IFISAcava
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Post by IFISAcava on Aug 9, 2021 11:35:23 GMT
Err, well it’s the basic pay that matters. The enhancements are for doing longer and more antisocial hours above basic hours. Not commenting on NHS pay structures specifically as I have very limited knowledge of them. But as a general point, I would disagree with that statement. There are many jobs which have anti-social hours, and people often quote basic pay numbers and then talk about how that is incompatible with the anti-social hours / shift working etc. If it is fundamental to the job that there are anti-social hours / shift work / bank holiday working, then the only salary numbers that really matter for comparison purposes should be those that incorporate what would be expected normal shift patterns for the job. Which inevitably in jobs like policing/health care will entail shift work / anti-social hours. The other consideration is how generous (or not) are the payments for abnormal (outside of reasonably to be expected for that job) work patterns. on what basis ? What are the grounds for saying that ? Perhaps they should be ? perhaps they should be paid 50% less ? Or 150% more ? Or maybe they should be paid the same but required to do a bit less hours ? Or maybe the issues around tax/tax allowances with Defined Benefit pension schemes should be resolved somehow, to encourage more qualified people to stay in the job for longer ? Comparing jobs and salaries is a minefield and often hugely subjective. Pay is only one part of any benefit/reward equation. More subjective indicators would be: a) Are there significant recruitment issues, which are NOT being caused by bottlenecks in training / qualification rather than willing candidates which pay increases would ameliorate. b) what does the overall renumeration & benefits package compare with same roles in other similar countries.Otherwise we're just plucking numbers out of the air. Yes, massive retention issues. Experienced professionals leaving/retiring early in droves. Including Yours Truly. And pay/package is less than most English speaking countries (Ireland/US/Australia/Canada) - hence people going there - a huge percentage of my cohort, and usually the best ones, have ended up in one of these places. Relative pay against other professions in UK is also relevant - massive pay decline since 2008 - 30% in real terms. And don't mention pensions - what a huge own goal by the government. It isn't just pay either - the micromanagement and distorted/inflexible/imposed/irrelevant targets one is subject to now are unbearable. And general conditions - long gone are the days where consultants are afforded any sort of status in the system. Admin support? Don't make me laugh. Less and less time doing medicine, more and more time doing basic . Add to it the loss of EU doctors, and there are big problems coming for senior doctor NHS staffing. How that is sorted I don't know - you can train more people (and they are) - but you need more people to train them, who aren't busy filling gaps in the service, and you need to wait 14+ years for new consultants or 10+ for new GPs to be fully trained. You also need them to stay the course - rates of junior doctors leaving the NHS for other types of work are at a record high. I suspect immigration rules will be loosened for overseas docs, and there will be need to be incentive payments to get people to work in less popular areas and specialities. Anyway, doctors don't get a lot of sympathy as they are regarded as sufficiently well paid by most people/politicians. We will get the NHS we are prepared to pay for, and the most experienced and the creme de la creme will increasingly be attracted elsewhere. I don't see this changing. Happy summer to you all from Greece where I am dodging fires safely ensconced on a fairly remote island.
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hazellend
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Post by hazellend on Aug 9, 2021 12:03:25 GMT
Err, well it’s the basic pay that matters. The enhancements are for doing longer and more antisocial hours above basic hours. Not commenting on NHS pay structures specifically as I have very limited knowledge of them. But as a general point, I would disagree with that statement. There are many jobs which have anti-social hours, and people often quote basic pay numbers and then talk about how that is incompatible with the anti-social hours / shift working etc. If it is fundamental to the job that there are anti-social hours / shift work / bank holiday working, then the only salary numbers that really matter for comparison purposes should be those that incorporate what would be expected normal shift patterns for the job. Which inevitably in jobs like policing/health care will entail shift work / anti-social hours. The other consideration is how generous (or not) are the payments for abnormal (outside of reasonably to be expected for that job) work patterns. on what basis ? What are the grounds for saying that ? Perhaps they should be ? perhaps they should be paid 50% less ? Or 150% more ? Or maybe they should be paid the same but required to do a bit less hours ? Or maybe the issues around tax/tax allowances with Defined Benefit pension schemes should be resolved somehow, to encourage more qualified people to stay in the job for longer ? Comparing jobs and salaries is a minefield and often hugely subjective. Pay is only one part of any benefit/reward equation. More subjective indicators would be: a) Are there significant recruitment issues, which are NOT being caused by bottlenecks in training / qualification rather than willing candidates which pay increases would ameliorate. b) what does the overall renumeration & benefits package compare with same roles in other similar countries. Otherwise we're just plucking numbers out of the air. Basic pay for a doctor covers 9-5 Monday to Friday. Some jobs you just do those hours and will get basic pay. Depending on how many additional hours (not instead of) you do for night shifts and weekends determines the enhancement. Pay is definitely far too low. Yes 50% was a rough number based on what I would get if I left tomorrow and locummed. Actually it would be more like double if I maintained my current hours. Either the NHS needs to recruit many more doctors to make the job more sustainable or it needs to massively increase pay to entice people to stay. The public don’t really understand the situation, but doctors are truly front line staff and irreplaceable (unlike a store worker for example). They are highly trained and work very long and intense hours. Something is about to give.
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Post by Deleted on Aug 9, 2021 12:48:40 GMT
I think the point is these numbers 30 and 50% are just too perfect they show that they are "air" numbers not calculated numbers. Further you have to start asking why people take 7 to 10 years to be trained. I suspect they are getting trained in 2 year and gaining experience and confidence in 5 to 8 years. All very valuable but let us not confuse our terms. Please don't let my "air" numbers stand but give us the facts.
Doctor Consultant
Training ? ? Experience ? ?
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Post by Deleted on Aug 9, 2021 13:40:11 GMT
You may like this discussion which points out that it is not all about the base money
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Mike
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Post by Mike on Aug 9, 2021 15:00:18 GMT
Women were not allowed to become doctors until 1876, and as recently as the 1960s the male:female ratio in training was 3:1. It was time for a big woke drive to encourage more young women to train in medicine to bring the %ages up to closer to 50/50! Oops! No-one thought that retaining mothers might be harder than fathers, or what the implications of maternity leave are on the time it takes to become a consultant. Loads of female doctors work part time ( the telegraph claims almost half of female consultants, comapred to 5% of male) which in addition to maternity leave means even those that do hang around to become consultants are far worse "value" in terms of lifetime hours worked per medical degree.
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registerme
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Post by registerme on Aug 9, 2021 16:28:47 GMT
Women were not allowed to become doctors until 1876, and as recently as the 1960s the male:female ratio in training was 3:1. It was time for a big woke drive to encourage more young women to train in medicine to bring the %ages up to closer to 50/50! Oops! No-one thought that retaining mothers might be harder than fathers, or what the implications of maternity leave are on the time it takes to become a consultant. Loads of female doctors work part time ( the telegraph claims almost half of female consultants, comapred to 5% of male) which in addition to maternity leave means even those that do hang around to become consultants are far worse "value" in terms of lifetime hours worked per medical degree. So your proposal is...?
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Post by crabbyoldgit on Aug 9, 2021 19:20:05 GMT
Gp , ah yes i remember them they were replaced about two years ago by nurse practitioners when all gp`s went part time. Of course since covid they are rumoured to be totally extinct , no one i know of has actually seen one under any circumstance. So how does the nhs operate in Dorset. 1 you phone 111, noreply 2 you phone gp , get told to go on line , fill in questionare .Nurse will phone you back within 48hrs having consulted Gp and does not 3 Go to A and E , but they will not see you without an appointment and you will not get one if they can refer you back to phone GP surgery. 4 Phone 999 and get an ambulance , the secret is to include the words chest pain or overdose, result! If you do not believe me talk to my next door neighbour a para medic, he is being offered time and a half plus up to £200 a shift bonus as the ambulance service is buckling under the pressure of people unable to gain access to the system any other way.The madest high priority call,an overdose of smarties but the magic word overdose made it automatic number 1 attendance .
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bernythedolt
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Post by bernythedolt on Aug 10, 2021 10:42:52 GMT
Gp , ah yes i remember them they were replaced about two years ago by nurse practitioners when all gp`s went part time. Of course since covid they are rumoured to be totally extinct , no one i know of has actually seen one under any circumstance. So how does the nhs operate in Dorset. 1 you phone 111, noreply 2 you phone gp , get told to go on line , fill in questionare .Nurse will phone you back within 48hrs having consulted Gp and does not 3 Go to A and E , but they will not see you without an appointment and you will not get one if they can refer you back to phone GP surgery. 4 Phone 999 and get an ambulance , the secret is to include the words chest pain or overdose, result! If you do not believe me talk to my next door neighbour a para medic, he is being offered time and a half plus up to £200 a shift bonus as the ambulance service is buckling under the pressure of people unable to gain access to the system any other way.The madest high priority call,an overdose of smarties but the magic word overdose made it automatic number 1 attendance . GPs do seem to have taken to working from home and not having to see pesky patients any more. My last two GP consultations have consisted of having to convince the 'triage nurse' (aka the telephone receptionist) of my urgency to speak to a hallowed one, followed by him telephoning back for a chat. I've given up on the idea of ever actually seeing a GP in person, but it now seems that diagnosis from afar is taking over, and I bet GPs are loving it. My daughter has a slightly troubling skin growth... diagnosed via phone picture to the GP as 'probably not a concern'. You can't tell me that a phone pic can replace a proper look in person with a magnifying glass. She remains concerned and not at all reassured by this half-assed level of remote diagnosis.
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hazellend
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Post by hazellend on Aug 10, 2021 20:26:57 GMT
Gp , ah yes i remember them they were replaced about two years ago by nurse practitioners when all gp`s went part time. Of course since covid they are rumoured to be totally extinct , no one i know of has actually seen one under any circumstance. So how does the nhs operate in Dorset. 1 you phone 111, noreply 2 you phone gp , get told to go on line , fill in questionare .Nurse will phone you back within 48hrs having consulted Gp and does not 3 Go to A and E , but they will not see you without an appointment and you will not get one if they can refer you back to phone GP surgery. 4 Phone 999 and get an ambulance , the secret is to include the words chest pain or overdose, result! If you do not believe me talk to my next door neighbour a para medic, he is being offered time and a half plus up to £200 a shift bonus as the ambulance service is buckling under the pressure of people unable to gain access to the system any other way.The madest high priority call,an overdose of smarties but the magic word overdose made it automatic number 1 attendance . GPs do seem to have taken to working from home and not having to see pesky patients any more. My last two GP consultations have consisted of having to convince the 'triage nurse' (aka the telephone receptionist) of my urgency to speak to a hallowed one, followed by him telephoning back for a chat. I've given up on the idea of ever actually seeing a GP in person, but it now seems that diagnosis from afar is taking over, and I bet GPs are loving it. My daughter has a slightly troubling skin growth... diagnosed via phone picture to the GP as 'probably not a concern'. You can't tell me that a phone pic can replace a proper look in person with a magnifying glass. She remains concerned and not at all reassured by this half-assed level of remote diagnosis. Yep, the public have truly broken GP with needless appointments. The future will be pay for an appointment. £60 for a half hour GP appt.
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Post by bracknellboy on Aug 11, 2021 6:29:46 GMT
GPs do seem to have taken to working from home and not having to see pesky patients any more. My last two GP consultations have consisted of having to convince the 'triage nurse' (aka the telephone receptionist) of my urgency to speak to a hallowed one, followed by him telephoning back for a chat. I've given up on the idea of ever actually seeing a GP in person, but it now seems that diagnosis from afar is taking over, and I bet GPs are loving it. My daughter has a slightly troubling skin growth... diagnosed via phone picture to the GP as 'probably not a concern'. You can't tell me that a phone pic can replace a proper look in person with a magnifying glass. She remains concerned and not at all reassured by this half-assed level of remote diagnosis. Yep, the public have truly broken GP with needless appointments. The future will be pay for an appointment. £60 for a half hour GP appt. Which is a fundamental issue in this day and age with an entirely 'free at point of use' system. Parts of the NHS delivery model are fundamentally broken and not fit for purpose: but virtually any discussion on ways of making it more practical/suitable/fit for today's demand is quickly squashed by interested parties and politicians as a 'threat to our [beloved/national treasure/unique asset - insert suitable emotion inducing word here] NHS'. By way of a small contrast. My brother has recently got residency - actually a form of interim residency - in Belgium (which they were very helpful in expediting to get the necessary done before formal Brexit date and ongoing). He has recently been having awful problems with a bad back. He got an appointment with a doctor in less than 24 hours, and was able to make a phone call to make that appointment. He has also been able to get a referral to a diagnostic centre, and for physio, and for a second appointment with another doctor. All in less than a week. Costs of use are MOSTLY covered by (compulsory) national insurance scheme. An effective throttle on demand is built in as some small element of the charges for use are not recoverable e.g. I think it was about 6 or 8 Euro cost he had to cover. Yes, healthcare spending per head of population in Belgium is higher than in the UK (I found wwide figures for 2017 which suggested about 20% greater), but its principles that matter. besides, we are also told (and it should be the case) that the size of the NHS should give it some additional economies of scale). Point is, its the principles that matter that should be up for discussion. It will never be £60 for GP visit: politically won't wash. And it doesn't need to be: you need a deterrent, not a full cost cover. But god forbid such things should get properly aired.
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keitha
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2024, hopefully the year I get out of P2P
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Post by keitha on Aug 11, 2021 10:32:48 GMT
here in Wales We all get free prescriptions.
An average of over 26 items per person per year.
Despite being told not to do it 1.5 Million prescriptions were issued for asprin and 1.2 million for paracetamol, This is millions of pounds wasted as the charge is at least £3 whereas you can buy them for 20P.
I know people who have Paracetamol and Asprin on repeat prescription, the general attitude is " I'm entitled to it free why should I pay "
But to go back to the main discussion,
I needed to see Doctor the other week I spent an Hour in a queue trying to get through, eventually got the receptionist explained the issue and she said doctor would ring back within 24 hours, in reality it was nearer 28 hours . I was asked to visit surgery to leave a sample. That was an eye opener I walked in 4 staff on reception chatting and ignoring the Phone In 10 minutes I only saw the phone picked up once. it felt as if we the patients less important than their discussions. I left my sample and got a response 48 hours later. Terrible service compared to precovid.
My OH literally can't get through to her GP surgery the phone rings then cuts off after a few minutes no chance to leave a message or anything
On the other hand a friend rang his GP surgery a month ago, and was asked if he could come down then and was seen within an hour of making the call
so it appears we have a major difference between GP surgeries
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