To think the junior / resident doctors are greedy, selfish, entitled & lazy?

[SpottyAlpaca]

So the resident doctors are out on strike. Yet again. Patients are being inconvenienced & treatments delayed. Yet again.

They have received a pay rise of 28.9% over that last 3 years, which is by far the highest increase of any group in the public sector. Very few people in the private sector, who ultimately pay the doctors’ salaries, have received anything like as much. Very few of their patients will ever earn as much as a resident doctor. Yet still it’s not enough and they are demanding even more.

Doctors do an important job and deserve to be paid properly for it. But the BMA’s current approach is completely unreasonable and deluded. They talk about “pay restoration’ to 2008 levels but that’s completely unrealistic. The country is poorer now & simply can’t afford it. AIBU to think they should get back to work?

Ok, if you want to look at it that way then Drs (and other public sector workers) paying tax from their wages does reduce the amount that has to be put in by others to cover the overall cost of public services though. IE, if they didn’t pay tax you’d pay more. A lot more.

And, because I can see your next ‘argument’ coming - if education, refuse collection, police/fire/emergency services, care and health became private entities then you’d still be paying for them separately when you need them, and/or be at the mercy of profit making insurance companies etc, who will not be looking to charge you any less as they have to provide the same service, employee people doing the same jobs, fiddle their taxes so they pay stupidly low rates and give massive bonuses to their board/shareholders. So you can see how you will end up paying more unless you refuse to use any of these services. Let’s just look at Thames Water as a case study for how well private companies do in providing essential services…

You wouldn't pay more. They would be paid net of tax, anything else would be a huge salary increase.

You have not understood. No tax paid by someone paid from taxation adds to the total tax revenue of the country.

@cafeconron We would save a lot in government expenditure with a smaller public sector. Tax take is a fraction of the expense! Add in NI, pension contributions and other employee costs and of course the public sector costs more! It’s even worse because they are not productive. The money spent doesn’t buy good productivity. It’s way below the private sector. We should expect the public sector to be far more productive!

I don't think they're lazy or selfish at all and I think anyone who would think that has no understanding of the role of a resident doctor. Also for all their who say the money "isn't there" it's funny how the government magically up the money to pay private hospital contracts mega bucks to carry out NHS work isn't it? There very clearly is enough money to pay resident doctors a fair wage, it's a political choice not to.

@MeetMeOnTheCorner I don’t disagree that we could/should expect more productivity. A decent way to achieve this would be reducing public sector reliance on private sub-contracting. Eg having to pay a private company to change a lightbulb in a school/hospital rather than just having a janitor or internal housekeeping/ estates staff. The money and time wasted by these private sub-contractors is frankly outrageous.

Well bugger me Imdunfer - so that significant portion of my NHS salary that says PAYE is not the same tax that everyone else pays?

What utter utter crap - I get paid like everyone else private sector, state etc and I pay tax on my earnings exactly like everyone else does.

Please tell me how every NHS worker does not pay tax ina any meaningful sense

Eh? That’s not a tax fiddle. It’s how every public sector worker is paid. Are you saying nurses are on a tax fiddle because they don’t pay as much tax as the salary they earn? And teachers? And dustbin men? How do you work that out?

It's an accounting fiddle done by the government.

They could just pay the public sector without the tax.

But it's easier, given that some of them will have private taxable income, simply to give them the tax and then take it straghit back again.

I don't think you understand how tax works @Imdunfer

The tax you pay was provided by another tax payer. If I give ten quid to the tax man and they put it in the pay packet of an NHS employee who then gives it straight back, it doesn't increase the total money available.

I'm sorry it upsets some public sector employees to hear it, but no tax paid on salaries paid to them for NHS public work increases the total money available to run the state.

@cafeconron Most schools have caretakers who do exactly this. Most schools are not PFI schools and don’t have such contracts. Unless they decide to.

The big issue we have is unfettered nhs spending and low accountability. We expect strikes (doctors now on 15th in .4 years) and we clearly have poor productivity meaning those who are not being paid by the state are worse off. No one cares one bit if the self employed (millions of people) have to take time off because of appalling wait times. They don’t get sick pay or huge pension contributions. Yet they employ people and are valuable to society.

We need doctors, from now on, to sign a no strike agreement and this can be made clear before they start their degrees. If they don’t like it, find another career. Holding people to ransom and not caring about the consequences is a brutal way for doctors to act.

Many people are suffering huge delays for important life saving operations. Even heart operations are severely delayed. We need to improve productivity and get much tougher on required outcomes for the 35% uplift plus overtime and enhanced weekend pay the doctors already get. I’m hoping Wes keeps his nerve.

The more I read of these attitudes, the more I think that, if this is indeed representative of the views of the general public, then maybe the NHS is moving towards being the healthcare system that they actually deserve.

Would that be the kind of healthcare system where your gran is left to expire after 3 days waiting on a trolley an A&E corridor? I think that ship has sailed tbh. For me, the main “threat” in relation to healthcare in the UK is that we blindly continue pretending that the NHS is up to snuff when it plainly isn’t.

I suspect we’d see more payment by results under an insurance system, perhaps productivity KPI’s would sharpen things up.

Although I personally benefit, I also can’t see the justification for retired consultants to receive 2 to 3 times the national average salary for life after they retire. I suspect that there is a lack of understanding amongst senior NHS staff over how much that type of scheme costs - even taking their own contributions into account - and how it compares to schemes in the private sector (which ultimately pays for it).

@MeetMeOnTheCorner ok yes most schools still have caretakers. But a significant proportion of other public services are now at the mercy of private sub-contractors. Hospitals, local govt and even the military.

DB is in the military and they recently had to pay £78 and wait 5 days for someone to change a lightbulb in his office. He’d quite happily have done it himself if he could have nipped to the QM for a £2 bulb like he should be able to. But instead they have to wait for a profiteering sub-contractor. And I’m sure they couldn’t work as efficiently in the dark for those 5 days either.

DSiL was laid off by Serco as she was doing local govt work too efficiently a few years ago. Made a show of the rest of the private employees working inefficiently by doing 150% of the expected output, so they refused to extend her contract so they can continue milking the council for the work done inefficiently…

All these arguments are quite circular aren’t they?

Agree! These people literally save our lives, treat our sick kids, everything. They are indispensable. I think they should even get more than the pay rise...they should legitimately be paid more. Plus they work damn hard and no doubt get themselves i to debt to qualify.

I refer you to my previous answer - you don't understand how tax - or the economy works do you?

Then again one day your appendix might burst and these doctors might literally save your life, or your DH has a heart attack or your little toddler chokes, and they'd be dead without the intervention of a doctor too. So its worth the extra tax.

imdunfer - i completely understand how tax paid by a public employee is effectively recycled monies. however, you are deeply offensive to suggest that public sector works do not pay tax which is what you are inferring.

It does not offend me as much as your patronising comments and inference that any public sector worker does not pay tax.

This goes away from the original debate and as your comment is very typical of certain patients who come in and say i pay your wages therefore do x,y and z and think the fact they pay tax entitles them to treat nurses, doctors and AHPS like shit - I hope I do not meet you as a patient.

@MintchocsWhat has that got to do with economics! You might have to mend your own car one day. Or be certain you are not under a collapsing building. A&E and doctors are not gods. I’m sick of this - they are doing a job and sometimes not well and they have been on strike 15 times in 4 years and they don’t operate in a bubble in the NHS! Others are in the teams.

I find the attitude that public sector workers are somehow a cost centre and private sector workers a profit centre a bit strange.

Would people be happier to pay doctors more if we abolished the NHS and moved to a system more like the U.S?

Ultimately we need doctors and they should be paid a fair amount based on their skill set and the responsibility that they take. The health model chosen shouldn’t be relevant to this.

@Newbutoldfather Why quote the USA! What system do you think Australia has? It’s where our doctors live to go. It’s not a NHS system. We just look at the worst and think we are so much better. We are not. Productivity is dire and we really should demand more and absolutely have a better service. Whatever that would look like. Wasting all this money and time by striking is appalling. No wonder we all notice the NHS is failing but it’s a shrine that’s worshipped and doctors are part of it. In other countries there is a far more sensible approach to healthcare and it’s better.

Yes, the NHS is broken but what you are talking about has far more to do with systemic issues and the management of the NHS than the doctors in it who are trying to work as effectively as they can whilst also suffering within this broken system. You seem to have problems distinguishing the two and just direct all your hatred at doctors in general.

This is called being a public sector WORKER.
And by the way, the economics of it are more complex than assuming that you and me pay for their wages.

If only they knew what the job entailed before starting it.

Would that be the kind of healthcare system where your gran is left to expire after 3 days waiting on a trolley an A&E corridor?

Yes - it will be exactly that type of healthcare on a large scale when privatisation happens in earnest, or maybe patients won't even bother going to the hospital, knowing that they don't have the private insurance to pay for their care. You can watch any US medical soap to see how great that is.

@MeetMeOnTheCorner ,

I think you missed my point.

It was about public vs private sector, not the best healthcare model.

i would love us to have a model like the French.