Junior Doctors Strike

[Lanchester]

Do the Junior Doctors seriously think that they are still
respected for always putting the interest of their individual patient first?

Twowrongs, not all will get consultant jobs, some will become staff grades (without the level of responsibility for management etc). So no, not everyone will be a consultant

Drs are taxpayers too and often patients BTW

I am happy to pay more tax to improve the NHS.
I do not think the way to improve the NHS is to privatise it so that easy tasks can be cherry picked and profits go to rich people (see PFI)
I do not think the way to improve the NHS is to get all the people currently working for it to do more work for less pay. If a 24-7 routine service is what is desired (and I actually don't think it's necessary) then taxes will need to go up to fund it.
It is particularly silly to think the NHS will be better if more junior Drs do more evening and weekend work as it is them doing it anyway. This reform only makes sense if it is applied to senior Drs and all other NHS staff.
There is a safety issue because of penalties for hours limits being removed. It is a real risk that we could go back to unsafe working practices of the 1980s and 90s.

The strike is about pay to some extent. There will be a real terms pay cut for most junior Drs (ask yourself why pay protection is required if this is a pay rise) because the rise in basic pay won't cancel the cut in out of hours pay. I don't think many people would accept a pay cut plus an increase in anti social hours lying down and since the NHS is the monopoly employer of junior Drs they can't leave for another job.

The positions are entrenched due to silly rhetoric on both sides.
The government should stop saying that their new contract is needed to stop deaths at weekends. The logical explanation for more deaths of people admitted at weekends is that these people are sicker. No link to staffing levels has ever been shown. It is quite obvious that having more junior Drs would not solve it anyway without all the other staff.
The government should stop trying to pretend this is a pay rise.

Drs should admit that we have a hard job but a rewarding one that we chose and can walk away from any time. Other people have hard jobs too. We are quite well paid and have great job security and pensions.
I don't like the whining about Starbucks managers as an argument myself.

The other point that I feel is often missed is that some specialties have much more out of hours work than others eg paeds, A&E O&G and these are already struggling to recruit as not many people want to sign up to a whole working lifetime of night and weekend shifts.

In the past the out of hours pay made up for the antisocial nature of these jobs but if JH increases basic pay and reduces out of hours then recruitment to these tough jobs will fall even more. That means that far from being safer nights and weekends will be more unsafe because only the very few dedicated enough to sacrifice any family life or those who couldn't get any other job will choose these front line specialties.

My friend who earns over £70,000 aged 31 as a hospital psychiatrist is not a consultant and he does not do any private work.

Can anybody post to say - How many weeks paid leave (of all kinds) per year do NHS hospital doctors get? Thanks.

The parents wondered WHY the teacher training days could not have occured during the 4 month teachers holidays

Not that old chestnut!!

Lancaster - I don't think Shezadoc was misleading or lying. I think it is the facts around what is 'private ' work that is not clear.

there are lots and lots of things that are 'private work' but what the public probably thinks of as 'private work' is indeed consultants doing clinics and operations at bupa and the like hospitals.

as far as leave goes...doctors below consultant grade get 5 weeks leave. But often when you can take it is determined by the hospital, i.e. you get told when your leave is.
It is rare to get more than 1 week at a time, and there is no way of makign sure you get the same leave as say your partner if they are also a doctor, special cases have to be made to HR to get leave for say a honeymoon.

In australia ( were i worked for a long time as a JD) i got 6 weeks leave and then for every 6 months that i was on a rota that involved night duty i got an extra weeks leave . So i was training in emergency medicine and did a whole week of nights every 5 th week, but over a year i got 2 extra weeks leave .

Lanchester- either your friend is not a junior dr or not telling the truth

You yourself posted the national pay rates at 10.27. On those rates a registrar can make up to 69,000 and that's with 50% banding presumably which is very unusual in psych as its not an acute specialty. On call is usually non resident as a registrar so 20% banding would be the norm.

Consultant starting pay is 75,000

Possibly if he's an experienced specialty dr he might make that money. This is the job you do if you do not become a consultant but finish/ quit training. I have no idea what their pay rates are and its non-relevant as they are not 'junior Drs'. They are not covered by the new contract and not striking.

I get 33 days leave plus bank hols (if working bank hol I get a lieu day) for full time contract.

Oh and up to 10 days study leave theoretically which in practice I can never get approved due to service constraints and can't afford to take anyway. I will usually take 3-5 days and I do go to conferences and courses for CPD which is compulsory so I hardly think it is holiday.

Letseatgrandma Mon 02-May-16 13:25:41

I am in favour of open and effective flexible systems of service provision.
I think that can be public sector or private sector - but it should be good value for money.
Entrenched self interests distort effective allocation of available funds.

In the current NHS strikes such entrenched self interests are led by the BMA.

Service providers of health care / social care / education have a duty to be open and accountable to the citizens of the UK.

So tell everyone - What was the answer to that "old chestnut" then?

Wouldn't it be nice if we could bang a gavel at this point:

"we have a hard job but a rewarding one that we chose and can walk away from any time. Other people have hard jobs too. We are quite well paid and have great job security and pensions. "

and then, with the ground duly cleared, move on to:

1. What kind of NHS do we need?
2. Is this strike the way to get it?

oh and 3.

Why aren't the nice girls with A stars like me savvy enough to become the neurologists?

but maybe that's another thread for the Feminism section

mamadoc Mon 02-May-16 13:38:03

Thank you for posting about the paid leave entitlements.

You probably know that in companies throughout the UK there are similar problems for staff trying to get paid leave at the same time as their partner, especially during school holidays, and as you know most people in the UK get A LOT LESS paid leave than BMA members, so trying to synchronise their leave to coincide with their partner's leave is commensurately more difficult for them.

MissTriggs Mon 02-May-16 13:48:58
"Wouldn't it be nice if we could bang a gavel at this point"

Well you certainly seem able to see both sides of an argument
actually quite constructive - and thanks for that
...but hang on ... you're not a judge just yet are you? :)

What kind of NHS do we need?

In my view we do not need a 24-7 elective service ie routine clinics on Saturday nights
We do need a very good 24-7 emergency service.
We could improve GP out of hours services which are a joke in many parts of the country especially rural areas.
We need more access to scans and investigations for inpatients and A&E at weekends but we'd need more staff at all grades not just Drs for that
We need much, much more social care and hospital at home type services to keep elderly people out of hospital and discharge them safely. We need more physics, OTs, geriatricians, dietitians and care staff around the clock in community settings. That is a big culture shift and very expensive. We'd probably need to close wards to afford it and that wouldn't go down well.

Most people who use the NHS are elderly, frail with multiple conditions not the people posting on this thread. The NHS is for them mostly it's not actually for the convenience of working people who'd appreciate a Saturday appt.

2. does this strike help that?
   Sort of a bit
   Certainly making junior Drs work longer, more antisocial hours for less money will not improve the NHS and it may well make it worse by having more tired junior Drs and by putting drs off doing A&E
   I support their right to strike mainly because I support their right to protest a pay cut and worse conditions. The same way I would the tube drivers or the teachers.

3. neurology is a very competitive specialty. It's got a reputation for super intellectual people. It's a bit depressing though. I wouldn't fancy it. I'm biased though my ex is a neurologist.

I think this comes down to what you were describing as private work, and what I would describe as private sunstantive work.
I apologise if anyone has misunderstood.

And the pony you missed was about supply and demand

"...but hang on ... you're not a judge just yet are you? smile"

I think that ship sailed when I decided not to follow my team into London but instead follow my bloke up north, despite the fact I'm in a very London speciality ;)

Oh the things we girlies are not told...

1. The doctors can strike if they want. They have legal right to strike. I don't think any of us dispute that. Whether it will be worth their while doing so is another matter and you don't get paid on strike either do you? (Unless the BMA has a strike fund like the miners had for a bit). As I say above these things always end up being a matter of market forces. When the state cannot get doctors it tends to increase pay or change working conditions or whatever else is needed to achieve the ends.

1. The junior doctors will shortly lose all public sympathy however other than from Corbynites because most people would give their high teeth to have a junior doctor's life and prospects but accept most of them are not bright enough to qualify. Junior doctors don't have some uniquely awful life like my great grandfather down the mines or even my postman son.

1. I was asked "Could you cope with a 20% reduction in your salary tomorrow? Or needing to pay a nanny on adhoc days? Or paying one months take home salary this year on exams?" I have had at least 50% cuts - in the free market of law firms and the like we dont' have the feather bedding of NHS workers with huge pensions and unions and employment protection. Also I now work for myself so get no pension, no maternity leave, no sick pay, no holiday pay, nothing.

1. On consultant pay mym family members who are/were consultants (and indeed in psychiatry) have done very well indeed. Now we might be an exceptional family - Oxbridge, very good etc etc top of the bunch but being myself within the M25 I know how much many doctors earn at the upper levels. My father did loads of work as an expert witness and was on mental health review tribunals although I don't know if current rates of pay for the latter or high or not.

Laura, I'm really sorry you have had a pay cut of that type. Market forces, however, are currently not being applied within the NHS as there is already a shortage of junior doctors, and in some specialties in some areas consultants. (See jane dacre, head of the Royal college of physicians recent pronouncements. )
It is very hard to see that many consultants do not do private practice (in the way of having priveleges etc) because of time, lack of demand or simply not believing that private practice should be done, and wholeheartedly believing that the NHS should be able to accomadate all.
I don't do private work, never wanted to, and hopefully will never have to.
Within the M25 is not representative of the rest of the country, clearly that us the same in many other professions. (Certainly seems so from other posters on here).
Again, a lot of misunderstandings I think come from the fact that these worlds are very different, and one will often think that the grass is greener elsewhere without appreciating the difficulties inherent in all walks of life.

I am also Oxbridge educated, have a PhD etc, etc but I never do expert witness or MHRT work because I'm busy doing my NHS job and bringing up my family. I have my NHS salary and it's fine but it's not 6 figures. Tribunal Drs are all retired around here you wouldn't have time to do it as well as your day job because it's 9-5 work.

Again I will remind you that there is a difference with an older generation of Drs (you speak of your father). In the past Drs were very well paid relative to the rest of society but this has been gradually eroded over time. They also did not have student loans and had free accommodation as junior Drs. I definitely cannot afford a nanny or private school fees which was taken for granted by previous generations of Drs. I drive a 2nd hand Ford Focus and live in a terraced house on a council estate. None of my peers privately educate their kids. You wouldn't choose this job just for the money.

I am not moaning. I accept I am well paid, have a good pension and good job security. I think it's slightly generous to about fair for the level of competition, the stress and the responsibility. It's a meritocracy people do tend to get paid better for more academic competitive to get into jobs unless you're a communist you accept this.

People can have sympathy or not but I just want them to be in possession of the facts.
The government say things like 'they are getting a pay rise', 'this is so that hospitals can be safer at weekends and we can deliver a 24-7 NHS' and these are untrue misleading statements.

It's swings and roundabouts, chalk and cheese

I won't get a huge pay cut (at least not without Union negotiation), am unlikely to lose my job and do have a good pension, sick pay (never used) and holiday pay.

However because I work for a monopoly employer I cannot (certainly not as a junior dr) negotiate a better pay deal if I'm particularly good at my job (it's the same national contract everywhere), get another job ( in medicine in the uk) if I don't like mine or set up my own private practice in the way you have done. If I want to be a dr I pretty much have to work for the NHS under the National Contract. Therefore I need Union protection more than someone who can just get another job.

My family found it amusing recently that when I was offered a management role with more responsibility it came with no pay rise as it would in any other job. NHS pay is just time served and hours worked.

". I was asked "Could you cope with a 20% reduction in your salary tomorrow? Or needing to pay a nanny on adhoc days? Or paying one months take home salary this year on exams?" I have had at least 50% cuts - in the free market of law firms and the like we dont' have the feather bedding of NHS workers with huge pensions and unions and employment protection. Also I now work for myself so get no pension, no maternity leave, no sick pay, no holiday pay, nothing."

To be fair Laura, the drs on this thread have clocked that now. Though the ones we resent are of course not on mumsnet, they're on holiday or preparing an expert witness statement.
I used to pay £10000 to expert witnesses (scientists) if that's of interest, but the Docs here are saying that they don't do that because 1 no time 2 they aren't tits.
[what's your area? employment?]

it came with no pay rise as it would in any other job.

I (and Laura too I bet) have known people become partners in firms in return for pay cuts.

It's the wild west out here in law! But I digress..