The controlled demolition of the NHS

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The controlled demolition of the NHS

Postby Elessar » Sun Sep 27, 2015 1:17 pm

This is a news story that has been rumbling on for a few weeks and has recently been picked up by the national media.

Here's a reasonable summary of what's going on:

http://www.standard.co.uk/comment/comme ... 54811.html

In a nutshell, the government started to review junior doctors' contracts a few years ago. NB a 'junior doctor' is any grade below consultant, up to and including the most senior of registrars, who may be well into their 30s or even 40s. The negotiations with the BMA broke down, and the BMA withdrew from negotiations. Now, the government is saying that it will impose the new contracts on junior doctors without any further negotiation.

The main issue boils down to antisocial hours. At the moment, 'normal hours' are 7am-7pm Monday to Friday. Doctors who work outside those hours get a banding supplement to their pay. Starting salary is around £22,000 (gross) but with 1A banding it can go up to as much as £33,000. For 1A banding, there needs to be quite a lot of evening, weekend and night work. An A&E job is typically 1A banding.

The new proposals would raise basic salary slightly, and re-define 'normal hours' to 7am-10pm Monday to Saturday. This would mean that doctors who work 9am-5pm Monday to Friday only (that's basically dermatologists and that's about it) would be slightly better off. However, those who do lots of out-of-hours work, such as A&E doctors, surgeons, acute medics and anaesthetists, would lose a lot of money. Some have estimated that it could be as much as a 40% pay cut.

Now some might argue that hospitals should be 24 hour services, and to a certain extent that's true, although clearly 'routine' stuff should be during normal working hours. No one wants to turn up to their routine colonoscopy at 3am on a Bank Holiday. So you could just about argue that doctors shouldn't get extra cash for working nights and weekends; although I think A&E doctors would argue that their lifestyles are significantly poorer than the likes of ophthalmologists! However, these new contracts amount to a huge pay cut, and surely that's not fair.

Furthermore, the new contracts remove some of the safeguards against dangerously long shifts or periods without days off, which has been shown numerous times to be dangerous to patients.

Lots of doctors have said that they might move abroad. It's true, medicine is an internationally transferrable qualification and there are plenty of jobs in other countries that pay more money and offer a better lifestyle. The Tories have responded to this suggestion by saying that UK trained doctors should be forced to work in the NHS for a pre-defined period of time before they can leave the country, although it is unclear how this could be enforced. They also haven't given any indication as to how they will recompense the countries who trained the thousands of doctors who trained overseas.

The BMA is now balloting its members to consider a strike. If they vote yes, it would be the first full doctors strike since 1975. Contrary to Freddie's lyrics in Friends Will Be Friends, doctors don't go on strike. If it happens, it will be a big deal. Doctors don't want to strike, but they also don't want to have their pay slashed and in a way that compromises patient safety.

Thoughts?
Last edited by Elessar on Thu Oct 13, 2016 6:37 am, edited 1 time in total.
 
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Re: UK junior doctors strike

Postby JLP » Sun Sep 27, 2015 1:32 pm

Unsocial hours should be paid for, no matter who works them. Doctors have my support in this case.
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Re: UK junior doctors strike

Postby Capt. Den Ronson » Sun Sep 27, 2015 2:02 pm

Yes, it's unfair. Lots of stuff in life is unfair but I respect all you gals and guys (like the lyrics in Roger's song) who take on these jobs because I would not have the stomach for it.
If Innuendos wants to link to a petition, I'll sign it.
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Re: UK junior doctors strike

Postby JLP » Sun Sep 27, 2015 2:18 pm

Capt. Den Ronson wrote:Yes, it's unfair. Lots of stuff in life is unfair but I respect all you gals and guys (like the lyrics in Roger's song) who take on these jobs because I would not have the stomach for it.
If Innuendos wants to link to a petition, I'll sign it.


she doesn't like doctors so don't hold your breath.
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Re: UK junior doctors strike

Postby fairydandy » Sun Sep 27, 2015 3:17 pm

I don't think it's fair that doctor's should take a pay cut (or anyone in the NHS). I do however think that change has got to happen. Increasingly we live in a 24 hour society and the very notion of a 'weekend' really needs to go! I remember saying this about 15 years ago on here and it wasn't popular then..and nor will it be now! :P

I work in a 24 hour operation and although it's different, it's also similar. If we want anything fixed, or purchased, it's pretty much Mon-Fri 9-5...and that's a real frustration, because after the office staff go home, the place has to run 24/7 for (almost) 365 days of the year...nothing changes.

I'm a real advocate of losing the 'weekend' altogether, it's not helpful!
 
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Re: UK junior doctors strike

Postby action » Sun Sep 27, 2015 6:45 pm

:butcher:

hold on, doctors on strike? :shock:

:arrow: i guess the oath of hyppocrates doesnt apply on junior doctors then. and if it does, it just goes to show the level of our future doctors. having barely treated patients and already breaking their code :roll:

:arrow: not to mention that in most countries, a doctor who refuses to treat a person in need, commits a criminal offence

:arrow: even discarding the above, doctors should never be allowed to strike. the right of medical treatment always prevails above the right to strike
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woe to you, teachers of the law, you hypocrites!

      
 
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Re: UK junior doctors strike

Postby Elessar » Sun Sep 27, 2015 11:04 pm

"I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment.

I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master's children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else.

With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.

Nor shall any man's entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child.

Further, I will comport myself and use my knowledge in a godly manner.

I will not cut for the stone, but will commit that affair entirely to the surgeons.

Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free.

Whatever, in the course of my practice, I may see or hear (even when not invited), whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret within my own breast.

If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate!"



So, no abortions, no chemotherapy, and if you need your appendix out, best go to your barber instead. Oh, and Christians and Muslims are in daily defiance of the oath as well. And nothing about not going on strike, either.

Invoking the Hippocratic Oath in 2015 is as useful as invoking the Ten Commandments. The broad principles mostly still hold true but the detail is irrelevant and unhelpful.
 
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Re: UK junior doctors strike

Postby Innuendoes » Mon Sep 28, 2015 4:08 am

JLP wrote:
Capt. Den Ronson wrote:Yes, it's unfair. Lots of stuff in life is unfair but I respect all you gals and guys (like the lyrics in Roger's song) who take on these jobs because I would not have the stomach for it.
If Innuendos wants to link to a petition, I'll sign it.


she doesn't like doctors so don't hold your breath.


Says who? I love the doctor I have now. She's fantastic. Just because I didn't like the doctor that killed my mother and got fired by the hospital for doing so and the one that had over 10 chances to diagnose the thyroid problem I had when he knew full well I had thyroid problems in the first place (or maybe not, even though he was prescribing synthroid for me for 8 some years :roll: ) does not mean I don't like doctors, does it? It means I don't like incompetent jerks! 2nd doctor mentioned, here, was KICKED OUT of both city hospitals. Go figure.
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Re: UK junior doctors strike

Postby Kes » Tue Sep 29, 2015 3:29 pm

People "should" be paid what they are worth.

On the one hand, I see completely what Elessar is saying, and on the other hand, you have the guys who get themselves into lucrative consultancy work, and are driving round in Bentleys, and the like.

It seems like a lot of jobs in that there isn't much consistency between the private and public sectors.

As regards "bonding", we get a lot of that in aviation. If someone forks out the money to train you, then maybe you should be tied into repaying that with a duration of loyalty. However, I think most doctors seem to wind up funding their own training, and experience, by taking shit pay, and putting up with terrible terms and conditions. So, there's an argument there, that you don't get loyalty for fuck all.
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Re: UK junior doctors strike

Postby Kes » Tue Sep 29, 2015 3:39 pm

At the end of the day, it seems like the agenda is to kill the NHS by starvation at the sharp end. Yeah, they're ploughing money into admin, but admin people don't actually help people who are ill.

Not paying doctors enough, that they fuck off to somewhere where they are paid for what they do. Encouraging Eastern European workers into the nursing jobs that natural British people simply can't afford to do, and then imposing threats on them that they won't be able to stay more than five years, if they're not earning in excess of 34k.

There's not many people at the bottom end of the nursing profession on anything like THAT much.

Whatever positives I can find with the Tories austerity measures, I'm not finding many with the NHS.
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Re: UK junior doctors strike

Postby Elessar » Tue Sep 29, 2015 4:38 pm

The problem is, the government aren't stupid. They know that a strike will damage the public's perception of doctors, no matter how much the public seem to be backing the doctors at the moment. Their sympathy will go very quickly if they're personally affected by a strike.

They also see all these juniors talking about how they'll have to move to Australia. That's easier said than done! The Australians roughly doubled the number of medical school places around 8 years ago, and those graduates are all starting to filter through, and they all get priority for jobs over international graduates. Anecdotally, it was really hard for people to find jobs in Australia for an August 2014 start. Anecdotally it was really easy for August 2015 though, so it's all a bit of a guessing game. However, if several thousand suddenly start applying, many of them will be disappointed. And only a few hundred will be able to spill over into New Zealand. And then there's about £2500+ worth of admin to get over there (flights £700, visa £500, medical £300, board registration £500, getting your degree approved £250) and then another £2000 or so on a flat deposit, a car and all that other stuff.

These idealistic doctors haven't necessarily thought that far ahead. The government have though. They know that no matter how shit they make the contracts, there'll still be people filling the positions.
 
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Re: UK junior doctors strike

Postby Elessar » Tue Sep 29, 2015 4:39 pm

Then there's the selfish bastards already in Australia who are eyeing up the situation back home with interest, knowing that this year might be the best time ever to apply for competitive jobs back in the UK with competition at an all-time low...
 
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Re: UK junior doctors strike

Postby Kes » Tue Sep 29, 2015 4:52 pm

I don't think it matters what profession any of us are in, unless you're already filthy rich, we're all dealing with the same sorts of pressures of external forces coming in, driving up the workloads, and down the wages.
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Re: UK junior doctors strike

Postby Elessar » Thu Feb 11, 2016 11:42 am

They're going for the nuclear option!

http://www.bbc.com/news/uk-england-35548091

Problem is, junior doctors are talking about further strikes, mass resignations and fleeing abroad.

Further strikes MIGHT happen, but eventually the Tories and the right-wing press will win the public over and the doctors will lose their backing. All it will take is a pretty blonde 5 year old poster girl to die of meningitis because the greedy doctors were on strike and the public will turn on the doctors (of course, that could have been avoided if the parents had just googled the rash, but that's another matter!!)

Mass resignations simply will not happen. I guarantee it.

Fleeing abroad is okay for some, but there's only a finite number of jobs abroad, and the people who stand to suffer the most under the new contract, i.e. those with young families, are exactly the kind of people who can't just uproot and move 10,000 miles away.

In short, the government is going to ultimately get its own way, and the cynic would argue that the endgame they have in mind is privatisation of the health system. As Chomsky said: "That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital."
 
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Re: UK junior doctors strike

Postby JLP » Thu Feb 11, 2016 12:09 pm

Amazingly, my employer has just recently agreed to pay unsocial hours for nights, Saturdays, Sundays and Bank Holidays.
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