Junior doctors' strike: All-out stoppage 'a bleak day'

[ballaughbiker]

There clearly is no similar vocation that involves nearly half a working lifetime of training (and of course consultants will say they are still learning). However a parallel situation might be argued to exist in commercial flying.

 

Say you ultimately want a command on a BA (other employers of status are available) 777. You may well get your ATPL licence to fly much quicker than a doctor's qualification (but usually at considerably more personal monetary cost) but it will take the same life time, very roughly to achieve status and remuneration which is comparable to a hospital consultant. I know a few approaching their late 40s, even early 50s, who are still sat in the right hand seat of something big and shiny. Whilst they do a job comparable to the fella in the other seat they are clearly less experienced with much less responsibility. The pay is accordingly less but comparable to a junior doctor. A first officer working for such an employer might roughly expect to earn the salary of a SHO and a senior first officer about that of a hospital registrar. Both types of FO are, like junior docs, still training.

 

So those imperfect vocation comparisons established we have to look at the differences. One is taxpayer funded and one is commercially funded. One is usually a job for life and the other could be gone in an instant. Both jobs involve being at work for very long hours whilst technically not working (but having to be at work) and one has its hours controlled by law although this only applies to flying hours.

 

Looking at the bones of contention of the junior docs in the present dispute and then trying to apply them to the world of commercial flying, I'd say the docs aren't too badly treated. Sure, the employer is trying to get more out of them for the same money but that is common to just about every single employer in the commercial world. One big difference would be that 'troublemakers' would be neutralised very quickly in flying and I think that some junior docs may well be pushing their luck because they aren't exposed to such, er, controls.

 

I think only the deluded really believe the current NHS can continue in its present form but given all of the above, I have difficulty trouble totally supporting the doctor's dispute.

[Addie]

As both sides in this dispute are coming out with totally different numbers, reasons, blame etc., we don't really know what on earth is going on, do we.

 

You've got Jeremy Hunt spouting the government's total obligation to adhere to their election manifesto (that must be a first) because that was the choice of 'the people'. Then you have the BMA trying, as all unions do, to justify their existence by trying to defeat anyone who doesn't agree with them.

 

Two bull-headed pugilists fighting over the rapidly decaying carcass of the NHS.

 

Film the negotiations so we can all watch their negotiating skills.

[thommo2010]

from my understanding and I'm sure I'll be corrected if wrong but the doctors currently work Monday to Friday. the government/hunt want them to work 7 days a week but won't fork out for more doctors so the workload will increase even more on the doctors that they already have causing them more stress and tiredness.

[the stinking enigma]

frankie knows the score

http://www.theguardian.com/commentisfree/2016/apr/27/jeremy-hunt-doesnt-understand-junior-doctors-book-dismantle-nhs

[woolley]

the government are trying to ruin the NHS fair play to these guys for standing up for something instead of sitting round whinging and doing nothing

How so? More billions are spent on the NHS every single year than were in the previous year. How is the government trying to ruin it? They are trying to extend to a full 7 day service which was a manifesto commitment. The problem was the contracts that came in under the Blair government that pretty much gave doctors the right to choose work or play. That was the error. Now it's being turned back, naturally they don't like it.

[benl]

I think a couple of point here are a bit muddled. No junior doctor can opt out of working weekends, I believe the clause exists in some consultant contracts but I think it's in single figure what percentage 'use' it. Most doctors work weekends but at present, like with most NHS staff, receive a premium for working such hours as part of the overall package. The independent review of pay and conditions 'DDRB' suggested this could be done but there would need to be a rise in basic ay so as to keep pay within the current cost envelope, or cost neutral. The government opted not to do this, offering a lower overall increase 11% and removing weekend premiums. To avoid backlash it would be cost neutral for those currently in training but then result in an overall pay reduction for those starting training schemes in the next couple of years. The changes are complex and both sides are trying to hide behind figures.

 

At present there are very few trusts who have planned a 7 day service (non-emergency) and at present would simply mean that staffing of doctors would be spread across 7 days rather than 5. Problem arises here with what can be achieved if more doctors are working, to function like any other day of the week you'd need cover from other allied professionals, more radiologists, OTs, PTs, and social workers. At present this isn't accounted for or planned for. Perhaps it will be after the doctors are sorted.

 

With tuition fees now only a fraction of the training is covered by the government, graduates are leaving with £70k debts when including maintenance. Other studies include salary in the cost of training doctors and exclude the value of service provision.

 

The issue about being at work and not working is difficult and depends on the job, some posts require you to be at work and be working all that time, others have non-resident on-call which the proposed rate would be around a few pounds per hour whether you spend the whole night answering calls or if your phone doesn't ring at all.

 

The NHS is a political institution like it or not, and doctors need to accept that change will happen and they are civil servants. I think Hunt has honest intentions but he made a mess of imposing the contract which has played into the BMAs hands, who have then whipped up their members. The government has mislead the public with use of data and the interpretation of said data, but a weekend effect probably does it exist, but there isn't so much to say it is down to staffing.

 

You may not think the NHS is great and is financially struggling but from a public health point of view offers a lot of bang for your buck. It is actually one of the most efficient world wide. Funding has actually been relatively static since the recession in the UK as a share of GDP whilst other countries have increased it, the world bank have some great data on this. Private health care particularly US models increase pay for staff, costs for consumers and don't actually improve outcomes. That said the decision is political and down to what people want.

 

It's complex and no one person will ever be right. I don't support striking but what do you do other than pack up and leave, approximately 40% of my cohort now work in Australia but most will return I guess.

[ballaughbiker]

I bet there's a few pilots who wish they only owed £70k when they eventually start work..... (that's if they actually get a job which is another aspect that's pretty much a certainty in medicine).

[rmanx]

If pilots had the same death/visit ratio that doctors probably have, would you want to fly with them?

[Barrie Stevens]

 

 

They pretty much exist to preserve life andit doesn't get more serious than that. Perhaps like Police and the Armed Forces it's time they lost their right to strike.

 

That said it has made me smile at the obvious frustration they have caused refusing to budge.

 

The Police and armed forces are Crown Servants who take an oath and for that reason cannot strike.. Junior Doctors are not Crown Servants...

 

dont they [doctors] also take an oath?

 

 

Doctors do not take an oath to serve as Crown Servants...ie Oath of Allegiance....Obvious I would have thought....

 

I am advised that these days hardly any physicians take the Hippocratic Oath and that being bound by it is a myth...

 

I am advised that some take it voluntarily but the original text requires one to work with all the healing gods (of ancient Greece)...This would not inspire me save for faith healing!...

[benl]

Aye, doctors do have job security. Medicine can learn a lot from the aviation industry, there was a guy Atal Gawande (?) who said similar things.

 

Barrie, some say the hippocratic oath at graduation others say a modified form of it. Now aways you pay your allegiance to the GMC (and a wedge of cash).

[Barrie Stevens]

I have never had any real troubles with or complaints about the NHS and I have often marvelled at the speed and quality of treatment done by the NHS and that includes Noble's...

 

In recent years family and friends over here down on my manor have had some serious treatment with minimal waiting times ie carpal tunnel, inverted hanging papilloma, two heart stents, lymphoma, as much as you can do for one with emphysema, two knee replacements, cancer of the pancreas sadly not a lot can be done.

 

There was one issue when an uncle was recently visited by a consultant in King's College Hospital and told that he was going to personally remove his rectum the next day...(Having a sense of humour he asked if that was a threat or a promise and did it have to sound like "You've just won the lottery!")

 

Actually the joke was always going to be on the Consultant because the operation had been done by another a few days before..

[pongo]

Sure, the employer is trying to get more out of them for the same money but that is common to just about every single employer in the commercial world.

Routine and emergency healthcare is not like Uber or the comparable world of commercial air travel. It is not currently a business open to disruption and cut-price competition.

 

Though it is certainly true that people can now shop abroad, eg Asia, and for non urgent specialist procedures.

 

 

I think only the deluded really believe the current NHS can continue in its present form

Indeed. One way or another it should be fully funded. Either by direct taxation or else via compulsory insurance - with the state, in reality, picking up the significant majority of the cost. Like in France which according to the WHO leads the world.

[rmanx]

Anyone who wants the NHS to fall are either comfortable paying vastly over inflated prices for their healthcare or are oblivious to just how bad its going to get for them.

[woolley]

If pilots had the same death/visit ratio that doctors probably have, would you want to fly with them?

But then the doctor is often trying to bring you back from death's door while, hopefully, for 99.99% of the time, the pilot is not.

[Tarne]

This second page of comments has turned into a shambles. What are you on about, comparing pilots and doctors, any rich idiot can be a pilot.

 

Back on topic - junior doctors do get massively overworked but so do other professions. If they don't like it, do another profession. Oh wait they won't, because they want the big bucks that comes with being a doctor. That's all it is.

 

Their strike still won't have the desired effect but may get concessions so let them crack on. It's not a conspiracy to shut the nhs, because thats just bullshit.