To think the BMA have misjudged with another doctor's strike?

[Locutus2000]

Last year they got more than anyone else in the NHS along with an improved deal. Nurses and other AHPs received lower rises.

BMA have just announced another 'resident' doctor strike continuing to chase pay restoration to 2008 levels.

Having just had the major win with changes to IMG prioritisation and the clamp-down on PAs it feels a bit tone-deaf and I can't see Streeting going for it.

There are not going to be any band 9 physician associates/ assistants. Not clinically anyway- if they move into management roles , perhaps.

I can tell you emphatically and conclusively that there is no comparison between 2005 when I qualified, and now.

2005, despite the 82 hour weeks was an absolute piece of piss. slept for at least half the night shifts, had immediate access to senior support and advice during the days, accommodation on the hospital grounds, food provided for teaching which happened twice weekly in a protected lunch hour. My typical day involved coming in arounf 7:30, prepping the case notes, doing a ward round of 15 patients, 10:30 am down to the mess, along with most other juniors - tea, toast, discuss patients, make referrals to other specialties, 11am do urgent jobs, discharge summaries discuss scans with radiology, 12pm lunch, 1pm chase and act on blood results, review all prescription charts, 3pm final check of the ward jobs book. 4pm check with colleagues in the same specialty if anyone needs a hand, if not, some of us went and did some portfolio work, and we took turns holding the other bleeps.

A couple of years ago (immediately before becoming a consultant) I covered an SHO shift for a weekend, and despite being consultant level in my decision making and experience - the sheer number of bleeps, increase in number of patients to look after, increase in paperwork and administration made it an absolute hell on earth, unrecognisable to what I experienced as a 'junior' PRHO. Literally did not sit down for the entire 2 x 13hr shifts, no lunch, no drinks, no time to do anything other than bounce from bleep to bleep.

Out of interest, do you think part of the problem with the number of bleeps, compared to years ago is due to a change in how the wards work?
Years ago, when I was an inexperienced nurse, I would have taken any queries or concerns to the senior nurse on duty first- and most of the time they had the answer. Now, there sometimes isn't a senior nurse on duty and even when there is, the junior nurses tend to bypass this step and have become bleep happy.

DD regularly has 13 hours shifts with no time to pee. Really bad at the start of F1 as her name is distinctive so she was the one that nurses bleeped first. Sleeping would be unheard of.

As her dearnery is still on the old 2005 contract they have the worst of all worlds. Old working conditions and the modern-day pressures. Interalia drug addiction levels are awful and alcohol use just as bad.

And no job at the end of it. F3 type roles have evaporated due to the changes in immigration law, and no allowance is made for the different contracts and opportunities in different parts of the UK.

Those who got training numbers will know how rare those are. They will know that perhaps the majority of their peers have nothing. They will know that cover for their strike action will soak up any spare funds that might be lingering in Trust bank accounts. Which means that their peers picking up enough NHS Bank Shifts to survive is increasingly unlikely.

If it coincides with a strike day will they turn up at the airport to wave their former colleagues off? Or will they head for the beach?

TD:LR the funding cake is limited. It does not matter how bad things were in the past. The question is about the best way to spend the limited amount of public resource. Really significant now when, because of fiscal drag, people who earn less than they would on if they were on benefits, are paying tax.

@FixTheBone

15 patients!

I can tell you emphatically and conclusively that there is no comparison between your experience and mine.

I'm not surprised you found it hard at the age of 40+ when you tried it again.

Orthopaedics I presume.

we had half a ward each, regardless of specialty - i did vascular, colorectal, endocrine and geriatrics

I still find if mad that bleeps still exist ! Why not just call someone on a phone, leave a message if busy. Is there a reason they still exist ? Bleeps must cost more than a simple phone in both money and time. Or am I missing something ?

I really don’t get the ‘we had it worse’ comparisons. Surely everyone wants to make it a sustainable job for all young doctors, who only know an NHS that is under staffed and broke and full of other staff who seem to look down on them.

Part of your issue is defo the comparative pay of resident doctors and PAs, as many of your past posts attest.

Many here who cannot get worked up about that may share concerns about patient safety. I do.

@poetryandwine patient safety is my main concern too. But it does seem mad that assistants are paid 30% more and shows the money is there, but might be going in the wrong direction. Nurses need a better pay rise too.

Surely it depends on role.

I saw a PA in an ENT clinic. I met the threshold for referral but mainly to rule out nasties. I was as happy being seen by a PA who was looking at throats day in, day out, as I would have been being seen by an F1 & F2 who might have been new to that department. Ditto I opt to go to a private skin clinic to be seen by a specialist nurse, despite the fact my history would qualify me for regular checks by the GP. Whilst the senior Nurse Practitioner at my mum's memory clinic was excellent.

Yes one of those could miss something. But so too could an F1/F2 or a new recruit from overseas adjusting to NHS treatment protocols.

That said I am pleased that my GP has stopped employing PAs. (And equally pleased they have been allocated three trainee GPs after not having any for a while.) But then the locums I saw on my last two visits did not inspire any confidence either.

I suppose it’s comes down to whether a medical degree is needed to perform certain tasks, or if you can learn on the job. And if you only know the simple stuff how do you spot the tricky stuff, that looks simple. I want a doctor to diagnose me. Happy for others to treat once a doctor has decided how. And yes, some are not that great, but chances are they at least have the knowledge required.

While we have unemployed doctors I don’t see what a PA brings to the team. Cheaper to employ an F3+. And an ANP can do more too, again cheaper.

Yes, but with current immigration law any doctor position would have to be advertised internationally. I don't think the same is true of PAs.

Well you know my thoughts on that. Hopefully that’s the next thing that will be sorted - Wes has said as much. Unemployed, UK trained staff, is madness.

He won't have the money. The story is he was already unhappy about last year's pay settlement as it took away his ability to work on other things.

Prioritising UK trained staff won’t cost him a penny, but will save loads and utilise the investment we’ve into training them. I’m hoping that Wes offers a plan, so no more money this year, but a clear roadmap to restore pay over next 5 years. Just as he promised last year. Like in Scotland. 🤞

This is naive. India has long lobbied for access to the NHS for newly qualified doctors who need experience. And the new UK India trade deal gives similar advantage to Indian firms to bring over skilled workers in tech and similar fields (Exempt from employment costs for three years.)

A familiar refrain in the MN HE board is that it does not matter where you train. A doctor is a doctor. There will be reasons why the Resident Market Labour Test was dropped, and suspect these will be related to either trade deals or cost saving.

There certainly does not seem to be any interest either by resident doctors or the BMA to ensure that those following them are able to find employment. They have jobs. They want more money.

I hope you don't mind me pointing this out as I'm sure that you feel a bit attacked on this thread in places, but ANPs are not cheaper than PA's, they are paid more.

@Minnie798 true. But I personally believe that ANPs are more worth it than PAs. Although do think doctors should be paid more 😊.

@Needmoresleep as you know a lot of people are doing their best behind the scenes to get UK prioritisation asap. Workforce plan out v soon and I am hearing v hopeful stuff 🤞. I don’t know any F2 or ST3 who doesn’t care about their friends.

This is why some of us are upset. I’ve supported many students to become doctors and so many of them now face this in August. Pay is one thing, but none of them realised unemployment would be a reality. 48% of F2s currently don’t have a job in August 6th.

https://archive.ph/tFmN2

Which is why I think that the BMA and those with work are disgusting, truly disgusting, to prioritise more pay. I don't think I have heard the BMA even speak about this huge problem. Indeed when the immigration rules were changed some in the BMA welcomed it as a "brave move".

Striking is very very unprofessional. People talk about how PAs are unsafe. Why is doctors leaving their patients OK?

On the Higher Education threads there used to be discussion about the usefulness of work experience, with some saying working in a supermarket was just as useful. When she was 16 DD spent the summer working in a care home, cleaning, kitchen portering and "waitressing". She had her eyes opened to how hard care workers work for so little pay. Balancing shifts so both they and their partners could work with barely any family time. Yet these are the people who pay taxes. Perhaps medical schools should go back to requiring that applicants have experience of the real world.

What are your daughters plans for her strike days? Last time, and rather inappropriately, you boasted that she went to the beach as if she was some brave equal rights warrier. Whilst her poor consultants were having to cover her job as well as their own.

@Needmoresleep I know you are angry but please don’t make this personal. My DD is currently still in work after starting at 8am and v likely not home until midnight, after 3 13+ hour days and another 3 long days to come. Her current plans for any strike days are sleep. She’s on 5 night shifts next week. And she wasn’t paid to be on strike so what she did was her business - and all her consultants fully supported them.

BMA is a union. It fights for its members and has been advocating for UK prioritisation. I believe it will be in place v soon.

And her ‘poor consultants’ were v well rewarded. Although most gave their extra income to the strike fund, and one lovely human took them all out for dinner as they’d lost so much pay.

My DD has worked since she was 13. Been an HCA in a care home and on Covid wards. Also worked in a supermarket, because if she wanted holidays or a car, she needed to earn money. We can’t afford extras, they either earn the cash themselves or they went without. Not sure if you know but teachers are not well paid either.

Why are doctors going on strike if so many doctors are unemployed?

@OonaStubbs because their pay is 22% less than 10 years ago. Jobs are there but because anyone from anywhere in the world can apply, UK trained staff don’t get priority. It’s a v strange and stupid system,