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?

The miners strike served govt agenda to sell off/close down the mines...

Agree totally with what mama doc says, a lot clearer than I have managed!

MissTriggs, yes, that phrase could be used too.

But race to the bottom can also describe a broader situation, with multiple parties. So eg a UK clothing company may ask manufacturers in the Philippines, India and China which can offer it the best deal. The companies compete to offer lower prices, by cutting wages, cutting H&S, using unsafe buildings, etc. Plus the UK company suggests local government offers it a deal to win the business - lower taxes for five years, exemption from local pollution laws, etc.

Eventually, one company wins the work. But the workers don't earn enough to pay the rent they need to live near the factory, and are injured by the work. And the local area doesn't receive much income and suffers the pollution.

So the contract wasn't really worth winning.

Race to the bottom describes this whole process. Once you recognise it, you can watch variations of this in operation everywhere.

thanks. what about when you are both the company and the worker though?

On some days over the past 12 years I've felt like an oppressed bullied ex worker "doing freelance"

On other days I've felt like a proper entrepreneur.

I made a law school graduate work for me for free

But after two weeks I was so impressed I found her a paid job elsewhere, and she now earns much more than me.

Modern life - it's confusing!

I've just re - read the thread title.

Mama doc- I agree- there is also an issue of beds ( ie enough nursing staff to care for the patients not just physical beds) as there isn't much capacity to do extra operating at the weekend when in some hospitals list after list are being cancelled in the week due to lack of beds.

I can't see any of this making sense from a 24/7 perspective other than a) wage cutting across other staff -Agenda for Change b) forcing an even worse staff crisis so they can say oh look can't staff the smaller A&E departments - will have to close (always an unpopular move for local MPs- this way can blame the NHS staff ) and c) paving the way for saying the NHS will cover the 24/7 emergency bit and shifting all the elective work to the private sector.

If they give up their amazing pensions then I'll be happy to support them over weekend working conditions, not before

Why's that nowork?

No work- Would you support them about unsafe working conditions? Unsafe for you and your family if you were a patient as well as for the exhausted doctor? That is the main issue!

What about sex discrimination?

What about if the contract threatened safety in the week though inadequate staffing?

It is not just about Saturday pay.
That is what the government would have you believe.

I would support a1% pay rise ( same as teacher)and the same or better benefits for actually working anti social hours that we have now.
Ie keep the status quo and concentrate on the changes we actually need to make.

I'm not even sure if training more docs is the biggest priority- what we need is better resourced hospitals where people are doing the job they trained for and very little else.

I have seen technology change my own profession beyond recognition. I think we will see similar things in medicine. The job itself will change, and soon. Computerized Initial diagnosis will be the norm, the computer will talk and say" we are looking for..." and all the other reassuring things Drs say. My smartphone, not an expensive GP, will tell me the NHS now recommends a different treatment for rhinitus or that" most back pain settles".counselors will do the counseling element of the job. The mystique will go from most medical work and yes there will be gentle downward pressure on pay. Perhaps if we harness all this well, we'll still be able to afford an NHS

We've had a pay freeze for years which no-one complained about. Junior Drs are not asking for any kind of rise at all just not a pay cut.

I still think people will want a human dr when they are sick. Computerised CBT apparently works in studies but in my experience patients feel pretty fobbed off if you suggest that. A therapeutic relationship is a valuable thing. For patients that I have known a little while I don't just go through symptoms of depression mechanically asking which they have I know which symptoms this particular person has when they're depressed, how they describe it, how they look and what works to help them.

I expect it is the same for other specialties. I watch my anaesthetist colleague putting people under every week. You'd think that might be quite 'cookbook' but I see him watching the monitors but also all the little physiological signs eyelashes fluttering, muscle twitches, skin flushing and adjusting doses very minutely. I wouldn't trust a machine to do that.

What you need the GP for is to filter out most of the back pain that settles but to recognise the handful of times when it has a sinister cause. GPs are great at this and hospitals would be overwhelmed without them. Algorithms like those used by NHS direct just seem to send everyone to hospital. They can't tolerate risk or understand nuance like a person.

Earlier in the thread some people were saying that the BMA doesn't want to train more Drs

The BMA is a trade union it has no say at all over how many places there are at medical school that is the governments business entirely and it is them who don't want to pay to train more Drs. It's expensive so they want to train as few as they can reasonably get away with.

The UK imports Drs from overseas formerly India, Pakistan and Nigeria and now more often the EU so they have no need to train more themselves.

Because medicine is so many different things there is oversubscription for popular specialties in London but also a massive recruitment problem to unpopular specialties in the North. I don't think it's as easy as get more Drs, pay them less.

In response to the PP who suggested that my DH was exceptional and over 60 because jammy jobs like his do not exist any more....

He is under 40 and was a JD until 3 years ago. He chose his specialism very carefully and made choices that could be made by any one of the JD's complaining on this thread. He has received a clinical excellence award (i.e. more cash) all but one of the years he has been a consultant.

I am one of those bottom feeders who took a pay cut to make partnership in my law firm, because I knew that my firm was an "up or out" model. My heart does not exactly bleed for people in the position of my husband, when his pension alone will be double the average salary of a FT worker in the UK.

He chose his specialism very carefully and made choices that could be made by any one of the JD's complaining on this thread.

But what happens if all JDs choose to work in the specialities with the best working conditions and the most lucrative opportunities? The answer is that there will be shortages in less fashionable, more gruelling and less lucrative areas of medicine, and particularly in poorer areas where there is little opportunity to practice privately.

Indeed mistigri, and there are already huge recruitment problems and rotagaps (check out #mindtherotagap ) in specialties such as emergency medicine, paeds, obs and Gynaecology and medicine. Any new contract should be incentivising these careers not punishing those who chose them with more gruelling rotas and worse pay! That is one of the fundamental problems with the contract I believe.

Sheza - your posts are interesting because you repeatedly really can't see that there is anything wrong with what you post. Even your 'apology' about disinformation was a self justificatory "I apologise if anyone has misunderstood"
Apologising for other people's supposed misunsderstanding is NOT a genuine apology for your own actions.
it is criticising your readers.
You seem to like to misinform, and then if you are caught out - you obfuscate and become evasive to justify yourself, and to deflect criticism from yourself.

I wonder how far patients would get in getting a responsible honest and "professional" response from a doctor like you
if they ever had cause to make a written formal complaint about care/treatment from such a doctor?

You should apologise clearly for YOUR posting incorrect claims.

Mamadoc,

Yes, we all used to say - and believe - those things too.

Lanchester I think you are misreading Shezedoc.

However, the voice of someone who has clearly had a very bad experience like you deserves to be heard, not dismissed.

The people you need to attack might sound superficially like Shezadoc but she isn't one of them. Does that make any sense?

A Hillsborough survivor reported in this weekend's paper that it was a helpful comment from a policemean that set him on the road to reclaiming his life. Don't tar them all wtih the same brush.

"I am one of those bottom feeders who took a pay cut to make partnership in my law firm, because I knew that my firm was an "up or out" model."
Just to confirm that this is real - indeed routine, in the new Wild West of law.
It is the same in business - YoungGirl and I know that our business clients' lives are not like the press releases suggest.

What is fascinating is that it's nearly always men who make the calculated lucrative choices that YoungGirl's husband made, getting the best of both worlds.
The Drs most of us want to support are the others, working in the less fashionable areas and carrying more indirect costs, knowing they will never be rich butwill get older and more tired. ie the ones on this thread.

I am in danger of agreeing with the JDs here - I just hate almost everything about their campaign!

When you think about it Younggirl, we are both relying on our pubic sector spouse's pensions for our old age.

How did that happen?

Nottsmove16 Tue 03-May-16 09:57:46
"....Any new contract should be incentivising these careers not punishing those who chose them with more gruelling rotas and worse pay! That is one of the fundamental problems with the contract I believe..."

Well directors in big firms in British industry are some of the best paid in theworld,
Despite that, efficiency in British industry has been in relative international decline for years.
Chucking good money after bad at them seems to have DISINCENTIVISED them compared to their German and other counterparts abroad.

Attempting to Incentive already already higher paid sections of society with more money is counterproductive.
It distorts their motivations to personal financial reward rather than effectiveness.

Their attention is deflected to the status that they think ever more money will give them.

Doctors' status should depend on medical outcomes for the population
That is what doctors attention needs to be focused upon, NOT money and a cushy work life balance provided at the expense of their - mainly poorer - fellow citizens.

No wonder the medical establishment regard this JD strike as a buffer against changes to the NHS which will tend to reduce their own privileged NHS funded lifestyle.
They have a lot to lose.

Miss triggs, your clients are very lucky to have you.
Lanchester, when things go wrong with my patients I say sorry, and try to investigate what I and others should have done differently, to stop it happening again. However it is rarely just one person, but a Swiss cheese effect of multiple mistakes that lead to a big one. And I see those patients in person. And where things go wrong, it haunts me.
When I talk about private practice in my head is having a regular outpatients and potentially surgical list in an approved private hospital. It didn't even cross my mind about Botox clinics, and I had thought private hospital registered medical officers were employed for a length of time, but is basically being a house officer and isn't a career path. You cannot train in the private sector.
I live in the sticks outside the m25, so have not come across Botox clinics. The sheltered life I lead.

www.justiceforhealth.co.uk/

This website details how the contract is felt to be unsafe and unfair.