Junior doctors strike

Thank you ronib, I did get the idea that you weren’t happy about the pay demands, glad to hear you approve. The problem is that the doctors have no other way to make their point. If they don’t do this, basically most of the public won’t care, and the government certainly won’t be persuaded to restore their pay to anything like 2008 values. And obviously the four year agreement has now ended, so that is why they’re doing it now.

Doctors and nurses are voting with their feet and I don’t blame them. If some think they do not deserve a decent pay increase then they are clearly happy to see this continue.

Those who enjoy the buffer of private health care no doubt.

Deal ends March 2023 Maddyone. I don’t know how you got the idea that I thought doctors should not be paid properly. In fact I have written to my mp about this, have you?
I don’t agree that junior doctors should cause havoc in the health service but I think fair pay is essential.

2019 is actually four years ago. And 8.2 per cent? When does the deal end?
I know you don’t agree with paying doctors properly, but really? You’ve had everything explained to you over and over and you still think doctors are the problem. I can’t be bothered any longer. There’s none so blind as those who will not see.

maddyone In 2019 a multi year agreement for doctors in training was reached. Junior doctors’ pay scales will increase by 8.2per cent by the end of the deal.
Why was this agreed in 2019 only to be overturned now by demands for 35 per cent?

Shropshirelass

Doctors take the hypocratic oath, in my mind strike action goes against this. They chose this profession with everything it brings with it. I cannot support any strike action by any health care workers whatsoever. Regardless of what they say, they are putting lives at risk going against the very heart of their work to look after people and save lives. Yes, the should be paid a lot more and working conditions improved but strikes are destructive and help no-one. Their workload will be much higher when they do return and then they will be moaning about that I suppose!.

What an ungrateful post. Doctors should just suck up poor pay and working conditions because they chose this profession apparently. NO! They should not. They should fight for fair pay and conditions. Why should doctors not be paid properly?
they will be moaning
It’s no wonder my doctor says many patients treat them with contempt.

There’s no legal requirement for doctors in the UK to take any oath, let alone the Hippocratic one. Some graduation ceremonies have oaths, some do not. Some doctors attend graduation ceremonies, some do not.

And no doctor pledges ‘first do no harm’ as that would seriously restrict the treatment they could offer, from steroids to surgery.

Nonetheless, if we assume healthcare staff are focused on helping patients to access good healthcare, then they have to strike. If they do not achieve change (including better pay), waiting lists will grow, patients will continue to suffer and die unnecessarily, and eventually the poor will have limited or no access to treatment - just look at NHS dentistry for the model.

Shropshirelass

Doctors take the hypocratic oath, in my mind strike action goes against this. They chose this profession with everything it brings with it. I cannot support any strike action by any health care workers whatsoever. Regardless of what they say, they are putting lives at risk going against the very heart of their work to look after people and save lives. Yes, the should be paid a lot more and working conditions improved but strikes are destructive and help no-one. Their workload will be much higher when they do return and then they will be moaning about that I suppose!.

That is so illogical.

The Hippocratic Oath:

I shall never intentionally cause harm to my patients, and will have the utmost respect for human life. I will practice medicine with integrity, humility, honesty and compassion. I recognise that the practice of medicine is a privilege with which comes considerable responsibility and I will not abuse my position.

Where does that say, "I will do all this without pay"? In all countries I can think of, you don't count as a patient until they know where the money is coming from to pay for your treatment. Do you think all UK doctors should should for free?

Doctors take the hypocratic oath, in my mind strike action goes against this. They chose this profession with everything it brings with it. I cannot support any strike action by any health care workers whatsoever. Regardless of what they say, they are putting lives at risk going against the very heart of their work to look after people and save lives. Yes, the should be paid a lot more and working conditions improved but strikes are destructive and help no-one. Their workload will be much higher when they do return and then they will be moaning about that I suppose!.

First step would be to stop the drain by paying them properly, second would be by making the training more user friendly. Currently Junior doctors are on the move every six months or so, it makes it difficult for them to maintain relationships and finding affordable accommodation can be a real problem. Increasingly, Junior doctors are deciding not to continue with training but become career locums, it's very lucrative, gives them a very flexible life style and once established within a group of hospitals the work is generally as much as they want (such are the shortages in most hospitals). The NHS can't afford the costs of locums but currently they have to employ them to try to keep within safe limits. The answer is to have well paid Junior doctors on training programmes not well paid locums supporting poorly paid and demotivated junior doctors. We can't expand any services without the necessary staffing.

Just watching a guest on LK give a great explanation why pay rises in the private sector could increase inflation while pay rises in state run areas do not.

If you want to see it it will be about 9:30/9:35

It may not be all about pay but do the strikers think their overwork situation can be improved any time soon? It takes years to train a hospital doctor so in the absence of more immigrant doctors how can the workload be reduced? Barefoot doctors? Nurse substitution?

MaizieD

^These silly little teetering around the edges to save NHS money ideas would plainly not be necessary if we paid more for our universal service, which of course isn’t cheap, but not unaffordable.^

It's not only not unaffordable, but it would be beneficial to our economy; as I have pointed out several times in the past.

It doesn't have to be more expensive either, although we may choose it to be so that we can do more.

I have just been listening to Any Answers. Ian Bainbridge, who describes his background (around 30:56), was talking about an "integrated whole system". What caught my attention most was that "we need a shift to prevention". So fewer people are going to hospital.

That means joined-up integrated community teams. Using both health and social care flying squads, offering support in the community. Then there need to be integrated rehab teams which take people out of hospital and back into the community. He went on to say that "we" have proven, with pilot schemes, that you can divert "huge numbers" of older people who are in hospital, needing long-term care, who can, in fact, go home.

He added that quite a big percentage of those don't need long-term support if they have joined-up health and care and intensive rehab. He pointed out that they had discovered that 70% of those in hospital, deemed to need long-term care, didn't need it when they had one joined-up scheme.

As Anita Anand then said, "And they want to go home". And she is right.

Quite uplifting to listen to someone with a cogent and tested answer. But are any politicians listening? I keep saying we can afford the NHS, and I am sure that is true. But we not only can afford it, but we also must. It may mean a completely different integrated system that is all in the community except for advanced surgery, etc., but times change and we need to change with them.

Siope

Short, plain English (but with stats and graphs for those who like to see data presented that way) analysis of whether public sector pay rises drive up inflation, as Hunt and Sunak are claiming.

blogs.lse.ac.uk/politicsandpolicy/does-public-sector-pay-drive-inflation/

tldr: no, because service is free + sector is too small, and doesn’t push up private sector pay to compete.

And the same conclusion from Richard Murphy

www.taxresearch.org.uk/Blog/2023/04/14/can-public-sector-pay-rises-cause-inflation/

Also connected and relevant:

Do pay rises cause a wage - price spiral? This has frequently been claimed by posters on here.

A more complex working paper from the IMF which examines 31advanced economies from the 1960s on. The conclusion is that pay rises very rarely cause a wages - prices spiral.

Their conclusion:

Wage-price spirals, at least defined as a sustained acceleration of prices and wages, are hard to find in the recent historical record. Of the 79 episodes identified with accelerating prices and wages going back to the 1960s, only a minority of them saw further acceleration after eight quarters. Moreover, sustained wage-price acceleration is even harder to find when looking at episodes similar to today, where real wages have significantly fallen. In those cases, nominal wages tended to catch-up to inflation to partially recover real wage losses, and growth rates tended to stabilize at a higher level than before the initial acceleration happened.
Wage growth rates were eventually consistent with inflation and labor market tightness observed. This mechanism did not appear to lead to persistent acceleration dynamics that can be characterized as a wage-price spiral.

www.imf.org/en/Publications/WP/Issues/2022/11/11/Wage-Price-Spirals-What-is-the-Historical-Evidence-525073

Short, plain English (but with stats and graphs for those who like to see data presented that way) analysis of whether public sector pay rises drive up inflation, as Hunt and Sunak are claiming.

blogs.lse.ac.uk/politicsandpolicy/does-public-sector-pay-drive-inflation/

tldr: no, because service is free + sector is too small, and doesn’t push up private sector pay to compete.

Glorianny I agree with you that obesity is an important aspect of self help and I am making an effort to improve both diet and exercise.
However from my perspective, the mixed Greek health system of affordable private healthcare has been very good in diagnosing issues that the Nhs has not. Greek doctors are very available for a fraction of the price here.

ronib

Glorianny effect of overweight/obesity on GDP averages 2020-50 so according to the information provided obesity is worse in
Uk, Sweden, Slovenia, Ireland, Poland,Lithuania, Latvia

Yes but nobody has stated people from those countries are well informed about diet and exercise, have they?
And others understand that a change in diet is largely responsible greekreporter.com/2022/03/19/childhood-obesity-rate-greece-europe/

These silly little teetering around the edges to save NHS money ideas would plainly not be necessary if we paid more for our universal service, which of course isn’t cheap, but not unaffordable.

It's not only not unaffordable, but it would be beneficial to our economy; as I have pointed out several times in the past.

Farzanah Fri 14-Apr-23 16:07:58
tinkering…….not teetering!

... it works equally well!

tinkering…….not teetering!

These silly little teetering around the edges to save NHS money ideas would plainly not be necessary if we paid more for our universal service, which of course isn’t cheap, but not unaffordable.

A short time ago our NHS was the envy of the world, and it’s decline is no accident but mirrors the Tory party being the primary governing power since 2010.

The ideological aim is clearly for a free market system, which has ruined other previously run state services.

Siope Wow! That's inflation for you! I lost count of the number of hospital appointments I had last year and I received a text before each one telling me that missed appointments cost the NHS £160 each. I didn't miss any.

I can't see how a 10 minute GP appointment costs £160, although I agree they're frustrating.

I get a regular update of the number of DNAs at my GP practice. I once worked out that that a maximum of 1-2% of appointments are DNAs - charging people £25 an appointment to stop those seems like overkill.

PS. I was once warned about a DNA I had allegedly caused. It turned out that the GP had tried to ring me when I wasn't expecting a call. I hadn't been able to answer the phone quickly enough, but it was a private number and I couldn't call back.

Glorianny effect of overweight/obesity on GDP averages 2020-50 so according to the information provided obesity is worse in
Uk, Sweden, Slovenia, Ireland, Poland,Lithuania, Latvia

growstuff It’s tricky to calculate. NHS England assign a flat unit cost, and say the cost to the NHS is c£200m per year for missed GP appointments and about £1bn (Covid skewed here) for missed hospital appointments.

But: that assumes there are no sunk costs, such as utilities; that doctors/HPCs don’t do something else with the time (catching up with paperwork, spending longer with other patients, studying); and that there would not be further costs relating to a patient turning up (prescription, referral, tests etc).

I find it slightly amusing that one of the ways the NHS compensated pre-Covid for no-shows was one of the things many of us complained most about; having, eg, 6 appointment slots per doctor in an hour, and inviting 8 people to attend, all at the top of the hour, thus causing the majority of us to have longer waits.

ronib

The Nhs has costed out missed appointments and appointments cancelled without sufficient notice. It’s a significant figure. A payment system might stop this?

I know that an impoverished country like Greece has a fee to see a gp in place. Also the Greeks I know seem very well informed on basic health care, nutrition, exercise etc plus use of pharmacy as first port of call. My feeling is that somehow the Nhs continues to struggle and some reform will become necessary in the future. It feels as if the two options here are very expensive private health insurance or an increasingly stretched public health sector.

Are you unaware of the huge and growing obesity problem in Greece? www.dianeosis.org/en/2022/04/obesity-and-its-consequences/#:~:text=As%20we%20mentioned%20in,overweight%20and%2024.9%25%20are%20obese.
It's largely put down to changes in diet.