Junior Doctors Strike

[Ethan]

To be brutally honest, who's actually seen a doctor senior or otherwise do any actual work? All they seem to do is fill in forms, talk sympathetically to patients, tell nurses what to do. I am being honest here. I've spent a lot of time in hospitals with my son, wife, wifes mum and the doctors do sweet fanny adams, whilst the nurses and such run about despensing pills, injecting stuff, taking blood...the actual work.

Brutally stupid, more like.

 

[Ethan]

Can I refer you back to post 110, in which you quote my post but seem to have completely ignored the second paragraph. It would appear I think the Ts&Cs are "unhealthy and unfair."

As to understanding how the NHS works, I've so enjoyed being blissfully asleep in the resies only for the phone to go.

In that case, don't make a post asking if you should weep and wail etc.

My point was that even if you don't give a toss for the doctors who work long hours, you should be concerned about the care they are able to give you as a result of those long hours.

And when I read your utterances, I don't go back and check the entire body of work that forms the collected wisdom of hobbit.

 

[Hobbit]

In that case, don't make a post asking if you should weep and wail etc.

My point was that even if you don't give a toss for the doctors who work long hours, you should be concerned about the care they are able to give you as a result of those long hours.

And when I read your utterances, I don't go back and check the entire body of work that forms the collected wisdom of hobbit.

What part of unhealthy and unfair don't you understand?

If that's what I posted it clearly suggests I do care about what they work but, as I said, they chose it.

Maybe you should read ALL of a post before you utter drivel. You might just find someone actually agrees with you............................. for a change

 

[SwingsitlikeHogan]

What part of unhealthy and unfair don't you understand?

If that's what I posted it clearly suggests I do care about what they work but, as I said, they chose it.

Maybe you should read ALL of a post before you utter drivel. You might just find someone actually agrees with you............................. for a change

They might have chosen the profession - they did not choose to work stretched and extended hours that results in them being so knackered and demoralised that the well-being of patients is put at risk.

A few here seem to be saying they doctors should just 'suck it up' and get on with the job - it's what they signed up to when becoming doctors and they get paid pretty well for it. Well that is fine - except that unlike most other jobs - if they don't do their job properly, or make mistakes through tiredness - people can die. Do they turn to us and say "well - it's what you voted for dear public - it was in the Tory manifesto - you are just going to have to 'suck that up'?"

 

[DCB]

Some incredible reading on this thread. Granted, I'm up here North of the border and our system is devolved and not going through quite the same traumas as the NHS down South, however, I've seen at first hand what our Doctors do for us. I had a fairly innocuous accident that resulted in a rather serious outcome. I have nothing but praise for the Doctors who worked out what was happening to me and who worked out what needed to be done. I saw them at all stages of my hospitalisation, A&E, Surgical team, Intensive Care, High Dependency, Neuro Ward, ReHab specialists. They all work within a failing system, but, they all, without exception, cared for the outcome of their patient. Without them I'd not be typing this today.

 

[daverollo]

They might have chosen the profession - they did not choose to work stretched and extended hours that results in them being so knackered and demoralised that the well-being of patients is put at risk.

A few here seem to be saying they doctors should just 'suck it up' and get on with the job - it's what they signed up to when becoming doctors and they get paid pretty well for it. Well that is fine - except that unlike most other jobs - if they don't do their job properly, or make mistakes through tiredness - people can die. Do they turn to us and say "well - it's what you voted for dear public - it was in the Tory manifesto - you are just going to have to 'suck that up'?"

But one of the main features on the governments proposal is to reduce the amount of hours a Junior Doctor can work over a set period of time. Therefore ensuring they get more rest and don't work excessively. The point being it should improve patient safety.

Currently a Junior Doctor can sign up and do 91 hours in a week, surely far too much to be making life threatening decisions accurately. The proposal is that a cap of 72 hours in any one week will be the absolute maximum they can work, along with other safeguards, such as:
- Not allowed to work more than 4 night shifts in a row or 5 long day shifts.
- Employers banned from scheduling any shifts over 13 hours
- Maximum 7 days or nights on call in a row

But the crux of it surely is the part which states:
The removal of the financial incentives in the current contract that encourage doctors to work unsafe hours.

Now I have no idea what the main motives are from the government to wanting to introduce a new contract when in the long run it won't reduce the wage bill. With the proposed increases in core basic pay it will mean an increased pension liability to the rest of the nation who work in the private sector in the future.

But just looking at the above and the reduction in maximum hours a junior doctor will be allowed to work, surely this whole dispute is about pay?

The government really have made a hash of the negotiations, because from what is on offer surely it will improve patient safety?

 

[Ethan]

What part of unhealthy and unfair don't you understand?

If that's what I posted it clearly suggests I do care about what they work but, as I said, they chose it.

Maybe you should read ALL of a post before you utter drivel. You might just find someone actually agrees with you............................. for a change

I understand both parts of it, and do read all of a post, but if you are accusing me of selectively responding to only parts of a post, well, Mr Pot, say hi to Mr Kettle.

 

[Ethan]

But one of the main features on the governments proposal is to reduce the amount of hours a Junior Doctor can work over a set period of time. Therefore ensuring they get more rest and don't work excessively. The point being it should improve patient safety.

Currently a Junior Doctor can sign up and do 91 hours in a week, surely far too much to be making life threatening decisions accurately. The proposal is that a cap of 72 hours in any one week will be the absolute maximum they can work, along with other safeguards, such as:
- Not allowed to work more than 4 night shifts in a row or 5 long day shifts.
- Employers banned from scheduling any shifts over 13 hours
- Maximum 7 days or nights on call in a row

But the crux of it surely is the part which states:
The removal of the financial incentives in the current contract that encourage doctors to work unsafe hours.

Now I have no idea what the main motives are from the government to wanting to introduce a new contract when in the long run it won't reduce the wage bill. With the proposed increases in core basic pay it will mean an increased pension liability to the rest of the nation who work in the private sector in the future.

But just looking at the above and the reduction in maximum hours a junior doctor will be allowed to work, surely this whole dispute is about pay?

The government really have made a hash of the negotiations, because from what is on offer surely it will improve patient safety?

It will not improve patient safety. It may make it less safe. The patient safety issue is that currently medical staffing is stretched to its limit, and vacancies are widespread. These vacancies are why the locum/agency issue has become such a big deal. There used to be very few locums and agency staff in medical positions. It is not possible to stretch this staffing even further over 7 days, and it is not necessary because the weekend effect is mostly contrived and what is left is due to case-mix (sicker patients). Further, the reduction in staffing during the week may adversely affect patient safety.

Few doctors work 91 hours a week. As work intensity has gone up, most juniors work more in the region of 72, but at higher intensity. They often work beyond their rota'd hours, but unpaid. They are often asked at short notice to cover vacant shifts. Their leave is often allocated in advance and The DH have said that 99% of doctors will not earn less, but that is only due to transitional arrangements. They will lose automatic increments though.

In fact, if some doctors work fewer hours, but the total number of hours needed to be covered stays the same or increases, more doctors will be needed. If the pay envelope is static, then they must on average earn less.

The BMA was willing to negotiate on the assumption there was no more money available, meaning no average increase. They wanted protection against abuse over hours and rotas and these assurances were not given.

You have hit on the main issue though - what is the Govt's motive if it won't reduce the wage bill? The motive is that Simon Stevens, the NHS England CEO (and former employee of a US HMO) was brought in to help the drive towards privatisation of services, and private employers want more flexible workforces. This is about breaking restrictive working practices.

 

[Foxholer]

Alright, if you want to be pedantic, let's call it compensation. This 'compensation' is still not forthcoming in other walks of life. Teachers for example get a salary. No enhancements for the work they do out of work hours.

Agreed! That's one of the reasons they have invoked industrial action in the past! To me, it's another example of government taking advantage of the 'good nature' of those in a particular industry in order to keep costs down. The compensation is, relatively, reasonable at higher grades, but the lower levels get hammered - not unlike the 'Junior' Doctors!

 

[daverollo]

In fact, if some doctors work fewer hours, but the total number of hours needed to be covered stays the same or increases, more doctors will be needed. If the pay envelope is static, then they must on average earn less.

It doesn't take a rocket scientist to grasp the idea that if you go from a 5 day a week service (for operations etc) to a 7 day a week service that you will need more Doctors. Absolutely a pointless exercise if all they intend to do is the same amount of operations/treatments but spread them over 7 days instead of 5. That's not increasing capacity or reducing waiting times in my mind.

I am not grasping the privatisation part though. Are you suggesting that patients will be sent down the road to a BUPA (or similar) hospital to have some routine operations carried out at a cost to the NHS? That would be completely counter productive if it will cost the tax payer more to do that. If however, it saves the tax payer money then what is the problem?

I have a lot of clients on my books who are medical professionals, quite a few who mix their time between NHS and private work.

 

[SwingsitlikeHogan]

Privatisation may save money - but do you get the same service delivered with the same ethos by equally qualified and committed staff? That's the problem.

 

[SocketRocket]

Privatisation may save money - but do you get the same service delivered with the same ethos by equally qualified and committed staff? That's the problem.

Surely many of the Surgeons, Doctors, Nurses are ones that were trained in the NHS and some probably work in the NHS as well. Why should the ethos, service or commitment be any different? My experience of Private Health supply is that it is very good.

 

[MarkE]

I didn't know teachers were rostered to do 30 to 50 hours of overtime including nights, weekends, high days and holidays.

Next time you call out an electrician or plumber on call for an emergency be sure to explain your compensation philosophy to him before he starts work. Then you might meet a junior doctor for removal of the wrench.

Yep. My daughter is a teacher and has to work all of those within her contract. Impossible to do everything in her 38 hours contracted. She knew this when she went into teaching, as do the junior doctors.
Fail to see what a leaky tap has to do with anything.

 

[drdel]

The medics I know work so hard for the NHS and are so tired, but still somehow manage to do private work in cosmetic clinics and private hospitals.

I guess one of the gripes might be that by putting a structure and process around their NHS contracts might impinge on these, their second jobs sometimes using the NHS hospital's kit !!

 

[Kellfire]

Are you suggesting that patients will be sent down the road to a BUPA (or similar) hospital to have some routine operations carried out at a cost to the NHS?

This already happens routinely. It costs less to send them private and pick up that cost than the fines that would be imposed if they breached waiting times.

 

[FairwayDodger]

I see our government chose the day the chilcott report came out to announce they were imposing the contract on junior doctors, despite them voting against it.

There's nothing like a good day to bury bad news for our dysfunctional administration.

 

[Deleted member 18588]

I see our government chose the day the chilcott report came out to announce they were imposing the contract on junior doctors, despite them voting against it.

There's nothing like a good day to bury bad news for our dysfunctional administration.

I am no apologist for Jeremy Hunt but I cannot see what option the Government now has.

Those chosen by the junior doctors to negotiate on their behalf accepted the revised terms but apparently those negotiators did not have the authority to make that decision.

Just who, therefore, are the DoH to deal with?

 

[FairwayDodger]

I am no apologist for Jeremy Hunt but I cannot see what option the Government now has.

Those chosen by the junior doctors to negotiate on their behalf accepted the revised terms but apparently those negotiators did not have the authority to make that decision.

Just who, therefore, are the DoH to deal with?

My point is they chose to sneak the news out yesterday rather than actually deal with the ensuing bad publicity.

On the broader issue, they need to negotiate a deal that can pass a vote of those affected. It's certainly unfortunate that the doctor's negotiating team haven't adequately represented their members' views.

 

[Deleted member 18588]

My point is they chose to sneak the news out yesterday rather than actually deal with the ensuing bad publicity.

On the broader issue, they need to negotiate a deal that can pass a vote of those affected. It's certainly unfortunate that the doctor's negotiating team haven't adequately represented their members' views.

Not sure that the publicity would be so bad.Much of the public sympathy that the doctors previously enjoyed now seems to have drifted away.

And as for negotiating a deal that might be acceptable, that is my point . How are the DoH to know what might be acceptable if the profession's own representatives don't know?

 

[Lord Tyrion]

How long do you give people to negotiate? This has been going on for years and the sticking point is the same. There has not been progress for months. As an employer you reach a point where you have to say "this is the deal, like it or lump it". If the junior doctors don't like it then they will have to leave and find work with another employer. That is how the rest of us work.