the main player I rekon. Obviously don't drink, smoke or get obese but it's not that simple...what about aging?

"I think a large part of this is due to Brexit. We aren't recruiting from the EU, and those already here from the EU have often left due to feeling unwelcome. Who could blame them?"

Brexit is not the sole reason as austerity is a large factor but Brexit has accelerated the decline.

It has stunted if not reversed economic growth, added extra inflationary pressure, exacerbated demographic changes, and the government is telling public sector it can't afford even below inflation pay "rises" despite the highest tax burden in decades.....

We are a poorer country with less prospects so now are having medical staff poached from us when it used to be the other way around.....

The NHS wouldn't be so stretched if people did more to look after themselves, leaving them with more time/resources to treat those with genetic issues/old age health issues, etc.

Reducing the burden on the NHS by being healthier, fitter, less obese, not smoking/drinking/drug taking, etc., would make a massive difference.

I've just left.