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Junior Doctors Strike

999 replies

Lanchester · 25/04/2016 14:29

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

OP posts:
Thread gallery
5
MissTriggs · 03/05/2016 20:46

But that is very definitely a different discussion for a very different day...

ah but it's not.

Take a bunch of people who have no sympathy whatsoever for the Catholic Church (me, etc)
Apply Francis
We eat out of his hand (it's just too hard not to, he's so good at what he does)

That's the kind of person you need running the BMA:)

Shezadoc · 03/05/2016 21:22

That's the person we need running the country!

Lanchester · 03/05/2016 21:54

Draylon 14:46

"....These days, redundancy looms, the pension has been slashed, my contributions are up and retirement is 67..."

That sounds par for the course in most jobs....
Perhaps you never realised ????? Perhaps you never cared?

By the way a band 8b nurse can retire NOW in 2016 at age 55 with expected pension receipts having a net present value of over £1 million
PLUS an immediate tax free lump sum of about £100,000.
If she wants to she can then come back to work and earn her full time salary AS WELL.
(The only change to her well paid job is that she apparently has to agree that the work will be under a non-NHS contract).

So if NHS pensions have been slashed as you put it what were they like before - what level of subsidy by the Taxpayer do you actually think you are entitled to?

  • what long term financial rewards were you led to expect when you entered medical school?

I am not sure if the doctors have any seperate even more favourable pension arrangements, but the following are the three pension schemes in the NHS at the moment for most staff

1995 Section

Final Salary 1/80th of final year’s pensionable pay for each year of service

2008 Section
Final Salary 1/60th of final year’s pensionable pay for each year of service

2015 Section Career Average Revalued Earnings
1/54th of earnings per year uprated by CPI plus 1.5% to retirement

Apparently previous earnings are 'Dynamised' ( i.e. uprated ) quite generously when calculating NHS pensions -
see the following examples if you want to:
www.medicalmoney.co.uk/media/2014/03/GPs_NHS_Pension_Scheme_V2.pdf

OP posts:
Lanchester · 03/05/2016 21:58

the above info on the three sections of the NHS pension scheme was taken from a UNISON document which was published while the 2015 scheme was still just a proposal - so it might not be completely up to date
www.unison.org.uk/content/uploads/2013/06/On-line-Catalogue207333.pdf

OP posts:
Lanchester · 03/05/2016 22:08

Note that in the 2015 scheme:
A build up rate of 1/54th of each year’s pensionable earnings with no limit on the number of years that can be taken into account. This is a higher build up rate than both the 1995 and 2008 sections of the NHS Scheme

there is a sliding scale of contributions these days - but the NHS Employer (aka the TAXPAYER) still makes a MUCH HIGHER contribution than is normal in companies.
(roughly about twice what would be the norm) !

OP posts:
Mistigri · 03/05/2016 22:08

Lanchester, so what do YOU do? Do you work in a caring role? Do you work at all?

I for one am getting a little tired of the constant insults thrown at people like Draylon working long hours in a physically demanding job in what is presumably a ward of very sick, highly-dependent patients. You may think that she is overpaid - that's your opinion - but what is a fact is that she is doing a physically and emotionally demanding job in difficult conditions. A job that most of us don't want to do and many wouldn't be capable of doing. I think that deserves some respect.

mamadoc · 03/05/2016 22:19

Lanchester- I do wonder, very genuinely, what your interest is. You started this thread. You always comment in a similar vein on other NHS threads and you seem very angry with all NHS staff.

What is your agenda?

(I feel somewhat entitled to ask because I've spent a lot of time 'talking' to you and been very open about mine)

PortiaCastis · 03/05/2016 22:30

Mamadoc I presume that the pension scheme attracts a lot of staff contribution ?

lougle · 03/05/2016 22:52

It's a higher build up rate, but it's career average, not final salary. I'm part time right now. 23hrs per week. Under the old scheme, as long as my last 3 years were full-time and the highest paid of my career,it didn't matter what had happened before. Under this scheme, each year's contribution is added to the pot. So my contribution this year will be 1/54×((14.3% [employer's contribution] + 7.1% [my contribution])×(Band 5 base rate x 0.6 [my part-time contract expressed as a proportion of Whole Time Equivalent)).

Each and every year the same calculation will be done and the relevant amount added to my pension pot. So the quicker you advance up the promotion ladder, and the longer you stay full time, the bigger your pension. It means that acute specialist nurses (such as ITU, A&E) may end up with smaller pensions because it takes longer to be experienced enough for promotion. But people who work in those areas tend to be driven by that kind of work so it's a sacrifice worth making.

mamadoc · 03/05/2016 22:52

I don't offhand know what the contribution is but it feels like a big chunk of my take home pay!
It was recently increased too.

What Lanchester's figures neatly show is what I have said ie that the pension scheme is gradually becoming less generous over time. Contributions also increased so we were paying more for less. We accepted that. No-one went on strike because we know it's still a very good deal. I expect in time it will be phased out.

Some googling suggests 14.5% staff contribution but this is max and is tapered so I expect I pay a bit less.
Staff contributions pay for 45% of the NHS scheme but only 25% in the civil service
A Dr contributes about twice as much for a similar size pension as a civil servant.

So we are not the fattest of the fat cats..

lougle · 03/05/2016 22:56

Junior Doctors will pay between 9.3% and 12.5%.

mamadoc · 03/05/2016 22:56

Apparently the career average scheme results in about a 30% reduction in pension for hospital Drs compared to final salary on average.

I expect it affects women disproportionately due to career breaks and PT working. Plus that stupid reticence to apply for clinical excellence awards.

PortiaCastis · 03/05/2016 23:00

Thank you for all the detail. I was really just trying to make it clear that contributions are made as Lanchester forgot to mention that side of the coin.

Lanchester · 03/05/2016 23:40

Mistigri Tue 03-May-16 22:08:59

Lots of people have physically and mentally demanding jobs

and outside the public sector lots of people FOR MANY YEARS have had the additional HUGE STRESS of economic insecurity for themselves and their children
They can also look forward to an impoverished old age.

I don't care if Draylon is a millionaire - so long as she does not expect that from public funding

I think that over the past number of years the NHS - in too many scandals - has shown an institutional decline in the dignity that it accords patients as human beings

JDs withdrawing emergency care is symptomatic of that decline in respect for patients as individual human beings.

I do not have respect for doctors who avoid saying anything that will criticise another doctor - even when they know that something has been done negligently which has injured a patient seriously.

I do not have respect for the virtual persecution of whistleblowers within the NHS

I do not have respect for relatively well off people - like apparently Draylon - falsely claiming hardship and expecting poorer people to fund an unaffordably comfortable lifestyle for them

Draylon at 14:46 said
"....These days, redundancy looms, the pension has been slashed, my contributions are up and retirement is 67..."

For her to complain about the level of NHS Pension benefits is ABSURD, and is offensive to many people
Can JD supporters not understand that?

And she may not have noticed, but redundancy has not only 'loomed' but been a constant problem in the country (outside the comfy public sector)
for about 35 years already !

Also, do you think that other workers have an easy time?
plenty of them feel worn out / get industrial injuries / etc - but in general there is no commonly available early retirement on health grounds - especially not on boosted pensions.
In the main, they just have to struggle on to 67, or claim ESA / or more likely JSA of about £71 per week -until they get their meagre pensions at age 67.

I am not saying that is how things should be at all - but I am saying that the Doctors and other NHS Staff should STOP COMPLAINING and STOP EXPECTING OTHER PEOPLE to provide them with so much money, when many of those other people have relatively very poor work conditions, and have so little economic security themselves.

Draylon is bemoaning her retirement age being the same as everyone else's (except most people not in the NHS pension scheme will never be able to afford to retire early of course) !

OP posts:
Lanchester · 03/05/2016 23:51

PortiaCastis Tue 03-May-16 23:00:33
Thank you for all the detail. I was really just trying to make it clear that contributions are made as Lanchester forgot to mention that side of the coin.

Actually I did say that contributions were now on a sliding scale, and I drew a distinction between them and the employer's contributions which I said were about twice the level that is common in companies.
The 14.5% contribution is the EmployERS (aka the government's) contribution I think.
I think that NHSstaff EmployEES contributions start at about 6.5% depending on salary level, but it is on a sliding scale which increases with salary.
The employee's contributions attract tax relief at your highest marginal tax rate I think.
So in effect those 12 % ish doctors contributions only result in an 8% ish deduction from salary?

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MeirAya · 04/05/2016 00:20

I wouldn't bet on public sector pension schemes being that safe. The government can change regulations and escalators/ calculations at whim. At least Maxwell and BHS had an actual pension fund to raid.

The public sector schemes are more of a pyramid savings system- what workers pay in now is used to fund today's pensioners.

If there isn't a publicly owned and operated nhs (or police/ council/ delete as appropriate) in 10years, who will be paying in to find the pensioners? That's right, no one.

And even it that doesn't work, all the country's pension laws could just be rewritten tomorrow. That's the downside of a govt backed pension. Terrible though the big insurers can be, they have zero power to change the law to decrease their own payouts. And there'd be sweet f-all any public sector worker could do about it.

Even the judges can't win this one.

Lanchester · 04/05/2016 00:45

mamadoc Tue 03-May-16 22:19:25
"Lanchester- I do wonder, very genuinely, what your interest is. You started this thread. You always comment in a similar vein on other NHS threads and you seem very angry with all NHS staff.

What is your agenda?"

I'm not sure what you mean by 'agenda'.
Unlike any Doctors and NHS Staff contributing to this thread -I have no personal financial interest in this issue - other than as a Citizen, Patient, and Taxpayer.

As a responsible member of society, I suppose I feel that there is a real problem in the UK with well paid elites hijacking the wealth in society causing polarisation and deprivation in society.

I think that Doctors increasingly are focusing on their personal compensation (money and benefits) to the detriment of their focusing on patient care.

Also, it must be pretty obvious to everyone who is paying attention to the world around them that as an organisation the NHS too often treats patients with considerable disrespect and lack of care and competence.
That does depend on the leadership in different units. Many are good, but more are poor.

This is having some devastating personal consequences for patients.

It is not ok.

The system needs fixing.

The BMA solution is 'More of the same'
i.e. more money if you please, lots of it , and now.

Labour chucked money at the NHS but the main difference people noticed is GPs getting wealthy.

Granted, the patient experience improved briefly with 'choose and book' but that seemed to fizzle out as an option.

The NHS Staff complain about "no payrises" but even at a time of "no payrises" they got their increments on the pay scale of between 1 and ? % PER YEAR.
0% payrise in the private sector actually means 0% and better not complain or you will be "let go", or whatever phrase might be used - to mean in effect "sacked".

So NHS Staff are beginning to feel defensive and concerned for their future.
They have come to expect better financial security than most,
and they are afraid and unwilling to lose any of it.

There is a rather outdated and offensive sense of entitlement amongst many doctors.
They have been brainwashed in a way by a system that tells them they are special from an early age.
SOME consultants are so arrogant that it is almost farcical - yet very dangerous for patients.
They seem to intimidate their more junior staff (from senior registrar downwards).

All that attitude is like something from the 1950's that should long ago have been swept away in the NHS. We want a modern effective service - not posturing and stupidity.

Also, it is rather annoying to hear young doctors talk about their years of hardship so far (i.e. since they got their A levels) and their sense of "despair" as 'it is so difficult to get nannies to cover hours when both partners are JDs on duty'. etc. etc.
They seem to feel that society OWED then a huge subsidy for their medical training but they seem to have little loyalty in return.
They sound quite young inexperienced and spoiled.
But its not really their fault because that is exactly what they are.
They will get older and wiser over the years.

JDs do work hard but lots of people in society workhard -e.g. factory workers working constantly rotating shifts early/ late/ night
for years
on low pay and in noisy wet and dangerous factory conditions - with none of the status or rewards or prospects of interesting work available to doctors.

JDs and also older Doctors are complaining about lack of autonomy.

Don't they realise that that is what working in most organisations in society entails, especially as an employee?

Even GP surgeries with a number of partners represents a lack of autonomy for each partner as compared to if that partner was working as a sole practitioner in a one doctor surgery , but there are obviously benefits from working in a partnership rather than as a sole practitioner despite all the "autonomy" that allows.
Those benefits are partly for the doctor but also for the patient - as for example there is (or should be) some mutual scrutiny of standards of care when doctors work together.

In the NHS there seems to be a pervasive culture of fear of speaking out when senior staff are not working safely, or have not put in place safe systems or working,
and there is a culture of coverup in the NHS where doctors and nurses will actually lie to cover up the truth so that no-one gets disciplined or sued.

Whistleblowers seem to be persecuted and so are rare and have to be brave people - (E.g. Nurse Donnelly at North Staffs)

Why then would more autonomy be a good thing?

So I could go on... but I have some other stuff to do - but anyway those are SOME of my reasons for taking an interest in the NHS and how it needs reforming.

OP posts:
Nottsmove16 · 04/05/2016 06:50

To those who have been having an interesting debate earlier eg miss Triggs etc please can I ask again a few questions -

The government wants to make this all about pay and the discussion has turned around but don't the other issues concern people as users of the NHS?

The biggest concern junior doctors have is safety- lack of safeguards on long hours and antisocial and horrible shift patterns leading to tiredness and mistakes.

This and the huge rota gaps and the spreading of an inadequate 5 day work force over 7.

It isn't just about Saturday pay!

YoungGirlGrowingOld · 04/05/2016 08:26

Just returned to the thread. Yes MrsT I also plan to survive on my DH's pension. My paltry annuity was more trouble than it was worth - so whilst I am grateful for the good pension he receives, I am genuinely stumped as to how it can possibly be affordable across the board in the long term. A friend of ours is an actuary (now they really ARE brainy!) and she talked DH through how much an annuity would pay if it was purchased for a comparable contribution to his NHS scheme. It was buttons and the scales fell from his eyes at that point.

I have no beef with NHS staff receiving good pensions, but what is a "good" pension to someone funding their own retirement and what NHS staff expect to receive seem miles apart. I suspect it's the same with pay, to some extent. As a PP said, I suspect a little willingness to adapt and learn is required from both sides.

As I mentioned upthread, I am pregnant and planning a career change, simply because I cannot do justice to motherhood and my clients. Frankly, I don't want to be the one whose weekend plans get cancelled at 4pm on a Friday because an urgent transaction cannot wait. I don't think that's sexist - it's just life. Irrespective of the outcome of the wider dispute I genuinely hope that the judicial review fails. It will set women's equality back years imo if the wimminz amongst the JD's demand special (not equal) treatment.

MissTriggs · 04/05/2016 10:27

PM me after your mat. leave (hang on - do you get mat leave? - proabably not ) my new firm has a good model for transactional lawyers working from home xx

Lanchester · 04/05/2016 10:51

Nottsmove16 Wed 04-May-16 06:50:27

"To those who have been having an interesting debate earlier eg miss Triggs etc please can I ask again a few questions ......
.....The biggest concern junior doctors have is safety- lack of safeguards on long hours and antisocial and horrible shift patterns leading to tiredness and mistakes.
This and the huge rota gaps and the spreading of an inadequate 5 day work force over 7.
It isn't just about Saturday pay! "

Well there's no actual question there in your post,

but i n fact I agree with what you are saying in so far as
on both contract OLD and NEW
The JDs' hours are too long
and they need to be reduced further.

Therefore we need less patients or more doctors
The doctors should not be expected to work no more than is safe (48? hours), and in fact except in an emergency it should be illegal for them to be required to do so, or allowed to do so.
The new slogan on the JDs picket could be
"48 hours work for 48 hours pay !"

OP posts:
MissTriggs · 04/05/2016 11:03

Lanchester, this is frustrating me hugely.

You have many many important things to say but they are being lost because of your tone.

You are saying things that need saying, you have drs on this thread who are actually prepared to listen but you lose it all because you don't show them that you are listening to.

Yes, Drs are a power group in this country. Yes, lots of people go into medicine because they like power and status. Yes, lots of them abuse it. Yes, there is a culture of covering up. Yes, any thoughtful citizen needs to be able to identify the way one group holds power over another group, whether by being a man, being in London, going to private school, going into a profession with barriers to entry, being a Freemason, essentially any situation where a citizen cannot hold them to account.

I get that, but it takes real effort to get it and if I was working nights there's no way I'd take the trouble to wade through your posts to get at the meat of them

MissTriggs · 04/05/2016 11:05

I take it back Lanchester,

"but i n fact I agree with what you are saying in so far as
on both contract OLD and NEW
The JDs' hours are too long
and they need to be reduced further.

Therefore we need less patients or more doctors
The doctors should not be expected to work no more than is safe (48? hours), and in fact except in an emergency it should be illegal for them to be required to do so, or allowed to do so.
The new slogan on the JDs picket could be
"48 hours work for 48 hours pay !"

I'll let you do the final post. thanks everyone for a great discussion xx

PausingFlatly · 04/05/2016 11:17

Yes, thank you to all the people who took time to post really informatively on this thread. I've learned a lot more from it than from the mainstream media.

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