Doctors strikes and Jeremy Hunt

New Topic
This topic has been archived, and won't accept reply postings.
 Toby_W 21 Apr 2016
In the news again and I saw this which explains the issues the doctors have. It has one error. From the start 4 years ago the BMA agreed not to ask for more money. The picture says doctors won't get paid for the extra hours they'll have to do, in fact the worst (most anti-social hours and nights) specialities will get their pay cut.

http://imagizer.imageshack.us/a/img922/3550/F1r5so.png

Cheers

Toby

 Phil Anderson 21 Apr 2016
In reply to Toby_W:
Eh? Where's the error?

Is not wanting to do more work for free the same as asking for more money? Nope.

Is not wanting your pay cut the same as asking for more money? Nope.

So what's your point?
Post edited at 15:18
 The New NickB 21 Apr 2016
In reply to Clinger:

I think he is just clarifying for those that think it is all about money!
OP Toby_W 21 Apr 2016
In reply to Clinger:
Sorry,
I mean it says the won't get paid any more for the extra work when in actual fact most of those working in a&e and the like will have their pay cut.

Sorry, text tied.

Toby
 Phil Anderson 21 Apr 2016
In reply to The New NickB:

Oh! Right... So what's the error then?
 Phil Anderson 21 Apr 2016
In reply to Toby_W:

Ooooooh! I think I read it in a weird way or something then 'cos I still don't understand what the error is, but then it's been a long day (with no sign of ending soon) so probably best I back away!

So you're with the doctors then?
OP Toby_W 21 Apr 2016
In reply to Clinger:

Yes.

Won't get paid for it should read may have pay cut.

Cheers

Toby
In reply to Toby_W:

Well thanks for support Toby. (I'm one of them). Not been involved in strike action so far cos I'm in A&E, but next tuesday and wednesday's the first total walk-out. Gulp.
 marsbar 22 Apr 2016
In reply to Just Another Dave:

I think most people realise you are doing this for them, not yourselves.
2
 deepsoup 22 Apr 2016
In reply to marsbar:

I certainly do. Horrible thing for such dedicated people to have to do.

All the best, Just Another Dave, with much love and respect to you and your colleagues.
Jim C 22 Apr 2016
In reply to Just Another Dave:

I have two questions please.

IS the contract being imposed?

If so, does Hunt have the law on his side to impose the contract?
 Short&Savage 22 Apr 2016
In reply to Jim C:

I think there lies the point of contention. Yes Hunt has said he is imposing a new contract. Whether he can do this is being disputed in court. There was a flutter of excitement earlier on in the week when he changed the wording he used to 'introducing' rather than 'imposing'. However he's subsequently changed it back to 'imposing' again so who knows...
KevinD 22 Apr 2016
In reply to Short&Savage:

It was his lawyers who changed the wording. Then he doubled down on the original.
All rather confusing.
 Dauphin 22 Apr 2016
In reply to KevinD:

Difficult to see how he can make a national pay deal mandatory since the NHS no longer exists. Shot himself in the foot, hoisted by own petard, unfortunately the downgraded a and e dept now operates as a minor injuries unit only between the hours of 8 and 20.00.

D
 Jack Whiteley 22 Apr 2016
In reply to Toby_W:
This industrial action is predominantly about safety! Hence the tagline 'Not safe, not fair'.

If you make elective work 7 days a week you need additional doctors to work weekends/nights.

There is no plan to fill this gap in staffing with more bodies.

Therefore current doctors/advanced nurse practitioners/physician associates are going to be spread more thinly across the week.

Giving a real risk that patient safety will be impacted!

Also no plans to increase number of associated health care professionals (pharmacists, therapists, radiographers ect) to match the anticipated increased workload, doctors can’t really do anything without a team around them!
Post edited at 10:53
 deepsoup 22 Apr 2016
In reply to Jack Whiteley:

In a nutshell:
http://imgur.com/gallery/rGmVnDu
OP Toby_W 22 Apr 2016
In reply to deepsoup:

Didn't I post that to start with?

The other thing that misses is that the financial penalties for trusts exceeding safe working hours for any doctor will be removed and replaced by a guardian of safety who will be a member of trust management. A junior doctor who is concerned about hours and safety can go to them instead, they then have no responsibility to do anything.

Cheers

Toby
 Jack Whiteley 22 Apr 2016
In reply to Toby_W:

Yeah, it was me being a dummy!
 deepsoup 22 Apr 2016
In reply to Toby_W:
> Didn't I post that to start with?

Ah yes, so you did.
OP Toby_W 22 Apr 2016
In reply to deepsoup:

we've all done it

Toby

 Dauphin 22 Apr 2016
In reply to Toby_W:
Do you know any of your colleagues that ever have had their pay uplifted if they breach EWTD? The trainee docs in my last proper job were doing all sorts of crazy shifts, 90+ hr weeks not unusual. The hospital just ignored it to pretend they complied, less headache, less money to pay out in wages. I don't have a problem with doctors striking for pay and conditions, ultimately if you treat your staff fairly and with integrity they do a better job - better patient 'health outcomes'.

HR 101.

If you leave it to the BBC etc to inform the public then you get the result of the clueless witterings on the BBC Facebook comments Alf Garnett's writing 'doctors should be prepared to work 24/7 365 days a year.....hippocratic oath...wibble wibble.' (Yeah you dumbfuck they already do!)

BMA need to pull there finger out and get busy with articulating their position to the public through social media etc.

D
Post edited at 15:26
OP Toby_W 22 Apr 2016
In reply to Dauphin:

No, none. It's also not made clear this is not overtime it is part of contracted hours. All the additional hours on top of this after shifts are finished are generally done for free, I've never met a hospital doctor who has put in for overtime.

I have been disappointed with the media, how can doctors be getting this 13% pay rise if the new contracts will cost no more money and none is available. How can a decreasing number of doctors, too few to cover the existing service, work less hours while providing routine service over 7 rather than 5 days? Why is the penalty for unsafe, excessive hours being removed?

Also I am merely a Dr of Engineering not a 'real doctor'. My wife is and due to her current job and speciality would get more money with this new contract and if things keep going the way they are will end up doing private work for the NHS so again getting a lot more money. She is utterly against the new contract, it would be nice to be paid more but the cost is too high, to the NHS, to people who will use the NHS and to working conditions for junior doctors.

Cheers

Toby
 Badgers 22 Apr 2016
In reply to Dauphin:

Never seen anyone get pay uplift for breaching EWTD. Trusts make their rotas EWTD compliant on paper, but this ignores the actual workload. Like all other professions we work considerably longer hours to perform our duties safely but get no recognition (even just a public statement of thanks would be a start). Instead what happens is the trusts have to undertake an 'hours monitoring exercise' where we log all actual hours worked over a 1-2 week period.

This is typically accompanied by a threatening email suggesting that if we record hours greater than that we are rota'd for we'll be taken to be in breach of our contracts and disciplined accordingly. Always makes me chuckle.
In reply to deepsoup:

Thank you Soup, and marsbar too, much appreciated.
In reply to Jim C:

Sorry for tardiness, been on this weekend, just finished my Sunday "twighlight" and I notice short&savage replied adequately, but anyway:

> IS the contract being imposed?
If we don't succeed with this current action, I have to assume yes, that's what's going to happen.

> If so, does Hunt have the law on his side to impose the contract?
Can't imagine so, since a contract is an agreement, and requires agreement from both sides. This is currently being challenged/looked into, but it wouldn't be the first time our government has got away with technical illegalities, and I wouldn't put anything past this administration.
1
In reply to Jack Whiteley:

> Also no plans to increase number of associated health care professionals (pharmacists, therapists, radiographers ect) to match the anticipated increased workload, doctors can’t really do anything without a team around them!

True. And why the junior doctor contract by itself cannot be anything to do with delivering the promise of "7 day care"
But I think the ultimate plan is for similar contracts to be rolled out for all others in the NHS: nurses and consultants would be next. The only logic in coming down so harsh on the 'juniors' first is that I think Hunt/government saw them as an easy target. Not the biggest part of the NHS, possibly believed by the public to be 23 year olds just out of uni who would soon be rolling in it anyway, and once they rolled over and took it, the other grades and professions would have much less of a leg to stand on and the way would be paved for further restructuring (dismantling?/priviatising?) ...I think there's much more to the government's plans than they're letting on.
Jim C 25 Apr 2016
In reply to Just Another Dave:


> Can't imagine so, since a contract is an agreement, and requires agreement from both sides. This is currently being challenged/looked into, but it wouldn't be the first time our government has got away with technical illegalities, and I wouldn't put anything past this administration.

I have worries about how it is drafted. If it is drafted that they have deemed to have accepted the contract IF they work to it, and accept a salary under it , then it could be a tricky one.

Good luck.

jasonpather 25 Apr 2016
In reply to Toby_W:
Just to be devils advocate.....

The new version of the contract limits the total number of hours that can be worked down to 72 hours.

I know Junior Doctors are no longer going to get 50% extra pay for working on Saturdays and evenings etc but the 13.5% increase in basic pay will go someway towards making up for this.

There is also a a guaranteed, 48 hour break between consecutive long night shifts and night work.

Why is the contract unsafe and is it really not about pay?

From the first contract proposed it seems like compromises may have been made. I don't understand why sensible talks can't be had. This might be the first strike I will not be supporting. Please convince me (and not in an abusive way).
Post edited at 09:27
1
 Offwidth 25 Apr 2016
In reply to Jim C:

Such 'custom and practice' justifications takes time and are easily deflected by standard letters refering to any work being subject to the agreed contract.
 Offwidth 25 Apr 2016
In reply to jasonpather:
Think on it this way. The government have defined the NHS house but don't have enough bricks to build it, but refuse to acknoweldge this, so have to play with smoke and mirrors. The reasons include ideology, a direct challenge to the power of the workforce, and a will to increase private contractors where possible. They are gambling with extreme brinkmanship that when people die or suffer as a result of strikes, that the population will, with the aid of a willing right wing majority press, turn on the doctors. I for one as a centrist liberal will blame Hunt and the government. A conservative junior minister (who was a doctor) said last year that this was a deliberate and completely unnecessary fight. The 7 day NHS needs more money and major contract changes elsewhere... junior doctor contracts are almost irrelevant. Hunt's justifications for the contract changes are completelty bogus.

The stories above about over contract work and how it is not recorded are not rare exceptions. Why would doctors believe all these promises of new protections will work any better. It is the professional role of doctors to be concerned about the gaping holes in the wider government picture of the NHS house. They genuinely see the changes as a political attack that endangers the service and patient safety.

When figures like 98% of an intelligent workforce like doctors vote to challenge a politician its almost certain the politician that is wrong. Talk of this being similar to contract 'protectionism' to when the NHS started is ridiculous: a significant minority of idealistic doctors supported that move.

Have the BMA played this as well as they could? .. I'd say nothing like, but it doesn't detract from the case.
Post edited at 09:39
 jkarran 25 Apr 2016
In reply to Just Another Dave:

> Well thanks for support Toby. (I'm one of them). Not been involved in strike action so far cos I'm in A&E, but next tuesday and wednesday's the first total walk-out. Gulp.

I'm sorry you've been put in this position. You're doing the right thing and you all have my support.
jk
jasonpather 25 Apr 2016
In reply to Offwidth:

Overtime not being recorded and management pressure for junior doctors to accept this without pay for those hours is illegal and outright wrong. Surely this means that the current contract is not fit for purpose either.

I just fear that we have two sets of people who can't work with each other and desperately need to for the good of the future of our health service. Both sides need to compromise more for the greater good, and for junior doctors to get a fair deal. It has become too personal.

We are obviously going to need more doctors and it baffles me how further recruitment plans haven't been announced but as far as I understand as part of the contract no one will lose out on pay for the first 3 years after the contract is imposed which gives some time to work out how we will fill the shortfall and means doctors should't suffer financially if they do end up being overworked as long as workforce numbers can be increased.

 neilh 25 Apr 2016
In reply to Just Another Dave:

I have imposed contracts on my employees, it took 1 year of negotiation to get to a point where I had no choice as an employer but to impose them. Its messy and as an employer you generally do not want to do it, but at some stage as an employer you have to force the issue, and you are entitled to do it.Ultimatley employees can always go and work elsewhere.That is also their entitlement.

I do chuckle at this concept of negotiation in this dispute. Christ -most employees/employers- never get anywhere near this timescale ( its been going on for 4 years minimum). Most of us do not have the luxury of either somebody else paying the costs or as employees on say zero hours contracts ( which I detest) no clout to negotiate.

Its a right mess.God knows how it will end up, cannot help feeling that neither party is going to come out of it looking good.

OP Toby_W 25 Apr 2016
In reply to jasonpather:

You are correct, the government has promised to protect pay so only those a year or two into their training or starting will get their pay cut if they work in the more antisocial specialities.

This is absolutely a way to get more private contracting into the NHS and I'll add that in my wife's speciality it has in every instance failed to offer anything like the same service for the money and several have failed altogether.

Financially this would probably end up benefiting us significantly, my wife is still utterly against it in terms of patient care and what would be available to the average person in terms of treatments.

I worry that a friend will end up in hospital and not get the care they need as only a basic service is offered. Someone had posted a link about how we no longer really have an NHS as the government has pushed responsibility for it onto the car commissioning group and legally only an ER service must be provided.

Cheers

Toby
1
jasonpather 25 Apr 2016
In reply to Toby_W:

The long term plan doesn't make sense. Like nursing would junior doctors not just become agency staff and get paid more through the back door costing the taxpayer more.

Poor management like this makes you think extreme thoughts like the government aren't fit to run anything (disclaimer - i don't agree with privatisation).

Perhaps the NHS needs to be taken out of politics and run by an independent body of doctors who put patient safety first. Run by doctors, for doctors. Give it a set amount of our GDP each year and protect it from any drops in funding.
 krikoman 25 Apr 2016
In reply to neilh:

> Its a right mess.God knows how it will end up, cannot help feeling that neither party is going to come out of it looking good.

It wouldn't be so bad but the government implying they are a lot of lefty anarchists wanting to bring down the government is about as helpful as them using false statistics to "prove" their point AND still try and roll them out even after they've been proved to be lies.

I still think the public have seen through the bullshit and still side with the doctors, how long this will last is a different matter. they've not had a great press so far and it won't be long before headlines like, "Grandma dies as Jnr Doctor hold placard."
 Short&Savage 25 Apr 2016
In reply to neilh:
> I have imposed contracts on my employees, it took 1 year of negotiation to get to a point where I had no choice as an employer but to impose them. Its messy and as an employer you generally do not want to do it, but at some stage as an employer you have to force the issue, and you are entitled to do it.Ultimatley employees can always go and work elsewhere.That is also their entitlement.

I don't know what type of industry you are involved in, but I think that the situation for junior doctors might be somewhat different from your business' employees in that the NHS is the monopoly employer for junior doctors. Medicine as a profession is somewhat unique in that it mandates a long post-graduate training period (minimum 5-9 years in UK to become a fully qualified GP or hospital consultant), and currently the NHS is the only organisation that provides it. Therefore, junior doctors cannot 'go and work elsewhere' (well, beyond moving abroad which an increasing number are doing).


> I do chuckle at this concept of negotiation in this dispute. Christ -most employees/employers- never get anywhere near this timescale ( its been going on for 4 years minimum). Most of us do not have the luxury of either somebody else paying the costs or as employees on say zero hours contracts ( which I detest) no clout to negotiate.

You're right, this should have been sorted years ago. I suppose the difference is that the NHS is not a private business (yet), and so doesn't have the same time pressure in negotiating a deal. Secondly, negotiating a single workable contract for a group of professionals with completely different work patterns (e.g. A+E doctor vs pathologist) was going to be hellishly difficult anyway. Lastly, the fact that this contract negotiation has been turned into a massive political football involving a chronically underfunded NHS doesn't help.



> Its a right mess.

Agree fully with you there.
Post edited at 12:25
 neilh 25 Apr 2016
In reply to Short&Savage:

Yes they can work elsewhere. They can go abroad and they can easily switch profession or jobs.Same as anybody else.

It is their choice!!!Just like with any other employee.

There is nothing complicated about it.

16
 Postmanpat 25 Apr 2016
In reply to jasonpather:

> Overtime not being recorded and management pressure for junior doctors to accept this without pay for those hours is illegal and outright wrong. Surely this means that the current contract is not fit for purpose either.

>
Which is rather the point, isn't it?
In reply to neilh:
> Yes they can work elsewhere. They can go abroad and they can easily switch profession or jobs.Same as anybody else.

> It is their choice!!!Just like with any other employee.

> There is nothing complicated about it.

And the big difference between junior docs and other workers is that they (in most cases) are overwhelmingly better educated, connected and intelligent (I hope). This makes them much more mobile that the majority.

There are clearly lots of politics here and I am no fan of Jezzer, his terms or his party but I take huge exception at front line critical services using strike action as a means to negotiate.

This, along with the fire service strike, is the worst kind of industrial action. Lives may be put at risk - shameful.
Post edited at 12:53
19
OP Toby_W 25 Apr 2016
In reply to jasonpather:

I agree with everything you say. My wife works with agency doctors who fill the many gaps in the rota. Half the consultant posts in the south west for her speciality are unfilled. It seems mad to me, why not train more doctors so we save money, why not pay and treat nurses better so we have more and save money. Instead they've recently cut the bursary student nurses??? Osborne cut 1 billion off the NHS equipment repair budget in the Budget.

I wonder if I should be buying shares in private medical providers that MP's have interests in or whether I'd just think I was an utter utter scumbag for profiting from this.

Cheers

Toby
 marsbar 25 Apr 2016
In reply to TheDrunkenBakers:
As I understand it, lives are not at risk because consultants will be covering. There will be more experienced staff than usual. However if this contract goes ahead then lives will be at risk because there won't be enough doctors to go around.

Post edited at 12:55
ultrabumbly 25 Apr 2016
In reply to TheDrunkenBakers:

>And the big difference between junior docs and other workers is that they (in most cases) are overwhelmingly better educated, connected and intelligent (I hope). This makes them much more mobile that the majority.

They have chosen a profession which they have usually pursued since being a teenager. Usually a junior Dr knows other Drs. They aren't swilling martinis at golf clubs being offered "opportunities" or whatever else you probably imagine their position gives them access to. Due to the demands upon their time they often have little life outside of work. They are probably the least mobile of any worker. And up to a certain point they have been or will be paid peanuts for the privilege esp. if you look at in terms of an hourly rate. Though this isn't really part of the issue, but if you look at the financial side of it alone (ignore the vast societal and educational waste for a minute of a dr dropping out) there is a strong financial reason to stay in the profession as it takes quite some time to start paying off in any way at all.

> his terms or his party but I take huge exception at front line critical services using strike action as a means to negotiate.

> This, along with the fire service strike, is the worst kind of industrial action. Lives may be put at risk - shameful.

Unless you get your panties in a tighter bunch about some specific grandma avoidably "shuffling off" on some particular day(as I am sure we will see the gutterpress report as fact rather than speculation following the strike) than you would over thousands of grandmas doing so every year in following decades I struggle to find what you find so terrible about their protest. It is hardly as if it has been their first step in this dispute.
1
 Short&Savage 25 Apr 2016
In reply to neilh:

> Yes they can work elsewhere. They can go abroad and they can easily switch profession or jobs.Same as anybody else.
> It is their choice!!!Just like with any other employee.

You're right, doctors can move abroad. Not sure how easy it is to work in other industry after such a specific career track for so long but I guess it's still possible. At the end of the day the government can impose any contract they want, hell, they can cut pay by half if they really really wanted to. Although, then the consequence of a mass exodus of junior doctors will be that the NHS will become unsustainable in its current form. Also, all the tax money investment to train the junior doctor up to that point would have been wasted.

Currently, something like 30% of GP training posts are un-filled for the next academic year. This is on the backdrop of an ageing, fatter population. I certainly can't imagine how the government will meets its promise of 5000 more GPs by the next election at this rate.

In reply to marsbar:

> As I understand it, lives are not at risk because consultants will be covering. There will be more experienced staff than usual. However if this contract goes ahead then lives will be at risk because there won't be enough doctors to go around.

Maybe, but cover will be reduced overall. I dont expect a massive upturn in deaths but risk has been increased.
2
 neilh 25 Apr 2016
In reply to Short&Savage:

Off course its possible. People do it all the time.If you do not like it anybody can move jobs to something else.lets not confuse this possibility with other issues about tax money and the unsustainability of the nhs.
6
 marsbar 25 Apr 2016
In reply to TheDrunkenBakers:

I was under the impression that non urgent care and private patients have been rescheduled to provide the same level of care.
 neilh 25 Apr 2016
In reply to ultrabumbly:

What on earth planet are you on?Drs not mobile and well paid?

Please tell me when writing such utter claptrap that you are not a doctor.
7
 galpinos 25 Apr 2016
In reply to neilh:

> What on earth planet are you on?Drs not mobile and well paid?

Ignoring the pay bit, what do you class as mobile?

 Short&Savage 25 Apr 2016
In reply to neilh:

> Off course its possible. People do it all the time.If you do not like it anybody can move jobs to something else.lets not confuse this possibility with other issues about tax money and the unsustainability of the nhs.

I don't think we are disagreeing on whether employers ever impose new contracts in employees or not, evidently that happens all the time. All I'm saying is that junior doctors perhaps don't have as many possibilities in moving jobs as in other professions (the NHS training monopoly, the specific nature of the jobs as I've mentioned earlier). Also, I think that causing large numbers of junior doctors to move abroad or to quit the profession would be a bad thing for the UK.

So what is your opinion then? Are you in favour of the government imposing the new contract or not?
 neilh 25 Apr 2016
In reply to galpinos:

Global skills, and Drs have that in oodles.It will continue to be one of the most sought after in the world.

It is also one of those professions what will continue to be in demand.





3
 neilh 25 Apr 2016
In reply to Short&Savage:

..very wary of both sides.
4
OP Toby_W 25 Apr 2016
In reply to neilh:

I can understand why you might be wary of the DOH but why would you feel the same about the doctors?

Cheers

Toby
In reply to ultrabumbly:
> They have chosen a profession which they have usually pursued since being a teenager. Usually a junior Dr knows other Drs. They aren't swilling martinis at golf clubs being offered "opportunities" or whatever else you probably imagine their position gives them access to. Due to the demands upon their time they often have little life outside of work. They are probably the least mobile of any worker. And up to a certain point they have been or will be paid peanuts for the privilege esp. if you look at in terms of an hourly rate. Though this isn't really part of the issue, but if you look at the financial side of it alone (ignore the vast societal and educational waste for a minute of a dr dropping out) there is a strong financial reason to stay in the profession as it takes quite some time to start paying off in any way at all.

Your first statement says it all really. They chose their profession rather than takings Hobson's choice and often not for reasons that you might believe. I worked in the medical profession for many years including neuromodulation, cardiology and orthpaedics. Many of the clinicians I had the misfortune to encounter were not doing their job because they had a desire to save or improve lives, they did it because of the kudos it gave them, the admiration from the general public it garners and because of the benefits of huge salary and huge pension, not to mention the 1 day per week built into their contract to allow them to do very lucrative private or medic-legal work. Many did it because they could and that they had the choice.

Many were narcissistic to a fault and did their job because they wanted their name in lights or on the next big medical paper. If they werent doctors, they would have been lawyers or politicians but you can bet it wouldnt have been a lowly paid job. Its one of the reasons I moved away from that industry (Ill come back to that). I acknowledge that this wasnt always the case (especially pain physicians) but the orthopods and cardiologists were mostly horrendous.

Their pay may well be peanuts for a time and the workload great but this is a means to an end. I have no stats to back this up but I can imagine that most fully qualified physicians with some exceptions came from middle class families. A good friend of mine has just married an A&E Dr and her dad is a judge, so dont expect me to cry into my coffee for the hard up Drs because Im sure that the vast majority have plenty of support.

Of course there is a great reason for Drs doing what they do but in the end, they have a choice, and its better than most people. Think of the poor folks at NHS or Tata who have lost their jobs, the former losing 50% of their pensions (not having the same protection or luxury as a Dr) and the latter looking down the barrel of the worst kind of structural unemployment imaginable. I mentioned earlier that I was in the medical industry; Im not not because I could earn more and have a better standard of living in IT, which I am now in, having made a choice at 35 years old. Im not a complete dunderhead but I have nowhere near the same intelligence as someone qualified enough to be a Dr.*

And to say Drs have limited contacts is somewhat naive.

> Unless you get your panties in a tighter bunch about some specific grandma avoidably "shuffling off" on some particular day(as I am sure we will see the gutterpress report as fact rather than speculation following the strike) than you would over thousands of grandmas doing so every year in following decades I struggle to find what you find so terrible about their protest. It is hardly as if it has been their first step in this dispute.

Ill tell you what I find terrible since you ask. I find the whole sorry affair a complete pile of shite. From the cack-handed way it was introduced to the political point scoring on both sides. (C)hunt is a complete arse and he has made a shambles of this. The Drs and their appointed leaders are no better and A&E Drs striking is no better than firemen striking IMO. They just shouldnt because whatever reason you had for signing up in the first place, the patient should be front and centre of it and striking completely destroys that trust.

*I had a pay freeze last year and so with inflation, I had a pay cut in real terms. I have a choice, I can choose to stay or look elsewhere.
Post edited at 14:58
7
In reply to marsbar:

> I was under the impression that non urgent care and private patients have been rescheduled to provide the same level of care.

What's non urgent is perhaps a matter of perspective. These non urgent cases might have involved patients who have taken time off or rearranged their lives at huge inconvenience. A hip replacement isnt urgent in general so if a senior doctor is drafted in from orthopaedics to cover the shoft then perhaps someone doesnt get a new hip which might be causing them huge amounts pain which would need to endured or be further controlled by drugs which upset the system. There is always a knock on effect.

I dont have the answer but Drs striking is appalling, as is the way that the politicians have enforced this. The difference is, the Drs are privileged in their position both because of the demand for their skills and the strength of the collective. If my company wanted to change its policies or my contract, I either put up or shut up. If I argue or fail to agree then I have two choices walk or be fired.
6
 galpinos 25 Apr 2016
In reply to neilh:

Qualifications don't always count in other countries, especially when you are a Junior. Should my wife decide to move to another country, 6 months off completing her training, she'd be back to starting the "junior doctor" scheme in her chosen country of refuge. It's not a case of just wandering off and being welcomed with open arms. We've friends who moved abroad and can't come back until they reach "consultant" status as there training isn't recognised.
 neilh 25 Apr 2016
In reply to Toby_W:

It strikes me that historically the BMA is hardly a paragon of virtue in negotiating.Credit to them for playing a strong card ( I would in their shoes), but it does not mean they should be treated with almost god like status.Far from it.

OP Toby_W 25 Apr 2016
In reply to TheDrunkenBakers:

But if junior doctors all said no thanks and resigned and did bank work to tide them over until they got other jobs that would be a disaster and far far worse than strikes which are limited.

I'm not arguing with a lot of your points (certain specialities and private work attracts a certain type, I've been less than impressed mainly with the latter) but what do you you think they should do?

Cheers

Toby
OP Toby_W 25 Apr 2016
In reply to neilh:

Cheers

Toby
In reply to Toby_W:

> But if junior doctors all said no thanks and resigned and did bank work to tide them over until they got other jobs that would be a disaster and far far worse than strikes which are limited.

> I'm not arguing with a lot of your points (certain specialities and private work attracts a certain type, I've been less than impressed mainly with the latter) but what do you you think they should do?

> Cheers

> Toby

I'm afraid I just dont know. Some of the UKs greatest minds are already failing on this already so I would have no clue. A great big banging of heads would be a good start, as my mum would say.

But striking as a Dr is never the answer in my view.
5
 Short&Savage 25 Apr 2016
In reply to neilh:

> It strikes me that historically the BMA is hardly a paragon of virtue in negotiating.Credit to them for playing a strong card ( I would in their shoes), but it does not mean they should be treated with almost god like status.Far from it.

I don't think any group of individuals should be treated as deity. People are people and will have their self-interest at the end of the day. You haven't stated your position though have you? So are you supporting imposition of the new contract or not?
OP Toby_W 25 Apr 2016
In reply to TheDrunkenBakers:

Thought you might cheer me up for a second. Banging of heads or a good shout of 'just sort it out will you' I don't need to be worrying about this shit.

Cheers

Toby
 Short&Savage 25 Apr 2016
In reply to TheDrunkenBakers:

> I'm afraid I just dont know. Some of the UKs greatest minds are already failing on this already so I would have no clue. A great big banging of heads would be a good start, as my mum would say.

> But striking as a Dr is never the answer in my view.

It's unfortunate but I feel the situation we are in now is:

Scenario 1: Junior doctors take no more further action. New contract imposed. Likelihood of disruption in recruitment and retention especially in specialities that are struggling currently (i.e. A+E, GP, psychiatry, paediatrics, obstetrics)

Scenario 2: Junior doctors continue to escalate industrial action attempting to force government back into negotiation. Likelihood of major disruption to services, especially in non-emergency care, at least in the short term.

I can't really see much else in terms of how this can play out from now, especially as the government has rejected a compromise deal to roll out the new contract on a pilot basis yesterday in return for cancellation of strike.

I guess it's now just which of those two scenarios above will be the lesser of two evils.





 neilh 25 Apr 2016
In reply to Short&Savage:

When you asked me before I said I was wary of both sides.I have not changed my stance.In a nutshell the govt is entitled to impose it and the BMA is entitled to oppose it.

1
 Short&Savage 25 Apr 2016
In reply to neilh:
So you are in favour of strike action (or at least not against it)
Post edited at 16:12
 neilh 25 Apr 2016
In reply to Short&Savage:

That is a different question to the one you asked......I cannot help but think its the patients who will suffer the most.For that reason I am against it.
6
 Short&Savage 25 Apr 2016
In reply to neilh:

I'm struggling to understand your views on this. So according to you:

1. The government is entitled to impose the new contract
2. The BMA is entitled to oppose the imposition BUT shouldn't go on strike

So what exactly is the BMA supposed to do? Write a series of angry letters??

As for the suffering of patients. That is where I'm not sure what the best outcome is, as I think it's balancing short term concerns with long term ones (as I've outlined a few posts earlier)
 neilh 25 Apr 2016
In reply to Short&Savage:

That is upto the BMA

If they really want to push it. Get everybody to resign and work as Locums.

But that will realistically never happen.

Otherwise drop the preconditions and just go and talk.
8
 Short&Savage 25 Apr 2016
In reply to neilh:
> That is upto the BMA
> If they really want to push it. Get everybody to resign and work as Locums

Well geez, that's really going to minimise suffering to patients isn't it? That's still going to result in operations being cancelled and the hospitals to go further into debt than they are in now



> But that will realistically never happen.

Well currently with less than 50% of year 2 post-grad doctors applying for their next jobs (the first specialist/GP training posts) I think all it would take is for this number to fall by a bit more - the effect will not be much different.



> Otherwise drop the preconditions and just go and talk.

That's difficult with the government's stance of not re-opening negotiations. See my comment above about them rejecting cross-party compromise suggestion this week
Post edited at 18:29
 Aly 25 Apr 2016
In reply to neilh:

The precondition is to stop the threat of imposition. With it still in place there is no potential for meaningful negotiation on any level. All you have is the government saying "we'll talk with you, but we have finalised the new contract and if the end result of negotiations isn't you accepting the contract then we'll just impose it".

As a JD I don't want to strike but it may be the only way to get Hunt to listen, as Short&Savage has pointed out above they have refused to re-negotiate previously and have ignored the cross party compromise. There is no reason that patients should be put at risk by consultant-led emergency cover.

As far as I can see the proposed contract benefits nobody, certainly not the public, patients, doctors or any other healthcare professionals.
1
 Offwidth 25 Apr 2016
In reply to jasonpather:

Read the mid staffs report to see what happens when managements get under pressure without safety target monitoring being properly in place.

http://webarchive.nationalarchives.gov.uk/20150407084003/http://www.midstaf...

https://en.wikipedia.org/wiki/Stafford_Hospital_scandal

This will all be happening again soon as the gap between real and imagined funding is growing to breaking point in trusts across the UK. The fight with the BMA over these contracts was said even by a conservative junior minister involved in negotiations to be a deliberate fight for no obvious operational reasons (they already work 7 days and the current contract is flexible enough, so its political). The dispute is obviously very expensive, its politically highly risky, so why are a government with such a low majority playing such games with a 'national treasure'. They don't want a deal (as they could have had that over a year back) they can't come even close to affording a true 7 day NHS, so all that is left is they want to break the BMA and the resistance to NHS private sector involvement.
 neilh 25 Apr 2016
In reply to Short&Savage:

You asked me what the BMA should do. Those are the choices faced by the BMA as the govt basically is calling their bluff. Its not pretty, these situations never are. But if you are not prepared to stick by your red lines then you may as well start talking.

Same in any other employment dispute or negotiation. I am not sure the BMA know how far to go which maybe one of the really big issues here.

trust it works out OK for your wife.
6
KevinD 25 Apr 2016
In reply to neilh:

> Otherwise drop the preconditions and just go and talk.

Bit of a waste of time when Hunt has made it clear he isnt interested in any discussion at all.
 Short&Savage 25 Apr 2016
In reply to neilh:

As my posts earlier (and others have pointed out) Hunt has stated that he is imposing the contract and refused to negotiate any further. So your comment for the BMA 'start talking' is a bit ridiculous.

Also, I think you are confusing me with another poster - I don't have a wife


 Paul Atkinson 25 Apr 2016
In reply to TheDrunkenBakers:

your description of consultant employment conditions is totally incorrect because it is based on some experience you may have had in the NHS at a time when today's junior doctors were in primary school or perhaps unborn and you have simply assumed that nothing has changed. The "new" consultant contract brought in universally in 2003 insists all consultants must offer 44 hours per week to the NHS before they can do ANY private work. If the NHS doesn't want the extra 4 hours then they can do private work after doing just 40 hours for the NHS. it's all a quick Google away
1
 Short&Savage 25 Apr 2016
In reply to neilh:
Also, if this dispute is the same as any other industrial disputes a you state. Surely the employee can withdraw labour in protest, as long as they ballot their members for a mandate and give sufficient notice to the employer (which the BMA has done)
Post edited at 20:32
Donald82 25 Apr 2016
In reply to neilh:

How 'had no choice' are we talking here?
 jepotherepo 25 Apr 2016
In reply to TheDrunkenBakers:

Lives may be put at risk? Not really - its no different to the days junior doctors change hospital posts (they all end up in work induction for 2 days). Clinics are cancelled, less elective work gets done, consultants have to actually do work on the wards rather than only theatre, clinics or admin etc. The consultant staff and middle grades are fully supportive of the junior doctors and are very experienced, If you were to attend for emergency treatment tomorrow you would probably get better and more timely treatment than any other day! No one wants an all out strike (except for Jeremy).
1
Removed User 26 Apr 2016
In reply to Toby_W:

In some respects this is a proxy dispute. Anyone working in the NHS on the Agenda for Change payscale will be well aware that if the junior doctors lose this dispute Hunt will feel emboldened in his desire to destroy national collective bargaining. Local pay is his objective and an eradication of unsocial hours pay.
 Offwidth 26 Apr 2016
In reply to Removed UserDeleted bagger:

There are a lot of equality and recruitment issues that remain part of this unsocial hour question. It stops being attractive for some especially women who have kids. All this feeds into the wider safety issue as it takes a long time to train doctors and opportunities do exist elsewhere once trained and in other areas if a potential mother looks at the carreer at the point of entry. In the meantime Hunt continues to lie on TV. If it is about 7 day working where is the more ugent priority of the tens of billions extra to fund the gap being tackled or the contracts which need much more change (or recruits) to acheive 7 day working... especially that of consultants.

Local pay is an interesting possibility. It may be a problematic "deus ex machina" as trusts get pissed off with both sides. One of my favourite NHS commentators Roy Lilley likes it. Trouble is it adds a lot of expense short term (only getting it back but competing downwards on pay) and dilutes BMA and government power, it worsens regional inequalities and likely increases other inequalities (such as gender), it complicates legal employment disputes. It can also lead to the FE/HE college problem where not only have pay and conditions reduced (except for senior management) but quality has dropped and too many rogue institutions put local provision at risk with few star performers being evident.

The leftist view on the subject is covered here

http://leftfootforward.org/2012/01/the-12-practical-problems-of-localising-...

And the right:

http://www.policyexchange.org.uk/media-centre/blogs/category/item/osborne-s...
In reply to Dauphin:

> if you treat your staff fairly and with integrity they do a better job - better patient 'health outcomes'. HR 101.

I fear 'HR101' has become 'f*ck your staff over wherever possible; reduce their T&Cs to reduce labour costs; do anything to reduce the short-term bottom line'.
OP Toby_W 26 Apr 2016
A consultants response to the Daily Mail headline : Don't get sick tomorrow.

Please, please, please, if you are sick tomorrow, COME TO HOSPITAL.

At my site, all non urgent work is cancelled so that:

The Emergency department will be staffed by all the normal ED consultant plus 8 general medical consultants, 2 general surgical consultants, 2 orthopaedic consultants, 1 ENT consultant, 2 paediatric consultants, 1 gynaecology consultant, and 2 consultants from anaesthetics/intensive care.

Radiology will be staffed as normal by consultants.

Labour ward will have two consultant obstetricians and two consultant anaesthetists.

Intensive care will have two consultant intensivists.

Every ward will have a named consultant, backed up by a team of floating consultant anaesthetists and specialist physicians to perform advanced diagnostics and invasive therapies.

The emergency theatre list will be staffed by consultants, as will the orthopaedic trauma list.

Coronary care will have a consultant cardiologist.

The paediatric ward will have consultant paediatricians.

The resuscitation team will be consultant physicians and anaesthetists with three extra resuscitation officers.

There will be extra GPs screening at the front door to filter out those who don't need to be in hospital.

The wards will have extra nursing, pharmacy and phlebotomy staff, and extra IT support staff.

The only time you will have experienced a hospital this intensely staffed by the top tier is if you're from the Saudi Royal Family.

It's safe.

Please come (if you're unwell of course).

The only time you should really worry about falling ill is if the Tories manage to destroy our beautiful NHS, and you can't afford your private health insurance.

And to the tw*t that signed off on this headline, even you'll be treated well.

You'll probably have to pop in to have the rolled up copy of your paper removed from your rectum.
 Postmanpat 26 Apr 2016
In reply to Paul Atkinson:
> The actual shizzle


Or an actual poorly evidenced conspiracy theory. But you are saying that the strike is overtly political.
Post edited at 23:14
2
 galpinos 26 Apr 2016
In reply to Postmanpat:

I find the whole thing thoroughly depressing. How come no one has challenged Hunt on how he intends to change the service from a five day elective to a seven day elective (emergency has always been seven days) with the same number of doctors without compromising/reducing the service provided over the traditional working week. I just don't get it. I'm also baffled by his "but the doctors will get a pay rise" whilst claiming the money is a neutral change and how no journo seems to challenge him on his supposed stats about mortality rates for weekend admissions and the reasons for that. He was still spouting it this morning.

Maybe the contract needs changing, the way the NHS runs probably does (more ancillary services on over the weekend - radiographers etc to support the medical staff who are in) but I'd like it to be a coherent plan for improvement, not just some repeatedly saying "it was a manifesto promise" without explaining why it'll improve the service provided.

 Postmanpat 26 Apr 2016
In reply to galpinos:
> I find the whole thing thoroughly depressing. How come no one has challenged Hunt on how he intends to change the service from a five day elective to a seven day elective (emergency has always been seven days) with the same number of doctors without compromising/reducing the service provided over the traditional working week.
>
So do I, but the BMA is just as bad by giving so many conflicting explanations for the strike and refusing to negotiate at key points.

Hunt is, at Osborne's behest, trying to squeeze a pint out of a quart pot but making an absolutely hopeless and dishonest case for what he is trying to achieve. I suspect the end game is to break the BMA which is regarded as the major block to change but he's making a pig's ear of that as well so far.
Post edited at 23:43
1
Jim C 26 Apr 2016
In reply to Postmanpat:


> Hunt is, at Osborne's behest, trying to squeeze a pint out of a quart pot but making an absolutely hopeless and dishonest case....

Well if there is ever dishonesty needed in government Hunt is the 'go to' man for the job.

1
 Dauphin 26 Apr 2016
In reply to Postmanpat:

Any strike is overtly political. Especially when it's between a group thats contains many of the brightest and most motivated professionals in the country, its political education for many of them who never saw the way in which class, power and media work together to create consensus and submission. Maybe the DOH spokesman just blinked by claiming the BMA are trying to bring down the government, unconsciously realising that this could definitely happen and the government picked the wrong group to fight. Difficult to marginalise as Trotskyists in the same way as working class hero's like Bob Crowe, although they already have had a go.

D
 Postmanpat 26 Apr 2016
In reply to Dauphin:

> Any strike is overtly political. Especially when it's between a group thats contains many of the brightest and most motivated professionals in the country, its political education for many of them who never saw the way in which class, power and media work together to create consensus and submission. Maybe the DOH spokesman just blinked by claiming the BMA are trying to bring down the government, unconsciously realising that this could definitely happen and the government picked the wrong group to fight. Difficult to marginalise as Trotskyists in the same way as working class hero's like Bob Crowe, although they already have had a go.

> D

No, some strikes are just about money or terms. The doctors are also in danger of overplaying their hand. Every journalist not in Warrington is loitering around a hospital waiting for a death that can be blamed on the strike.
 galpinos 27 Apr 2016
In reply to Postmanpat:

I agree the BMA have been woeful is articulating the Junior Doctor's position and the reasons for the opposition to the contract.

I'm not sure about the "refusing to negotiate key points bit" - what have they refused to negotiate on?
 Offwidth 27 Apr 2016
In reply to Postmanpat:

I'll put money on the fact that death rates drop during this particular 2 day strike. Those consultants filling the gaps have more experience will be less tired. Also people seem to be staying away from A&E so we will just get a boost for the incorrectly diagnosed weekend effect . Let the vultures circle.
Graeme G 27 Apr 2016
In reply to Postmanpat:

What i don't understand is Hunt could have had his deal, he just doesn't appear to want to compromise. He wants a 7 day NHS, the BMA say ok here's what we'll accept. Hunt could have said ok. Job done, now move on to next job.

I understand his arguement that no union should be able to hold an elected government to ransom, but compromise is what leadership at his level is all about.

I've also not heard any rational arguement why we want an 'elective' 7 day NHS. I can only presume it's so employers don't have to give people time off for appointments. Thank god i don't live in England just now.....
 Offwidth 27 Apr 2016
In reply to galpinos:
Read the BMA website before you say they are woeful. I think they have made mistakes but it's the press output that is woeful and that is more to do with a lack of sympathy to any strikes from most of the press and even in more neutral papers like The Guardian a seeming inability of some journalists to grasp such a complex dispute. The Hunt case is that this is political action against a manifesto promise needed because more people die at weekends. This is a classic rhetorical political construct based on quicksand. The BMA claim that there is a massive funding hole with huge safety implications and this needs answering before any junior doctor contract changes that make things worse; contract changes which they say remain unfair and aside from safety issues, have serious retention and equality concerns. Show me where that is wrong. All the research says it's better putting money elsewhere than 7 day working and that attributing the deaths to a lack of 7 day working is wrong. Junior doctors work 7 days anyhow. The funding gap is real and no one thinks the government can do this magic trick of a quart from a pint pot based on £15 billion efficiency savings. The conservative GP on the health select commitee rightly says they need to sort out links to social care or any change won't work anyhow. So Hunt is either completly stupid or a very nasty liar on a very serious issue.
Post edited at 08:55
 Postmanpat 27 Apr 2016
In reply to galpinos:

> I'm not sure about the "refusing to negotiate key points bit" - what have they refused to negotiate on?

I meant that at various times (points) in the process the BMA has refused to negotiate eg.after the DDBR recommendations in 2015, in January 2016-at which point Dalton recommended that Hunt impose the contract.
So, of course, has the government at various times.

OP Toby_W 27 Apr 2016
In reply to Postmanpat:

> Or an actual poorly evidenced conspiracy theory.

Can you elaborate? I know a lot of that to be correct (in terms of processes and things that have happened and documents published), do you mean the jump to it's a sinister Tory plan to privatise the NHS?

Cheers

Toby
 Postmanpat 27 Apr 2016
In reply to Toby_W:
> Can you elaborate? I know a lot of that to be correct (in terms of processes and things that have happened and documents published), do you mean the jump to it's a sinister Tory plan to privatise the NHS?

>
Yes. It's the equivalent of a random game of join the dots ending up with the Mona Lisa.

The next stage is when someone publishes the usual list of MPs' and Lords' investments in the healthcare sector which apparently proves that they want to destroy the NHS. Most of them are along the lines "Reginald Algernon Gobshite, the MP for Little Wittering (West) has a personal pension which is run by the Prudential which has a UK equity fund which sometimes owns shares in pharmaceutical companies. A non executive director of the Prudential was once a non executive director of a healthcare company and takes ibuprofen for his arthritis "
Post edited at 11:04
3
 galpinos 27 Apr 2016
In reply to Offwidth:

> Read the BMA website before you say they are woeful.

I'm on the side of the junior doctors but the BMA have consistently failed to get their point across, even when directly interviewed and given a platform to state their position.

I agree, add to that what seems, to me, to be a media slightly biased to the government's position and I spend a fair amount of time arguing with colleagues at work over the reasons for the strike.
OP Toby_W 27 Apr 2016
In reply to Postmanpat:

I think people are looking for an explanation for the situation other than incompetence or total ignorance of the current state of the NHS.

The whole thing seems so utterly inept in every way. What is that quote people always bring up about conspiracies being most likely down to mistakes and stupidity rather than an immense plot.

Perhaps private by design is better rather than collapse by accident.

Cheers

Toby
 Postmanpat 27 Apr 2016
In reply to Toby_W:
> I think people are looking for an explanation for the situation other than incompetence or total ignorance of the current state of the NHS.

> The whole thing seems so utterly inept in every way. What is that quote people always bring up about conspiracies being most likely down to mistakes and stupidity rather than an immense plot.

>
I agree. If I can see one "guiding hand" it would be Osborne and the Treasury forcing other departments into ill thought out and ill targeted cuts. But I fear it's just plain incompetence by ministers and civil servants.
Post edited at 11:14
1
In reply to Postmanpat:

> I suspect the end game is to break the BMA

The 'end game' is privatisation of the NHS, on the specious ground that the NHS "isn't performing".
 Postmanpat 27 Apr 2016
In reply to captain paranoia:
> The 'end game' is privatisation of the NHS, on the specious ground that the NHS "isn't performing".

Blah blah blah. They've got to murder all the first born first.
Post edited at 17:42
4
 Dauphin 27 Apr 2016
In reply to Postmanpat:

Why the opacity, outright lies and unwillingness to empirically test radical health reforms before national roll out or indeed simply articulate them? If it works well and saves money it should be easy to demonstrate its utility to clinicians and the public. No issue with that. What we have is endless subterfuge.

Okay blah blah blah, evil Tories.

D
 Postmanpat 27 Apr 2016
In reply to Dauphin:
> Why the opacity, outright lies and unwillingness to empirically test radical health reforms before national roll out or indeed simply articulate them? If it works well and saves money it should be easy to demonstrate its utility to clinicians and the public. No issue with that. What we have is endless subterfuge.

>
It's very sweet that people think they have a grand plan but much more likely that policy has been made up on the hoof. Hunt just knows that things must change and that the BMA will block change, so he has picked what he wrongly thought was a good ground to fight on. "Seven day week". That should play alright with the electorate. Wrong.

It was, of course, supposed to be based on the experience of hospitals that have rolled it out.

Anyway, about those babies that he wants to put to death....
Post edited at 19:37
 Dauphin 27 Apr 2016
In reply to Postmanpat:

Which hospitals? There's lots of elective stuff going on at weekends all over the country, imaging, routine diagnostics and surgery. It involves paying senior people to come in at the weekend, normally after a full week at work.

Sure they got no plan Pat. All those baby entrails take your mind right off the job.

D
 Postmanpat 27 Apr 2016
In reply to Dauphin:
> Which hospitals? There's lots of elective stuff going on at weekends all over the country, imaging, routine diagnostics and surgery. It involves paying senior people to come in at the weekend, normally after a full week at work.

>
South East Essex, Wigan, Medway, North East Lincs, Chorley, Bassetlaw, Durham and Darlington and about half a dozen others. I'm sure you can find the full list. You could even read the Keogh report on the subject.
Post edited at 20:40
1
 Dauphin 27 Apr 2016
In reply to Postmanpat:

All those top performing trusts punching above their weight, most of which you listed can't even get the nine to five stuff right. Oh yeah the Keogh report, investigation into the wild disparity in hospital deaths between different trusts, some of which feature in your list, many of which were put into special measures and senior management teams gutted from their excellent work of killing babies and old people. Great that they got with the coalitions programme of running a seven day elective service while performing such sterling service to the nation. Hats off, huge bundles all round.

D
 Postmanpat 27 Apr 2016
In reply to Dauphin:

> All those top performing trusts punching above their weight, most of which you listed can't even get the nine to five stuff right. Oh yeah the Keogh report, investigation into the wild disparity in hospital deaths between different trusts, some of which feature in your list, many of which were put into special measures and senior management teams gutted from their excellent work of killing babies and old people. Great that they got with the coalitions programme of running a seven day elective service while performing such sterling service to the nation. Hats off, huge bundles all round.
>
You asked. Don't blame me if you don't like the answer. You seem to be agreeing that policy is being made up on the hoof, so that's nice xx
3
 Dauphin 27 Apr 2016
In reply to Postmanpat

How could you imagine that I'm agreeing with you?

Incompetence and 'knowing things need to change' kinda thingy opaque DOH P.R. missives don't preclude a strategy. All that money spent on the boys education and he's just muddling through as best as he can. I might not like them but these people are considerably top flight political operators, don't do them and yourself the disservice.

D
 Postmanpat 27 Apr 2016
In reply to Dauphin:

> In reply to Postmanpat

> How could you imagine that I'm agreeing with you?

> Incompetence and 'knowing things need to change' kinda thingy opaque DOH P.R. missives don't preclude a strategy. All that money spent on the boys education and he's just muddling through as best as he can. I might not like them but these people are considerably top flight political operators, don't do them and yourself the disservice.
>
Rightyho...

 nutme 28 Apr 2016
Why private health care is bad? You will get service you pay for. Now with NHS everyone gets paracetamol.
6
 galpinos 28 Apr 2016
In reply to nutme:

1. It's expensive
2. Not everyone can afford it.
 abr1966 28 Apr 2016
In reply to nutme:

Interesting naive view....my neighbours son was involved in a serious accident in December....he's recently been transferred to a regional rehab service for people with significant head and spinal injuries. He's walking again now with a little help and his speech is starting to get there slowly. He's had the most excellent service from paramedics, a&e, critical care, neurosurgery, life support, acute care, rehab and social care.....paracetamol heh....!
KevinD 28 Apr 2016
In reply to nutme:

> Now with NHS everyone gets paracetamol.

Really?
F*ck
Now I am worried since with all the exclusions on my private health policy what will happen if I have any of those conditions?
 Andy Hardy 28 Apr 2016
In reply to galpinos:

> 1. It's expensive

> 2. Not everyone can afford it.

3. They won't cover you for an existing condition
4. When your policy cover has reached it's limit you're screwed.
 nutme 28 Apr 2016
In reply to galpinos:

But that's awesome! Motivates people to get jobs and work asses or die under the bridge.
 galpinos 28 Apr 2016
In reply to nutme:

Ah, you're a troll.
 nutme 28 Apr 2016
In reply to abr1966:

And my girlfriend had pneumonia and was told to take paracetamol. I had both arms broken, but GP was sure it was just swollen bruisers making it so painful to move hands. I seen an NHS dermatologist google pictures to compare my bleeding rash. And to diagnose my friend with diabetes it took NHS few months while we had to call ambulance twice.

So yeah, I really hope that NHS will collapse as soon as possible.
2
 nutme 28 Apr 2016
In reply to galpinos:

Not really, just don't like socialism all together.
 JoshOvki 28 Apr 2016
In reply to nutme:

Do you have private health insurance now then?
OP Toby_W 28 Apr 2016
In reply to nutme:

A lot of what you mention is down to under-funding or staffing, you have to fight for your treatment these days. Why don't you want a better run and funded NHS? Would you prefer to pay for private health care, do you know how much this costs?

Family cover in Australia ~500 a month with a 1000 excess.

How on earth did you go to the doctor with two broken arms and not get send for an Xray?

My daughter had pneumonia, it's quite hard to spot, my wife took her straight to A&E, skipping the GP, A&E did all the tests, why are you wasting our time, could you not have gone to your GP, then the chest x-ray came back.. bang straight to intensive care, admitted on the spot. Eventually needed a chest drain, also had an infection round her lungs along with fluid build up, 3 weeks in hospital.

Cheers

Toby

 abr1966 28 Apr 2016
In reply to galpinos:

> Ah, you're a troll.

No just a dickhead...
 Dauphin 28 Apr 2016
In reply to Toby_W:

Not uncommon in young people unfortunately. They seem okay and then decompensate really quickly.

I had a similar A&E experience with my Dad a couple of years ago, hadn't pissed for 16 hours, short of breath, felt really unwell, took him straight to A&E, the triage nurse asked him if he'd been to see his G.P. with the O2 sats reading 87% with a resp rate of 30.....nah fella I saved the system time and money and brought him straight here - Pneumonia. It's just another bogus initiative to deflect responsibility for a underfunded system with high variability in clinicians on to the user. Its hemorrhaging good staff at the moment.

D

 Badgers 29 Apr 2016
In reply to Dauphin:

Sadly, it's the loss of good staff across the board that will destroy the service and lead to the greatest harm. The support services, admin and clerical have all but disappeared making elective and outpatient work a miserable experience (for staff and patients alike). The rota gaps and increasing workload for inpatient and emergency care are unsustainable.

The contract imposition is very much the weighty anvil that broke the camel's back. It will have a significant adverse impact on working conditions and quality of care so is a big issue being pushed on a demoralised workforce. The NHS management (national exec level) clearly haven't read the mood of their staff and should have realised how stretched the front line are and advised the powers that be how risky a time it is to push negative reforms, even if well intentioned (which I don't believe).

Most Drs i know are working on 'exit strategies' and our units have lost a lot of good senior nurses to other areas of work.

As the staffing gets thinner other people who intend to stay get stretched and will be pushed to jump ship too. It's really quite bleak and worrying from where I stand. The contract will barely affect me (long in the tooth JD) but I fear it will affect the ability of the NHS to deliver safe care directly and drive good staff away.

New Topic
This topic has been archived, and won't accept reply postings.
Loading Notifications...