mv
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Post by mv on Apr 22, 2016 8:07:49 GMT
DOI: I am a junior doctor. I have been since I graduated in 2004.
The current contract dispute has been a contentious subject. There has been a lot of disinformation and spin from the government side. I don't think the BMA has been very clear with the public what the issues are either.
What do people think of what is going on? Does anybody have an questions I can try and answer from a personal perspective?
Matt
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mv
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Post by mv on Apr 22, 2016 9:55:00 GMT
The contract renegotiation started before the the promise of 'seven day services'. Junior doctors already cover 24 hours a day seven days a week on a rostered system.
Despite a pay freeze for several years and a unilateral detrimental change to the 'gold plated' pension we have never asked for more pay.
It is true that we do not want to be paid less to work more anti-social hours.
Currently every hospital has MAJOR rota gaps. The routine services Mon-Fri are massively stretched. The emergency cover is the same out of hours seven days per week. There are no more doctors (in fact they are leaving).
So far what we have seen of hospitals trying to implement the new rotas are that it is more difficult to roster adequate staff, including at the weekends due to the various restrictions in place and the need to adequately cover the service Mon-Fri too.
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Post by yorkshireman on Apr 22, 2016 10:57:33 GMT
A close relative, who holds fairly “liberal” views, used to work for the BMA and considered it to be a dinosaur like the trade union movement as a whole.
Before I became self employed, I worked for a firm that was cutting jobs and in order to protect my own interests I joined a union that supposedly represented the interests of professionals and managers. Big mistake, they were happy to accept my membership fees but when the chips were down and I needed their advice they were nowhere to be seen which summed up the view I have held for 40 plus years, unions are useless in looking after the interests of employees. Consequently I cancelled my membership and was allowed to “honourably resign”
When trade unions were originally founded, there was a need for them to protect employees but today and indeed for many decades they have done nothing for their members and are nothing more than a self interested Neanderthal branch of the Labour party engaged in guerrilla warfare against the majority of people in the UK.
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Post by davee39 on Apr 22, 2016 11:31:46 GMT
The new contract has nothing to do with patients, it is about NHS privatization.
It has been a well used government policy to deliberately weaken a public service and then claim that the private sector is the only solution. As the dispute escalates failing hospitals will be outsourced to private management - It is already happening across sectors such as ambulance services. Doctors are merely pawns in this process.
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mv
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Post by mv on Apr 22, 2016 11:37:26 GMT
It does seem rather strange that throughout this dispute the BMA has been described as socialist/left-wing agitators by the government and media. The BMA is a very conservative (small-c) organisation that has been very slow to react the needs of it members.
There are of course some outspoken socialists amongst an organisation with 10s of 1000s of members but this doesn't come down to party politics.
Everything the BMA has done from the ballot, the re-entering of talks with ACAS and the strikes has been forced upon it by grass roots members.
Unfortunately the whole thing has been stoked up by Jeremy Hunt who has persistently misrepresented facts in parliament, the media and on twitter in a provocative way.
Many people will not believe it, but junior doctors are firmly of the belief that the true point of this whole saga for the government is nothing to do with patient safety but to 1. set a precedent for anti-social hours definitions that can be used to exploit a broad range of public sector staff including nurses and 2. Make individual hospital trusts more attractive propositions for private enterprise (emergency work costs money but more elective work at weekends by a cheaper more compliant workforce could be profitable for private companies).
Whilst I am appalled with what the Conservatives have done to the NHS (disastrous re-organisation HASCA, worst waiting times for A+E,cancer, surgery, outpatients in recent history, record deficits) I am well aware that despite massive investment in funds whilst in government, New Labour did not cover themselves in glory either particularly with the terrible PFI contracts under their watch.
Ultimately, this country needs to decide whether it wants a properly funded, comprehensive NHS and pay for it at a %GDP commensurate with other developed nations or not.
Lastly, no-one would be contemplating striking next week if we were not 100% sure of the support and commitment of the consultants who will be providing full, comprehensive emergency cover. My local hospital is going to have 19 A+E consultants in the casualty department covering the strike. I can honestly say that I would have no additional concerns if any member of my family required emergency care on a strike day. I would be more worried if they were being admitted on one of the numerous days that they can't find a locum to fill the registrar night shift and the day registrar is forced to stay and work until the following morning. Or a day when multiple operations are being cancelled because there is not a single available ITU bed in the hospital--these are the current realities...
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Post by yorkshireman on Apr 22, 2016 11:39:29 GMT
It does seem rather strange that throughout this dispute the BMA has been described as socialist/left-wing agitators by the government and media. The BMA is a very conservative (small-c) organisation that has been very slow to react the needs of it members. There are of course some outspoken socialists amongst an organisation with 10s of 1000s of members but this doesn't come down to party politics. Everything the BMA has done from the ballot, the re-entering of talks with ACAS and the strikes has been forced upon it by grass roots members. Unfortunately the whole thing has been stoked up by Jeremy Hunt who has persistently misrepresented facts in parliament, the media and on twitter in a provocative way. Many people will not believe it, but junior doctors are firmly of the belief that the true point of this whole saga for the government is nothing to do with patient safety but to 1. set a precedent for anti-social hours definitions that can be used to exploit a broad range of public sector staff including nurses and 2. Make individual hospital trusts more attractive propositions for private enterprise (emergency work costs money but more elective work at weekends by a cheaper more compliant workforce could be profitable for private companies). Whilst I am appalled with what the Conservatives have done to the NHS (disastrous re-organisation HASCA, worst waiting times for A+E,cancer, surgery, outpatients in recent history, record deficits) I am well aware that despite massive investment in funds whilst in government, New Labour did not cover themselves in glory either particularly with the terrible PFI contracts under their watch. Ultimately, this country needs to decide whether it wants a properly funded, comprehensive NHS and pay for it at a %GDP commensurate with other developed nations or not. Lastly, no-one would be contemplating striking next week if we were not 100% sure of the support and commitment of the consultants who will be providing full, comprehensive emergency cover. My local hospital is going to have 19 A+E consultants in the casualty department covering the strike. I can honestly say that I would have no additional concerns if any member of my family required emergency care on a strike day. I would be more worried if they were being admitted on one of the numerous days that they can't find a locum to fill the registrar night shift and the day registrar is forced to stay and work until the following morning. Or a day when multiple operations are being cancelled because there is not a single available ITU bed in the hospital--these are the current realities... I assume that you participate in P2P and therefore have sufficient funds to do so which would indicate a reasonably comfortable life style, therefore with respect, if I was a junior doctor I would have thought twice about making this post.
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mv
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Post by mv on Apr 22, 2016 11:50:20 GMT
I assume that you participate in P2P and therefore have sufficient funds to do so which would indicate a reasonably comfortable life style, therefore with respect, if I was a junior doctor I would have thought twice about making this post. Do you think that 2 married doctors in their thirties should not have a penny left at the end of the month after they have paid their mortgage? I've been in full time professional employment for 12 years and am quite sensible with my money. I've never asked for more money, nor complained that I am not earning enough. The problem is staff being spread thinner in an already over stretched system.
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Post by ablrateandy on Apr 22, 2016 11:53:23 GMT
The BMA has handled this nearly as badly as the government.
They key point that people don't seem to get is this :
Junior doctors in hospitals do NOT get to opt in and out of weekends and nights in order to increase their pay. They are told where to go and work (which for North London trainees could be anywhere from Heathrow to Southend) and they are told what shifts they get and many move jobs every six months. The quid pro quo for this is that if you are allocated a nightmare shift then your pay is a bit higher. All of their salaries are effectively X and then you get Y as your banding top-up, where Y is a variable that depends on what shifts you have been allocated to work (that is up to something like 30% of their pay).
What the government is proposing is pretty much to get rid of Y completely (ie. a 30% pay cut for those on ridiculous hours), but to keep X the same (or 2% higher or whatever it is).
And don't believe the cushty hours theory - my wife works every other weekend from 7pm until 11am (yes - that is a 16 hour shift) and gets the next Monday off to compensate for that... but still works 7.30am - 6.30pm on Tuesday to Friday as a "short day" or 8am - 10pm on "long days". That's in a department that is already 50% short-staffed.
Yes - it is partially a pay dispute of course, but it is not about having some perk removed - it is about having, in my wife's case, about a 25% pay cut.
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Post by bracknellboy on Apr 22, 2016 11:54:50 GMT
.... When trade unions were originally founded, there was a need for them to protect employees but today and indeed for many decades they have done nothing for their members and are nothing more than a self interested Neanderthal branch of the Labour party engaged in guerrilla warfare against the majority of people in the UK. .... Well I'm not sure I'd agree with the statement that they '...do nothing for their members...'. I would contest that part of the problem with many trade union actions in the UK both historically and currently is precisely that they are completely self interested and often act purely in the interests of themselves and their current members but in a very short term and myopic fashion, and without view as to the longer term interests of current and future members, and certainly not of the broader constituent of UK population. It's hard to say that the RMTs actions in holding London to ransom with tube shutdowns etc. Has not been in the cause of the short / medium term interest of their affected membership. Whether actions which have led to pay and conditions for e.g. Tube drivers which are arguably completely out of kilter with comparable jobs etc. Are justified is a different question, but it's certainly aimed at the narrow interest of their members. Would a number of industries which have suffered massive decline in the last 30-40 years have a greater presence and therefore greater employment if historically a number of unions had been motivated by the long term interests of maintaining a competitive industry rather than short term job protection.
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mv
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Post by mv on Apr 22, 2016 12:01:06 GMT
The BMA has failed to put forward a clear, coherent argument for opposing the contract in its current form and this has been an enormous source of frustration for junior doctors.
As you say Andy, we already work frequent weekends. Making us work more weekends when there is no evidence that it will help and there is no funding for allied staff is pointless. If there is no intention for us to work more weekends then this is simply an excuse to cut pay.
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Post by yorkshireman on Apr 22, 2016 12:04:31 GMT
I assume that you participate in P2P and therefore have sufficient funds to do so which would indicate a reasonably comfortable life style, therefore with respect, if I was a junior doctor I would have thought twice about making this post. Do you think that 2 married doctors in their thirties should not have a penny left at the end of the month after they have paid their mortgage? I've been in full time professional employment for 12 years and am quite sensible with my money. I've never asked for more money, nor complained that I am not earning enough. The problem is staff being spread thinner in an already over stretched system. My heart bleeds.
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mv
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Post by mv on Apr 22, 2016 12:05:11 GMT
Well I'm not sure I'd agree with the statement that they '...do nothing for their members...'. I would contest that part of the problem with many trade union actions in the UK both historically and currently is precisely that they are completely self interested and often act purely in the interests of themselves and their current members but in a very short term and myopic fashion, and without view as to the longer term interests of current and future members, and certainly not of the broader constituent of UK population. It's hard to say that the RMTs actions in holding London to ransom with tube shutdowns etc. Has not been in the cause of the short / medium term interest of their affected membership. Whether actions which have led to pay and conditions for e.g. Tube drivers which are arguably completely out of kilter with comparable jobs etc. Are justified is a different question, but it's certainly aimed at the narrow interest of their members. Would a number of industries which have suffered massive decline in the last 30-40 years have a greater presence and therefore greater employment if historically a number of unions had been motivated by the long term interests of maintaining a competitive industry rather than short term job protection. The counter to that is that if governments were not idealistically committed to the privatisation or destruction of a particular industry, they wouldn't need to kick back so hard.
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Post by yorkshireman on Apr 22, 2016 12:06:17 GMT
Well I'm not sure I'd agree with the statement that they '...do nothing for their members...'. I would contest that part of the problem with many trade union actions in the UK both historically and currently is precisely that they are completely self interested and often act purely in the interests of themselves and their current members but in a very short term and myopic fashion, and without view as to the longer term interests of current and future members, and certainly not of the broader constituent of UK population. It's hard to say that the RMTs actions in holding London to ransom with tube shutdowns etc. Has not been in the cause of the short / medium term interest of their affected membership. Whether actions which have led to pay and conditions for e.g. Tube drivers which are arguably completely out of kilter with comparable jobs etc. Are justified is a different question, but it's certainly aimed at the narrow interest of their members. Would a number of industries which have suffered massive decline in the last 30-40 years have a greater presence and therefore greater employment if historically a number of unions had been motivated by the long term interests of maintaining a competitive industry rather than short term job protection. The counter to that is that if governments were not idealistically committed to the privatisation or destruction of a particular industry, they wouldn't need to kick back so hard. Why is privatisation a dirty word? Because the unions and politicians use it to mislead the gullible into believing that they will have to pay for using the NHS. That is a red line and a no no as far as I am concerned, it should be free to everyone, no argument. However, I believe that the NHS could be better managed by being run privately rather than continuing as a state monolith, after all, most nationalised industries cost the tax payer dearly and never turned a profit. And then of course there is the increasing pressure put on the NHS through a rising population caused by, dare I say it, immigration? 
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Post by bracknellboy on Apr 22, 2016 12:09:41 GMT
for the record: my earlier post was not in anyway a commentary on the current junior doctors dispute. I don't feel particularly well informed on it and certainly welcome hearing views from the front line, whether that is from doctors or nhs management.
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mv
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Post by mv on Apr 22, 2016 12:17:32 GMT
Why is privatisation a dirty word? Because the unions and politicians use it to mislead the gullible into believing that they will have to pay for using the NHS. That is a red line and a no no as far as I am concerned, it should be free to everyone, no argument. However, I believe that the NHS could be better managed by being run privately rather than continuing as a state monolith, after all, most nationalised industries cost the tax payer dearly and never turned a profit. And then of course there is the increasing pressure put on the NHS through a rising population caused by, dare I say it, immigration? I worked in a private hospital for three years whilst studying for my Phd. They are far less efficient than the NHS. So many wasted consultations and investigations simply to generate more profit for the hospital. The reason they make money is simply because they charge more money to the patients, insurers or embassies that are paying than it costs to provide the service. Contrast this with the NHS where they are contractually obliged to provide services that run at a loss including emergency care and can't pick and choose which patients to take on. I am fully aware that there are other countries that run a good health service with a public-private provider system however there appears to be no desire to move in this direction. Rather a trend towards the disastrously unfair, inefficient American system. I agree it is difficult to reconcile a comprehensive health care system, free at the point of use with an open door immigration policy
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