Junior doctors contract- please read

[Limpetsmum]

I'm cross posting to raise awareness
In my mid 30s, mother of three and I'm a junior doctor.
I just wanted to raise awareness of why doctors are upset at the moment.
We already work many hours a week unpaid (out of good will because we care about our patients). The new contract in essence wants us to work even more but for less money. It's not 'cost neutral' - it's using the same pool of money to recruit more doctors and pay larger number of doctors within the same pool of money. This is resulting in up to a 30% pay cut for doctors.
Furthermore, finer detaIls of the contracts penalises part time workers and those taking maternity leave further.
A common misconception is that our union is not open to talks/negotiations. This is because the powers above will only talk if certain details such as the ones above are accepted ie only the smaller fine print is yet to be decided. Therefore our union has walked out of talks as the contract is being thrust upon us.
Doctors up and down the country are furious and concerned about patient safety as we're being forced to work unsafe hours. we are all concerned with what is going to come of the Nhs. If this is a step towards privatisation by alienating doctors we are the ones to gain in the long run financially as health care becomes private but we all believe in the Nhs and want to work in a safe, free and fair Nhs.
In addition, my own personal view is that I'm a mum of three. I want to see my kids and not have my normal week extended to include 7am-10pm mon-sat. I want to spend time with my kids and be there for my family as I'm there for my patients. I also have a life to fund and kids to support. I have a mortgage to pay and financial commitments.
Please understand why we are upset, why we are considering striking and if you support us, write to your local Mps to raise the issue.

This is not an official post in anyway but a plea for greater understanding from the wider public as I'm left feeling disheartened about my future and my family's future. Thank you for reading.

The OP said it herself in her post at 20:46. It's just so unhelpful when it comes to gaining support from others outside of the medical profession. I do support junior doctors in what they are fighting against but not quite as much as I could, while this rhetoric of devaluing others continues.
It makes it sound like the issue is really around status not money and working hours etc.

Apologies if that's how it comes across and I can understand why that's the case. the point I was trying to make (although not very well) was that we have missed out on income while increasing student debt when other jobs do not require the same level of training and therefore enter the workforce sooner and have less debt as well.
It's not meant to devalue anyone's contribution in society but if you think that in the 6 years Of being at Uni, people would have come out with £54k debt (on tuition fees alone) as well as missing out on £150k potential warnings in that time, it highlights that our wage isn't ridiculously high - given what some members of the public think.
We are in effect starting on at least £200k negative.
I hope I've not offended anyone and apologies if my wording has done.

I would like to wade into this argument and give a nurses opinion. I'm late 30s and have 2 children. I have been qualified for 13 years and have worked in the same hospital all that time. I have watched junior Doctors over the years the same age as me when I qualified who were not in the position to have relationships because they kept moving around every six months for work. They didn't have homes of their own due to moving all the time so were forced to rent. They're constantly studying etc etc as said above.

All of this aside, I remember back when I qualified just how ill the junior Doctors looked at 3 am. We used to make them sit down and drink a cup of tea and eat some toast because we were concerned for their safety. The poor buggers would be green. They used to say to us that they couldn't understand how we could cope with nights but when you examine it, we used to leave at shift end and drive home to our nearby homes and sleep all day. They would finish when they finished and then commute for at least an hour- usually after having had a 10am meeting. They would then have to come back later that evening.

Doctors work very hard. They deserve their wages. If these contracts are forced through, it signals the end. It willbe a race to the bottom.
I feel that the Doctors have no choice but to strike and want you all to know that as your colleague, I support you.

This is a really interesting thread.

I don't think that doctors are communicating their case very well. I think they can come across as feeling very superior. I am not sure the union is doing them any favours.

Some of the arguments are very sensible, such as the ones about family life. But the ones about money comes across as a bit naive to be honest.
The medical community as a little bit "closed" in its own little world. Nearly everybody in that community has only ever worked for one employer. And when you are effectively still in your first job, You don't have that sense of perspective that you get when you have worked in several different types of businesses -you don't "get" that so often you were not aware of the things that were good about the job you had . It's a case of out of the frying pan into the fire.
I think that the BMA might do better at advocacy in this matter if its leaders had experience of working as managers at Greg's. Then their comparisons would be far less ill informed than they are.

Anyway OP maybe you can feed back back to them! Good luck with the campaign please excuse my bizarre typographical errors which are due to having to use voice recognition software

Miss triggs I think you may be misinformed about doctors. My husband, room mate and I (all doctors) had part time jobs in fast food careering, telesales, bar work to fund us through Uni. I'd often work 20 hours a week despite having lectures 9-5pm mon -fri. We dont all come from priviledged backgrounds and the concerns financially is that future medics will be recruited from an elite background as 'normal everyday folk' can't afford the tuition fees with the lower wage at the end as well.
These contract changes won't affect me as I'll finish my training by the time they are in place, but we need to look after future generations of doctors and the Nhs.
The main concern which the BMA is primarily promoting is the effect on the public. Longer hours (the government are trying to get rid of the European working time directive and have agreed that funding a 7 day Nhs is not possible with the EWTD as it is not cost effective). Tired doctors = mistakes. We are human. We make mistakes and more mistakes when over tired. It is simply not safe. I support my union on this matter and trying to make the general public aware that this isn't about greedy doctors.
We have the worlds best healthcare because of it's staff goodwill (and by that I mean all Nhs staff). Doctors in UK earn one of the lowest wages amongst doctors in the western world despite helping to provide top healthcare. we are dedicated to our work for our patients not our career progression. I don't stay late to impress my boss. I stay late so I don't let down my team and my patients.

Please dont vilify us, we're already demoralised -although I appreciate as a lawyer you're probably up for a good debate!

LimpetsMum, before you plan a move to Oz (my home country). I suspect a consultant's wage is $100-120k AU, not £100k. But, like here, $100k is a pretty good salary, prob the equivalent of £50-60k, lifestyle-wise.

I just want to add that maybe some doctors earn more than the prime minister. Ok. But I'm fairly sure that it doesn't come with a free house, expenses, and all the other benefits of being a prime minister. I'm fairly sure that David Cameron pays for diddly squat out of his salary that an NHS consultant has to.

And it totally misses the point that if the entry salary and the hours are so bloody unattractive, why would anyone take on so much debt and sacrifice to become a doctor?

Is this what we want for our society? That every job drives down wages until we are all earning nothing? There must be ways to make the NHS effective and efficient without simply cutting salaries of the people it relies on to make the system work.

Just wanted to add that if you are a junior doctor with the ability to move, you would be very welcome in Scotland...
www.independent.co.uk/life-style/health-and-families/health-news/scotland-opens-doors-to-junior-doctors-angry-at-nhs-contracts-in-england-a6669411.html

My DD1 is a newly qualified doctor in her first F1 post. On her grand sum of 22k she can barely afford to rent a flat where she lives, certainly can't afford to learn to drive and is in oncology where the consultant is stretched between several hospitals and she is dealing with a lot of difficult stuff on a daily basis.
She has said clearly if they are CUT then she won't be able to continue... many other junior docs are in the same position.

It takes a HUGE amount of committment and graft to become a doctor.. it's a vocation but it's one which is different to most jobs..they have life and death in their hands every day. They need a living wage which reflects the work they put in, the hours they do and the stress.

They will lose many of the doctors that the NHS has trained and needs if they do this because, frankly young doctors are bright enough to do other jobs and ones which pay more and demand less. Junior doctors work hard.. they are responsible for lives, but get no time to have lives of their own.. and this is how they are to be treated?

It WILL signal the end of the NHS... and anyone who wants a doctor that has been trained in this country might like to write to their MP.
Oh and let's not forget the 50k + worth of debt that most will have just to make it through med school to their graduation day...

My facebook feed is swamped with posts about this atm but it is actually very hard to be sympathetic about the pay.

Nobody likes a pay cut, and 22k doesn't sound like much - but that is a training salary and goes up very fast indeed.

It is impossible to feel sorry for somebody who will be earning an absolute minimum of 75k by their early 40s if they work full time as a hospital doctor - and most hospital consultants also do private work on top of their full time NHS work by choice, and earning a very healthy 6 figure salary for at least the last 20 years of their working life.

If doctors want public sympathy they need to emphasise the hours - that is what non doctors care about (because of the safety aspect) and can feel sympathy for. I don't think I am the only one who really, really cannot bring myself to feel sorry for people earning multiple times more than I do whinging about their mortgages!

www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-doctors/

Likedmyoldusernanebetter - we are not asking for sympathy. We are not asking for a pay rise. We've had a pay freeze for 5 years with no complaints. We've had our pensions cut - twice.
What we are trying to raise awareness about is the safety aspect. The government have not said how many hours they are going to get us to work. It is all very vague other than the fact that they are trying to remove the safety aspect In overworking us. This is non negotiable by mr hunt hence why our union has walked out of talks.

David Cameron is trying to abolish the European working time directive, one of the other safety aspects limiting our hours we can work. But on the other hand mr hunt is saying the European working time directive will prevent us working too many hours.

When oncall, I can do 90 hours a week currently. This is likely to go up with a 7 day NHS as more hours need to be covered.

I think it is only reasonable for people to appreciate that a pay cut. for anyone of 30% is huge. You can still be a junior doctor, like myself in my mid 30s with kids (which is the norm). I appreciate the public see us all as being 'rich' and that's why we're being hit first. Once this is rolled out nurses, porters, secretaries will all be next. a 7 day service needs all these aspects of health care as well and so it is inevitable that they'll be getting a pay cut too.

And please answer this honestly. Junior doctors may see they're kids only 1 hour a day working 9-9pm (sometimes not even that) and this can be for a week at a time, -would you want a job like that for the pay (bearing in mind that our higher wage also has to cover expensive childcare to accommodate these hours?)

I've questioned my work life balance many times - more so now. And the truth is, I don't have to be a doctor. That's what a lot of doctors are thinking currently.

Please don't think we're greedy, we're not asking for more money. We're trying to save the NHS.

Limpets I come from a family of doctors. I know how the working hours are. I also know how very comfortably off doctors are by the time they achieve their consultant job (or, as a family member in her late 30s refers to it her "forever job").

My parents expected at least one of their several children to follow in their footsteps and those of wider family and go into medicine. They took it very personally for years that we all chose not to. Its not a work life balance I would choose, no.

But complaining about pay when consultants are very comfortably in the top decile of the UK income charts - and every doctor can become a consultant as long as they continue to practice (unlike teachers, say, where the huge salaries only go to a very, very few "superheads" with primary school heads reaching retirement on around 50-55k and those who remain in the classroom rarely every topping a career high of 45k).

A doctor in their second year of training is earning more than the UK national average salary, and is normally still in their mid to late 20s, and a GP is always on a higher salary than a primary school head, assuming both are full time.

No I would not choose to be a doctor, because of the hours. Junior doctors work very long hours (but the "unpaid" bit is disingenuous - myriads of salaried jobs don't pay overtime). I do not think being bitter about money comes over well though, for people on a path towards a place firmly among the top 10% of national incomes.

Talking about 22k as a salary is very much sympathy bait - that is the year one salary, it goes up to 28k (above the national average salary) in the second year of training.

Ikedmyoldusernamebetter - I think you're perhaps focusing on something that as doctors we're not. We're not complaining about our pay. Please think about the wider NHS.
You can't compare us to teachers when you've already mentioned you wouldn't do our jobs. I wouldn't be an oil drill worker in the middle of nowhere and I think (may be mistaken!) but they get paid a wage to reflect that others wouldn't want to do their job. There's pros and cons to all jobs and some have more cons than pros and that's reflected in the wage.

Most of your opening post is about money though Limpet - including but not limited to "I also have a life to fund and kids to support. I have a mortgage to pay and financial commitments." don't we all? But you do earn a lot more than the national average salary, and are on track to earn well into the top ten percent of salaries in a few years. You are complaining to people who are statistically mostly going to be earning a lot less than you already do, and many multiple times less than your ultimate salary will be.

Many, many jobs have unsocial hours, and there are many, many jobs I wouldn't do - they are not all highly paid, or even respectably paid.

Nurses, police and fire fighters all do essential work but are paid far less than doctors.

There are all sorts of justifications for high pay for doctors - long training, long hours, unsociable hours (but not throughout a career - consultants do far fewer unsociable hours). None of these are exclusive to doctors though.

Whenever anyone points out that doctors are not actually badly paid compared to most people, there is a massive back track and it's all "oh but we are selfless angels who don't really care about money and only thinking of the NHS, not of our pockets at all!"

I absolutely agree the uncertain contracts must be very worrying and the long hours, if they impact on ability to keep patients safe, are a massive issue. I think you are putting lots of people's backs up by complaining you cannot fund your lifestyle on 48k a year... and that is what most of your opening post is about.

I don't actually have a problem with doctors being well paid (I know it might sound as if I do :o) I do have a problem with my fb feed and now MN being full of memes complaining that a nurse practitioner (at the height of his or her salary expectations) has occasionally been seen to be on a higher salary than a junior doctor and pleading poverty of the poor junior doctors eating beans on toast in their bedsits on 22k (for one SINGLE initial year of training, glossing over how fast that pay ramps up).

I think this whole thing has been presented in a highly irritating, arrogant way by the people pushing the social media campaign, whatever the rights and wrongs of it.

I think we'll have to agree to disagree as I don't want to cause offence in the way you have. The people who watch us work day in day out support our campaign (nurses, allied health professionals etc) which is reassurance enough for me.

I agree with those who are irritated by the sandwich shop management comparisons. Plus graduate debt is an issue for all graduates who don't all go on to earn top salaries. I'm 31 and earnings peaked at £23500. I have a mortgage and a child to pay for.
Please focus on patient safety, I want junior doctors to earn a fair salary for decent hours and not be making decisions when they are totally knackered.

It is about patient safety - thats what we're trying to get through but there are some that want to talk money and if we avoided the issue then it would look like we've got something to hide. I'm trying to be open and honest about it all.

BUT lets leave that aside, facts about patient safety....

• the government are taking away two things that keeps us safe to work - primarily the EWTD (European working time directive) - they will say that it is in place to prevent this happening, but we have found out from NHS documents that David Cameron is trying to get out of this clause. The NHS Employers document states that the EWTD is good in principle but is not financially viable to run the NHS. If we leave europe, it won't cover us and he's trying to retract it anyway whether we're in europe or not. If this goes, then to cover the hours required for a 24/7 NHS for elective procedures, doctors and other NHS workers will inevitably work a lot more hours.
• there will be a mass migration of doctors leaving hospitals under staffed further
• medical degrees attract high academic achievers at 6th form- this won't be the case anymore and there may be a recruitment crisis.
• doctors wanting to carry out research will be penalised further

Tired doctors = more mistakes = compromises patient safety. DO you want a knackered doctor making life or death decisions?

This "The new contract in essence wants us to work even more but for less money. It's not 'cost neutral' - it's using the same pool of money to recruit more doctors and pay larger number of doctors within the same pool of money. This is resulting in up to a 30% pay cut for doctors. " is baffling.

How can a larger number of doctors mean worse patient care?

[[http://www.nhsemployers.org/your-workforce/pay-and-reward/national-negotiations/q-a-on-the-new-junior-doctor-contract-proposals]] states that the maximum hours junior doctors can be made to work will actually be dramatically reduced under the new contract.

I think you're partly right - there probably won't be more doctors as there's a recruitment issue. So to make up the hours we'll be flogged instead. Hence why they're getting rid of monitoring hours and fighting to get rid of the EWTD - a work in progress by the government.
These are two of the things the BMA want in our contract to ensure we're safe. These same two things are non negotiable by the government hence why bma walked out of talks.

Just to let everyone know this thread has been moved to Petitions as we don't allow Petitions on our Talk Boards, no matter how worthwhile they are.

MNHQ