Doctors striking?

[Dopamine1979]

So the junior doctors are striking.

There seems to be good support from the public on the whole.

Hunt continues his spin.

The full walk out will probably happen next month.

There may well be some deaths attributed to this in the media.

Then what??

[JohnL]

I generally support NHS workers.

But my work colleagues general consensus is how can anyone strike in this day and age.

You get higher wages by moving on - so you need private negotiation to create a wage market.

You never ever get higher wages in the job you're in - other than cost of living increases sometimes.

[mikeb]

I've never considered striking either but I can see the doctors' case. I don't think we should bring in national widespread private sector providers just to break the government's monopsony on health workers. I suspect that the government is seeking to introduce more private sector providers for the exact opposite reason i.e. to reduce costs.

[JohnL]

Well looks like the World Medical Association has given support to the junior Doctors now.

Not that the Government will care.

[uncleglen]

It costs the taxpayer nearly ?300,000 to train a doctor so the salaries need to be offset against this cost.

Their salaries are fair for public sector professionals imo

Their hours need to be addressed if the sick are being put at risk.

[mikeb]

Uncleglen, a registrar (5-6 years of formal academic training, with a further 10-15 years of practical experience) earns about the same as a tube driver. I don't think they are fairly paid for the job.

Not sure the costs to train are directly linked to how much they should earn - if it cost only ?20k to train them then should they earn ?10k more? The fact is that becoming a doctor is hard work; if they had to pay for it themselves then there would be far fewer doctors all paid very considerably more.

Also, I'd add that they also pay for rquired professional qualifications out of their own pocket (each costing >?1.5k) and have to take annual leave to study and take the exams

Mike

PS I am not a doctor ...

[uncleglen]

we all know about tube drivers, and GPs for that matter. The tax payers' pockets are not bottomless pits, (regardless of what the miners and others might think).They want the kudos and the potential ?75,000+ for being a consultant then they have to take the rough with the smooth.

[mikeb]

actually there are two things junior doctors want just now

1. not to have their take-home pay cut by 10-20% as a result of reclassfying their weekend hours (which they already work) as "normal".

2. Ensure NHS trusts continue to be restricted in their rostering to ensure safe coverage

This is not about weekend working as doctors already do this (unlike many other parts of the NHS) and they did not start this battle to get paid more.

I would also encourage you to look at what local council officers get paid, or London primary school teachers with 5 years experience.

In fact, the only job that I'm aware of in the public sector that pays even worse is nursing and social work, both averaging about ?25-29k.

[Blah Blah]

Nurses start on less than that (?21k) and the government is set to replace bursaries with student loans.

Uncleglen, it takes at least 10 years to qualify as a GP, and much longer to reach consultant level. It requires a lot of hard work, study and student debt. Renumeration reflects that. And GPs btw, start on salaries of ?55k after qualification. Salary will rise according to experience and length of service.

Junior doctors on the other hand earn between ?22k and ?28k.

It's very easy to pluck out the salaries of top consultants and think that is the norm for pay scale, but it's actually not true. Most people working within the NHS are on very average salaries for their levels of skill and expertise.

[LondonMix]

Pay doesn't really have anything to do with how much training or how much skill is involved with the work someone does. Its set based on what it takes to recruit and retain people with the requisite skills. If the NHS has a shortage of junior doctors and is struggling to recruit, they need to adjust their pay scales. If not, then there is no issue irrespective of what train drivers or anyone else makes.

The fact is there is a shortage of junior doctors so worsening their existing working conditions both with respect to overtime pay and expected overtime work per person will be damaging.

I support the governments efforts to rain in costs but in this circumstance it simply won't work long term.

[Otta]

uncleglen Wrote:

-------------------------------------------------------

> They want the kudos and the potential

> ?75,000+ for being a consultant then they have to

> take the rough with the smooth.

Bit like teachers really. Do you really think a teacher is worth more than a doctor?

[LondonMix]

Junior doctors do make a lot more than their base pay. On average junior doctors make 40k including the bonus pay for weekend and evening work in the early years of training and on average 56k in the later years of training including bonuses and supplements. Junior doctors in certain specialties make between 53k and 70k including bonus pay and as seniority progresses. Consultants make up to 100k.

Regardless of how much doctors make though, the pay isn't enough to retain and recruit appropriately so lowering it by reducing the hours that qualify for bonus payments is a bad long term strategy by the government.

Hunt is offering an 11% pay rise to help offset the loss of bonus payments for certain unsocialable hours; however, its obvious that given junior doctors nearly double their base pay rate through the supplements and bonuses an 11% payrise will still leave many of them worse off.

[srisky]

Salary scales are on the BMA website. 100k for a consultant is after 19y service at consultant level, which is usually reached around age 55-60y.

LondonMix Wrote:

-------------------------------------------------------

> Junior doctors do make a lot more than their base

> pay. On average junior doctors make 36k including

> the bonus pay for week end and evening work.

> Junior doctors in certain specialties make between

> 53k and 70k including bonus pay and as seniority

> progresses. Consultants make up to 100k.

>

> Regardless of how much doctors make though, the

> pay isn't enough to retain and recruit

> appropriately so lowering it by reducing the hours

> that qualify for bonus payments is a bad long term

> strategy by the government.

[LondonMix]

The salary scales do not reflect total compensation of junior doctors. The whole argument they are making is that they want to keep their bonus pay for evenings and weekend work rather than lose them and get an 11% pay rise on the base pay.

My figures are based on the department of health estimates of total compensation. Of course, depending on the exact hours worked it will vary for each junior doctor.

http://www.telegraph.co.uk/news/nhs/11887308/How-much-are-junior-doctors-paid-and-why-are-they-threatening-to-strike.html

[Otta]

LondonMix Wrote:

-------------------------------------------------------

> Junior doctors do make a lot more than their base

> pay. On average junior doctors make 40k including

> the bonus pay for weekend and evening work in the

> early years of training and on average 56k in the

> later years of training including bonuses and

> supplements. Junior doctors in certain

> specialties make between 53k and 70k including

> bonus pay and as seniority progresses.

> Consultants make up to 100k.

>

How many hours a week do they need to work in order to earn these amounts? And how many of those hours are during the night or at weekends?

Personally I am not 100% behind the JD's striking, and a dislike the emotive arguments being used to support them. BUT I do think the offer that is on the table is shot.

[srisky]

I am not disputing that there are salary supplements - I mentioned the BMA salary scales as it has a link to the supplements as well as pay progression for junior doctors and consultants.

[LondonMix]

Otta-- its not the total hours as much as the weekend and evening hours and that will vary be specialty a lot. I'm not sure what the average amount of evening and weekend work is across all doctors but that's where it comes out to.

There are two big issues with the proposal. Even though Hunt is guaranteeing no one who works a normal 48 hour week will be worse off, this is only possible by guaranteeing certain junior doctors' salaries through to 2019- its estimated that a quarter of doctors would be worse off due to receiving less supplements for weekend and evening work if this wasn't included in the proposal.

The doctors' concerns are: 1.) what happens after 2019; 2.) that because hours formerly classified as unsociable won't be classified as such anymore, it will be cheaper for those hours to be allocated to the roster and there will be an increase overall in evening and weekend work in the NHS; and 3.)as the pay guarantees don't apply to new doctors, this is going to have a negative impact on recruitment, particularly to specialties that already require lots of unsociable hours like A&E.

There is already a shortage of junior doctors in the acute care professions so its a ridiculous long term strategy. Salaries have to be set based on what's needed to recruit and retain staff and its already too low for that so the governments' proposal is idiotic and is just going to result in long term shortages in emergency care and the labor ward.

[Blah Blah]

Broadly I agree with that summary LondonMix. Retention is a huge problem for the NHS and Jeremy Hunt seems to have no understanding of that. Similarly, the nursing bursery scheme was also introduced because of a shortage in nursing recruitment. A third of NHS staff are from overseas.

Srisky though is also right. Those higher levels of pay are dependent on length of service and experience. No-one walks into a higher level consultancy job. As for junior doctors, ?40k with overtime isn't unreasonable.

[LondonMix]

I don't disagree with Sirsky-- the up to 100k is definitely a consultant as I stated not a junior doctor and applies to a rather senior consultant at that. I was just providing the final potential salary as part of the discussion as people had brought up the 'end game'.

I get that the NHS is a blackhole of costs that is eating up more and more of the budget but this isn't a feasible solution. We can't run the NHS with no doctors willing to work in gynecology, A&E etc.

Something else has to give and if I had to guess its one of 3 politically suicidal options;

1. Raise taxes on everyone (not just upper tax payers)

2. Make pensions means tested disqualifying most except the extremely poor OAP from receiving it

3. Increasing the retirement age dramatically.

[Earl Aelfheah]

We need to raise taxes and we need to increase retirement age imo. Most importantly though, we need to pursue policies which reduce the cost of living, particularly housing (which means a much more regulated housing market / bigger role for the state).

[Earl Aelfheah]

Oh, and the state needs to do fewer things and do them really well.

[uncleglen]

I did say POTENTIAL ?75,000+ I have taught aspiring medics in school and that is what they (and their pushy parents have their eye on). With everyone falling over themselves to earn a massive salary very quickly in order to buy an overpriced house in a suburb of London then medicine is not the road to go down...there was a time when flats were ring-fenced by the council for essential workers (and before you all start up it was Labour that first introduced the right to buy into their manifesto)

[Blah Blah]

Medicine and law have always been seen as lucrative, respected and stable professions by parents, but as with most things it depends on speciality. That's not really the issue though. And housing is something that affects everyone, and both New Labour and the Conservatives are responsible for the place we are in. With more of the same to come, you have to wonder how bad it needs to get before government does something meaningful about it.

My own feeling is that ultimately, income tax will need to rise - although it's worth pointing out that NI has risen over the years, which amounts to the same thing (they both go into the same pot).

[LondonMix]

The demand for doctors has increased and like with anything, that results in increased cost. I'm not sure if junior doctors work longer or earn less in the past but today's reality is what it is.

There are lots of reasons the demand for medical professionals is so high-- we are living much longer, we are much less healthy (obesity resulting in co-morbidities that make treatment more complex and expensive), the EU directive restricting junior doctor hours to 48 hours (to keep rota fully staffed you now need more junior doctors than before).

There really needs to be a cultural shift where maintaining good health is seen as a civic duty as well as a personal good. Exercising should be as normal as brushing your teeth.

[doublesj]

The new deal although offering an 11% base pay rise, takes away the overtime for unsocialble hours after 7pm weekdays and Saturday, which could effectively amount to a 20% pay cut for doctors. It is a highly demoralised plan to force through on Junior Doctors, I can't think of any private companies who could get away with this, because the company would lose their talent. Its taking advantage of the current crop of Junior Doctors who can not seek work outside of the UK as there is only one employer. Doctors who are training now would be wise to move abroad, which conversely will cause the NHS to hire doctors from abroad often on expensive locum rates.

It does seem very unfair to force through a paycut, no other public service has had this put upon on them and in the mid to long term its likely to cause staff shortages.