Junior Doctors strike

Maizie, do you seriously believe that everything can be solved by just printing more money - without an increased flow of taxes into the Treasury to underpin it? 35% for the doctors, whatever the ambulance staff want, increases in benefits etc etc etc?

Because giving all JDs 35% will just mean that there will be far less funding to pay more doctors

It doesn't have to mean anything of the sort. There is no actual limit to what the state can pay its doctors. It isn't funded from taxation, nothing the state pays for is funded by taxation.

The refusal to pay any of the NHS staff enough money to compensate for the real terms cuts that they have had to put up with since 2010, not to mention the recent cost of living increase, is a purely political and ideological one.

An F1 doctor will pay 9.8% of their pensionable pay towards their pension and about the same amount to pay off their student loan. I think people forget most newly qualified doctors will have a high level of student debt because of the length of their training eg my daughter did graduate entry so was at uni for 7 years in total. I pay my cleaner £17 ph, she's registered as self employed but I do pay holiday and sick pay and she was paid the full amount throughout the pandemic although we asked her not to work. We also keep her supplied with logs for her wood burner and OH does little DIY jobs as she's a single parent. She's got to have an op that will require a number of weeks off work, we'll pay her of course but will be looking for help so if you are interested, do send me a private message as getting cleaners in this area is not easy.

I think I may give up my job to be a cleaner if so many of you pay them so much. But what would happen to my paid holiday leave, paid sick leave and pension should I retire?

As far as I can gather it is very very junior , newly qualified doctors that are paid £14 an hour, so why not just give them a payrise?
But I can't see how giving all junior doctors 35% will solve their problems. They need to decide if their main concern is overwork or underpay. Because giving all JDs 35% will just mean that there will be far less funding to pay more doctors.

An F1 is is a fully qualified doctor. They are currently paid £29,384 for their 40 hours contract at just over £14 an hour. Yes, some of them are working up to 80 hours a week, the extra at the same hourly rate unless working after 10.00 pm at night. But those with young children needing to pay for childcare (and don't forget they need to cover those longer hours) will struggle, and cannot manage to work double hours. And do we really want to be looked after by someone utterly exhausted, with money worries on top?

Apologies to everyone else for my derailing.

Germanshepherdsmum

I mentioned governments being unable to issue money ‘willy nilly’, if you look back. As I am sure you will agree.

I agree that the state cannot create money 'willy nilly' but that wasn't what I was saying.

I said that banks conduct their business with state 'created' money; either created by themselves or by the BoE.

The exception would be their earnings from foreign business..

As far as I can see the financial services sector exports made up about one third of the total value of financial services to the economy in 2021 (source House of Commons research briefing). The remaining two thirds has to be derived from state issued money (whether newly created or already in the economy), there is no other source of money in the UK.

This whole argument derives from the discussion about junior doctors' pay. I agree that the state cannot create money 'willy nilly' but that wasn't what I was saying.

I said that banks conduct their business with state 'created' money; either created by themselves or by the BoE.

The exception would be their earnings from foreign business..

As far as I can see the financial services sector exports made up about one third of the total value of financial services to the economy in 2021 (source House of Commons research briefing). The remaining two thirds has to be derived from state issued money (whether newly created or already in the economy), there is no other source of money in the UK.

This whole argument derives from the discussion about junior doctors' pay and your contention that financial sector wages aren't paid by 'the taxpayer'. No' they're not directly, but they are paid in the main by profits made from money initially issued by the state. There is little difference between doctors being paid directly by the state and financial sector pay being derived indirectly from money issued by the state. It's all money and it all, apart from those foreign earnings, has the same source.

I mentioned governments being unable to issue money ‘willy nilly’, if you look back. As I am sure you will agree.

Germanshepherdsmum

Thank you for your kind but very patronising lecture Maizie. You assume me to be ignorant of the workings of the banking industry but haven’t told me anything I didn’t already know. Do you really think I believe that a lender transfers a shedload of notes to a borrower? And did I suggest that hyperinflation is likely to occur in the UK? No. Ye gods.

In which case, GSM, why did you even bother to mention the Weimar hyperinflation?

I didn’t start that comparison. It is indeed plain daft.
Apologies foxie, I see my information was dated October 2019. Government careers website now shows starting salary £30-£35k.

Germanshepherdsmum

Thank you for your kind but very patronising lecture Maizie. You assume me to be ignorant of the workings of the banking industry but haven’t told me anything I didn’t already know. Do you really think I believe that a lender transfers a shedload of notes to a borrower? And did I suggest that hyperinflation is likely to occur in the UK? No. Ye gods.

This thread is not about the financial sector, and the comparison is, sorry, plain daft.

Germanshepherdsmum

Perhaps rather than comparing doctors with bankers we should compare them with vets. Similar training, working all hours but employed in the private sector. Average first year salary £28,000.

Sorry but you are wrong, average starting salary is now 35K+ and although they need a lot of support in the first few years as far as I am aware there are no more formal exams although they can choose to do additional qualifications if they wish. Most vet practices are now part of large organisations and because vets are in short supply they have to offer very competitive salaries to attract applicants. I have several friends who are vets, my local equine hospital does offer an out of hours service, so their young vets do on call work over the weekend and at night but tbh it is nothing like as intrusive as the rota that the average Junior doctor does. My small animals vet doesn't offer out of hours now but there is a vet 10 miles away who does nothing else and covers all our local small animal vet practices. I have huge respect for vets, particularly large animal/equine vets, who are at great risk of serious injury but to equate their training with that of doctors is very questionable.

Thank you for your kind but very patronising lecture Maizie. You assume me to be ignorant of the workings of the banking industry but haven’t told me anything I didn’t already know. Do you really think I believe that a lender transfers a shedload of notes to a borrower? And did I suggest that hyperinflation is likely to occur in the UK? No. Ye gods.

Yammy

Fleurpepper

The buck does stop with the Junior doctor indeed- working alone in the middle of the night exhausted! They can get sued for negligence just like any other doctor- and there is NO-ONE holding their hand in the middle of the night. Consultants make it very clear that they are NOT to be disturbed! With respect GSM, you have not a clue about the realities out there for Junior docs.

Whilst I agree with most of what you say you should say"SOME Consultants ", make it clear they do not want to be called during the night. I lived among them and know a lot who went in when there were problems and stayed until it was sorted.

Yes, a generational thing too. This is how it was in the 70s and 80s, and hopefully changed somewhat. Same as the hours, when 140 hours + was normal for Junior doctors in call- living at the hospital when on call. If you were in Casualty, Cardiac Unit or Obs and ginea- you were lucky if you got any sleep at all, often a day, a night and another day, non stop, 1 night off and again. Thank goodness this is no longer allowed.

MaizieD yes I do have a relative who trained as a doctor . Gave up.

More interestingly two good friends also medics who told me in no uncertain terms that when they were training, 80 hours a week was the norm. This was because of the sheer complexity and range of human illnesses that as full an exposure as possible was given to doctors still in training. So maybe only doing 48 hours a week seemed a retrograde step to my friends who both made consultants eventually.

Fleurpepper

The buck does stop with the Junior doctor indeed- working alone in the middle of the night exhausted! They can get sued for negligence just like any other doctor- and there is NO-ONE holding their hand in the middle of the night. Consultants make it very clear that they are NOT to be disturbed! With respect GSM, you have not a clue about the realities out there for Junior docs.

Whilst I agree with most of what you say you should say"SOME Consultants ", make it clear they do not want to be called during the night. I lived among them and know a lot who went in when there were problems and stayed until it was sorted.

ronib

maddyone F1 and F2 scales do not indicate highly trained medics. Think of it more as an apprenticeship and the many years of hard graft ahead.

The pay scales do not show all the allowances paid for extra shifts, locum work etc.

Do you have any doctors in your family, ronib?

If you don't then I think that telling people who do that junior house posts are an 'apprenticeship' is a bit cheeky.

Germanshepherdsmum

You know as well as I do that governments can’t simply print money willy nilly Maizie. I am reminded of Germany when one had to take a wheelbarrow of money to buy a loaf of bread. I fear your knowledge of the banking industry is not as great as you think. I learn a great deal about it from my son who is a capital markets lawyer. And many of his clients are foreign banks.

GSM, you might have been a brilliant solicitor, but trotting out the Weimar republic's hyperinflation as a 'proof' that money creation is a Bad Thing just shows that you don't have any in depth understanding of the dynamics of money creation.

It's not the money creation per se that causes hyperinflation, all countries with sovereign currencies 'create' money all the time. If they didn't, their economies would grind to a halt. The hyperinflation is caused by the specific circumstances under which the money was created.

Try googling for articles on the causes of hyperinflation, or try this: clintballinger.com/2021/01/12/the-myth-of-hyperinflation/

Then look at the UK's current socio/political circumstances and see if they indicate any risk of hyperinflation.

In fact, your bankers 'create' money all the time when they make loans. They don't fund loans from deposits, they are completely 'new' money.

Don't take my word for it, take the Bank of England's word

Commercial banks create money, in the form of bank deposits, by making new loans. When a bank makes a loan, for example to someone taking out a mortgage to buy a house, it does not typically do so by giving them thousands of pounds worth of banknotes. Instead, it credits their bank account with a bank deposit of the size of the mortgage. At that moment, new money is created.

www.bankofengland.co.uk/-/media/boe/files/quarterly-bulletin/2014/quarterly-bulletin-2014-q1.pdf (P 14 onwards "Money creation in the modern economy"

The bank creates new money by way of loans. When the loan is repaid, the money is destroyed. The bank's profit comes from the interest charged on the loan. Government issued money works in the same way. The government issues new money to fund its activities, taxation returns the money to the government, thus destroying it.

NB banks create the 'new' money under licence from the Bank of England. Not every one can 'create' money, only the BoE and those licenced by it can do that.

ronib
I think six years training is pretty highly trained. Those six years are spent at university but three of those are on Clinical Practice, in other words, a bit like an apprenticeship. Student doctors are not paid for these three years of working on the wards and in clinics alongside experienced doctors because they are learning. Of course doctors continue to learn throughout their professional lives, they never know everything because practice and treatments change and improve all the time.

F1 and F2 are compulsory years spent in a hospital working on a variety of rotations and therefore junior doctors widen their experience and expertise in a range of areas. After that they can start to specialise although not all do. This period of time is not an apprenticeship because that has already been done during their time in university and in clinical practice before they qualified.

Frankly I find it difficult to believe that you are comparing a six years trained doctor who may be the only doctor on duty if you’re admitted to hospital as an emergency during the night to an apprentice what? A hairdresser? A car mechanic? Both necessary jobs but I’m sorry, there is no comparison!

I saw an advert on the back of a bus offering £13 an hour vacancies for bus drivers. Junior doctors deserve so much more.

Vets train as dentists too!

Germanshepherdsmum

Perhaps rather than comparing doctors with bankers we should compare them with vets. Similar training, working all hours but employed in the private sector. Average first year salary £28,000.

Well I know many vets- and all of them earn a lot more than GPs, and very quickly after their first year.

As a GP friend used to say, vets are so clever because they have to guess what is wrong even if the 'patient' can't tell them. However, antibiotics, anti-inflamatories, steroids- and when they stop working, pts. You can't do that with people!

Bankers have been bailed out by the public purse, again and again, and with vast sums of money.

maddyone F1 and F2 scales do not indicate highly trained medics. Think of it more as an apprenticeship and the many years of hard graft ahead.

The pay scales do not show all the allowances paid for extra shifts, locum work etc.

GrannyGravy13

Whilst I totally get that taxation does not fund Government spending

Successive Governments/MPs of all persuasions continue to trot out that they cannot afford things, which commentators/interviewers go along with.

MaizieD any ideas why this happens? I cannot believe that just a handful of GN members and a couple of low profile economists are the only people ^in the know^

It's not just a handful of GN members and a couple of low profile economists, it's much more widespread than that. In fact, just about any macroeconomist* will tell you that a state with a sovereign currency can creates its own money, they just don't agree on to what extent and to for what reason it can be created.

There are whole books and masses of academic documents written about the topic.

Successive Governments/MPs of all persuasions continue to trot out that they cannot afford things, which commentators/interviewers go along with.

Well, think about it. If politicians admitted that the government could fund anything it wanted to, so long as there were resources (labour or materials) available to purchase, how could they explain away completely unnecessary but ideologically driven, cuts in spending?

The household budget myth is massively politically convenient.

(*macroeconomists look at a national budget and activity as a whole, whereas microeconomists look at economic activity individual sectors. You also get some political economists who look at the way that economic activity interacts with society as a whole. Adam Smith and the early 18th/ 19th C economists tended to be political economists)