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?

Sorry. What ARE they actually striking about? What hours are they currently being expected to work per week and what will it be with the new contract?

I don't accept that in this day and age Saturday or Sunday working should get extra pay. It doesn't anywhere else, Saturday and Sunday are just another day.

At the moment are pay increases automatic for time served or performance related? From my experiences with the NHS quality can vary massively. Just like any other working environment. Do doctors still get final salary pensions unlike the rest of the country?

Yeah the weekend is just another day, because childcare is just as readily affordable or sourced at the weekend or in the middle of the night.

I do support the junior doctors' stance but removing emergency care is utterly unacceptable. Emergency care will be chaos.

My support is now rapidly waning.

Jeremy Hunt should be fired, however.

morale obviously

Except Emergency care is being covered by senior doctors today.

OP you are clearly being goady and that is unhelpful

However I do not support the junior doctors who are striking. Its important to note the distinction between "junior doctors" and "junior doctors who are striking". Not all junior doctors are backing this action and actually there has been a significant amount of misreporting of the issues and people jumping on the bandwagon when they don't actually understand what has been proposed.

I have discussed this at length with a number of consultants recently (on holiday with six) and most of them were not supportive of this action (one was). I was surprised by this but when you look at the contract as a whole it is actually a very reasonable attempt to move forward and create a better functioning NHS providing better care for patients.

My biggest concern about the new contract is that it doe snot have any of the old safeguards to prevent very long hours. The contract removes those and we will instantly be back to 70 - 80 hour weeks and that is not safe.

Making junior Drs work 70 - 80 weeks is the only way they can make a 7 day NHS with the same number of Drs. Its simple maths and once they don't have to pay a premium for Saturday and Sunday working there will be no barrier - it s the thin end of a wedge and I think junior Drs know full well that once it goes through the NHS trusts will absolutely ruthlessly exploit them with wholly unfair and dangerous working practices.

They are striking because, although we already provide a 24/7 emergency service and a 5 day a week elective service, hunt wants a 24/7 elective service. However, he can't magic up more doctors so is wanting the same amount of people to provide more cover. He is also failing to acknowledge that one of the main barriers to a 24/7 elective service is the support staff - doctors are already in the hospitals, even if you put more doctors in, you can't do anything without the clinic nurses and admin, the radiographers, the theatre nurses, odp's, secretaries and so on and so on. Which all costs money.

So hunt wants doctors to work more hours. Junior docs already work on average a 48 hour week, generally on a shift system (so when on call you work a 12 hr shift, because it is a shift you are not entitled to sleep breaks on a night shift)

back in the old days they used to work longer hours (but were entitled to sleep breaks if working 24 hrs) but this was deemed unsafe. Doctors were making mistakes cause they were exhausted, dying in car as they were falling asleep at the wheel on their way home and so on. It was decided that this wasn't safe so rules were put in place that said that hospitals couldn't force doctors to work these awful hours any more, to protect the patients and the doctors.

If hunt gets his way, these rules, put in place to protect the patients, will no longer stand. We will go back to the days of exhausted doctors who may make mistakes.

As for the antisocial hours bit...

The way junior doctors are paid is as follows - everyone gets a 'basic' pay - so if you were in a Monday to Friday 9-5 job with no on calls and an hour for lunch every day, you would just get basic pay.

The vast majority of doctors work a 48 hour week, so they need to get paid for these extra hours. How much they get paid is decided on by their banding supplement - so if most of your work is mon - fri 9-5 then you do a few evenings and maybe a weekend day here and there, your banding supplement will be lower than if you work every other weekend, have a few weekdays off and do loads of nights or twilights that finish at 4am with an unpredictable shift pattern.

You don't get to choose your shift pattern. I couldn't decide I want to do all the weekends and get more pay.

What hunt wants to do is increase basic pay a bit, but also increase the hours that are included in basic pay. So if you mainly work mon to fri 9 to 5 you will get a bit more money.

But almost none of us work those hours. My day shifts are half 7 to half 7. With the new contract, I would actually get paid less for the same hours.

But hunt also wants us to work more hours to provide a 24/7 elective service. Which he can't provide the infrastructure to support.

So in a nutshell, he wants to take away rules that were put in place to protect patients and make doctors work longer hours for less pay, but even if he does this he won't achieve what he is telling us he wants as we need more than just doctors to provide these service.

We don't have final salary pensions any more.

As far as pay rises are concerned - as a junior doctor you are in training. So every year you should have learnt more than the year before, so are worth more, so you get paid a little bit more. However, you do have to prove every year that you have done what you should have done, achieved the things you need to do to progress, passed the right exams, ticked the right boxes and jumped through the right hoops. If you do not achieve these things you will be supported to do so but if you continue to underperform you risk being removed from the training programme at which point you are likely to stay on your current pay grade. There is also a top limit so if you were to stay a junior doctor for a very long time (ie if you'd taken lots of detours in your training) you'd get to a point where your pay wouldn't go up any further.

I support them.

Senior doctors are covering for them. If you're going to get ill/be in an accident, you'll be seen by a senior doc instead of a junior one. Senior = more experienced, probably more knowledgeable, possibly more skilled. Why would you complain about that?

I'm OK about missing OP clinics today (I did have an appt and now I don't). I can wait. If it were that urgent, I'd be in a&e.

I support them. I know what I'm like at work when I'm stretched too thin, definitely don't want medics faced by the same thing.

The consultant anaesthetist I know doesn't believe there will be enough cover if there is a major incident such as a multi-car pile up

One of the other consultants works at a more rural location and says they don't have enough A&E cover. Frantically trying to source some locums as of last night

The final consultant is a neurosurgeon and says they won't have enough cover if there is a major incident.

All 3 consultants work in different parts of the country and in different hospitals.

Rather worrying.

That's why I understand the strike and support to a certain extent but I absolutely do not support the withdrawal of emergency cover

Thank you for that summary Sally I don't know how anyone with half a brain can think JDs are being unreasonable.

It beggars belief that the govt are trying to get away with this. It also makes my blood boil when the govt NEVER answer journalists' questions properly, they just spout out doublespeak and lies

Thank you for that summary Sally I don't know how anyone with half a brain can think JDs are being unreasonable.

It is these kind of comments that put people's backs up.

People are allowed to not agree with JD withdrawing emergency care. Or being fed up because their surgery has been cancelled for the second time due to the strikes.

Their views are no less valid than yours.

If there was a major incident the JD would go back to work, they've said that.

I support them.

I support them (I support anyone in their right to withdraw their labour in a dispute with employers).

I think they are striking for the collective good of the NHS as much as their individual pay.

Negative consequences for the NHS seem to me to be:

1. Dangerous working hours with exhausted junior doctors treating patients in life or death situations. This is where Hunt is putting lives at risk, not the dr's.

1. It risks creating a long term staffing crisis as doctors go abroad, go private or people take a different career path altogether.

We are seeing this with teachers already, this new contract will set up perfectly for the same in the NHS in a few years.

ThinkAboutItTomorrow Tue 26-Apr-16 09:45:26
" I support them (I support anyone in their right to withdraw their labour in a dispute with employers) "

But that freedom is not absolute.

e.g. in an extreme and purely theoretical example:
say an imaginary (no reference to real world events is intended here)
pilots' union had been negotiating with the employers (presumably airlines) for 3 years about pay and conditions, and the employer decided to compromise on the terms of a new contract but nevertheless eventually to implement the contract..... NO ONE would support a pilot who declared in mid air that he was no longer prepared to fly the plane!
He might say that this was all for the long term interests of air travellers in general in the future.
He might tell the passengers that their worry and distress was a necessary thing for the greater good - in his considered professional opinion.
He might say that the plane was now on autopilot for the last 1000 miles of the journey and would be able to land itself, and if necessary the management would be able to further control the plane remotely, and that it is reassuring to note that the cabin crew would be valuable backup in an emergency.
He would go straight to jail if and when the plane landed safely !

Lyndie Tue 26-Apr-16 09:40:08
If there was a major incident the JD would go back to work, they've said that.

But for an individual and their relatives their personal incident of illness can be the most major incident.

Where is the logic in your argument?

The doctors have not agreed en made to go back in. In fact, the BMA have advised them that they are not obliged to as the duty to provide care rests with the individual hospitals. The BMA say they have taken legal advice to that effect bit there are a number of senior barristers who disagree with that analysts. The GMC have also issued a warning about potential disciplinary action if any patients are harmed - again, they have taken legal advice to the effect that they could take disciplinary action.

In any event, the consultants I have spoken to all work in emergency/acute specialisms. It is not ideal to have to go and and rally the troops from the picket lines to see if anyone will assist. My 20 week old was recently in hospital and received immediate treatment. If she hadn't she would have died. Half an hour waiting for someone to agree to come in and clean up and resuscitate her etc woud not have been possible.

As I have said up thread, I think Hunt has made a gigantic mess of this and I support junior doctors to a certain extent but I do not support the withdrawal of emergency care

As for the current arrangements for today/tomorrow, as one consultant said, if it works so brilliantly and safely, why don't we run hospitals like that all the time? It's not safe and there will be very sad repercussions from these strikes

I support them. Also, I wanted to say that there is always an anaesthetist in theatre. PA's have to be supervised by an anaesthetist.

I was going to post a well reasoned and polite response to the OP's ramblings but after reading the 'three cheers for Jeremy Hunt' line, the only thing that comes to mind is,

What a goady fecker.

The Australian system is basically semi-private/insurance led

How can you say you don't agree with the alleged privatisation of the NHS and then go and work in that system? It doesn't make any sense ideologically

The junior doctors have my full support