Save the NHS!

[Dolph]

Its not as easy to go elsewhere though. And also imagine if all of the thousands upon thousands of JDs did that. It isn't blackmail and you know it or are deliberately obfuscating the situation as though it is. These people are saying if you change work conditions, patients and the sector will be put at risk.

If the junior doctors were able to walk into jobs with better rewards or working conditions, they wouldn't need to strike to get what they want.

I would guess you disagreed with firefighters and local youthworkers/college staff who had to work for longer with less pay while paying more into a pension and getting a third less out of it.

I think they still get a substantially better pension than many others making the same or higher contributions, while forcing those people with worse pensions to pick up the shortfall. In short, they may not have got what they wanted, but they are still doing well.

one thing that once got me and this is the type of person whom you fit: A lawyer came on commenting about Tube strikers saying they are very unprofessional yada yada yada and that as a lawyer her profession and by extension her "click" were sensible about things and would not strike because they wouldn't act spoilt. Not long afterwards lawyers and barristers themselves did the very unprofessional thing of striking at changes to legal aid where they would lose out on thousands.... I laughed but still supported that corrupt and cretinous sector to strike as I understood changes can affect mot just their pay but peoples lives. You see my allegory

I see it, but you assume I have never been on the receiving end of contract changes. I have, several times, and I did exactly what I advocate, I took my labour elsewhere where the pay and conditions were more reflective of my view of my value. If I had not been able to do that, then i would have accepted the changes.

 

[Dolph]

It is not the market that has decided the worth of the doctors as there are many 'customers' of the NHS that fully support what the doctors are striking for. It is not about what is profitable and what is not, the NHS has been caught in the crossfire of politicians for years. You may feel that the striking is just about doctors pay premium but many non doctors are protesting changes to the NHS as well.

The job market in general decides the market value, not the customers (especially given the customers in this case have no choice in whether they pay for the service).

Popularity (or amount of noise generated by a small section of the population) is not an alternative to good practice and management.

You disagree with the protest because you abhor the reasons the union give and you apply basic standard business ethics to the NHS as if it was any old high-street retailer. These changes will have an impact on everyone if it reduced the incentive to train as a doctor or to stay in public healthcare. The average tax payer will feel the weight of their own pockets decrease as the many professionals threatening to leave to join private healthcare need to be replaced by much more expensive agency workers. As the average person and employee gets more disgruntled by the nhs, more people will start to call for change and that could even lead to privatisation.

Special pleading again, the nhs is no different to any other business when it comes to best practices such as workforce planning, demand management and so on. It is entirely appropriate to look at what impact the current and proposed contracts will have on service delivery, workforce planning and customer management.

You also make an implication that privatisation is bad. Most of the more successful healthcare systems across europe use a much more mixed system than we do. I dont care how healthcareasy is delivered, I care about the outcomes.

Finally, given than you have already tried to justify the junior doctors position with an appeal to popularity, you then try to defend the dishonesty of the bma around the reasons, when the driver for the dishonesty is to drive that popular opinion.

You call it blackmail but what they are doing is well within their right and is totally legal. Many of them dont want to see a decline in public healthcare regardless of whether they can quit and get a job in private sector or not.

Other thread discussing supermarket employee contracts having Sunday premiums removed and a change in night premiums had some people in uproar.

Careful with the appeal to legality, laws can be changed, so that isn't really a justification for anything other than campaigning to change the law.

In general, people don't like it when their employment conditions change, but those same people are customers of other businesses where they expect value for money or timely service when it is convenient for them.

This isn't about reducing the cost of employing junior doctors, it is about cost neutrality when the service changes to better reflect the needs of patients.

 

[Dolph]

You've summarised very accurately my own thoughts on Dolph. He really does come across as a very bitter individual with a massive chip on his shoulder. I don't understand this "race to the bottom" mentality that he demonstrates either ...

It isn't a race to the bottom, it is a race to merit based value, there's a world of difference.

As for the nhs, the sacred cow treatment it gets ignores the failures, the premature deaths, the dragging out of treatment and so on. The idea of the nhs is fantastic, the current implementation is not.

 

[Destination]

Dolph, out of interest, within the UK in it's current structure, do you think the NHS has sufficient staff at all levels to be fit for purpose?
Separate from the strike arguments.

 

[Raumarik]

Hikari, the NHS in the U.K. Isn't one organisation, they are very different in Wales from England and Scotland too etc.

 

[Dolph]

Dolph, out of interest, within the UK in it's current structure, do you think the NHS has sufficient staff at all levels to be fit for purpose?
Separate from the strike arguments.

I think the nhs has sufficient headcount to work correctly. Whether that headcount is in the right roles at the right time doing the right things is a different question.

 

[Dolph]

Hikari, the NHS in the U.K. Isn't one organisation, they are very different in Wales from England and Scotland too etc.

Indeed, you can see that by looking at the performance variations.

 

[Destination]

Hikari, the NHS in the U.K. Isn't one organisation, they are very different in Wales from England and Scotland too etc.

I am aware of this, doesn't make the question any less valid, as a block grant pays for the other regions.
I earn significantly less than my equivalent colleagues in England for doing the same work on the same number of patients, but there is mass variation even within that also.

 

[Minstadave]

It isn't a race to the bottom, it is a race to merit based value, there's a world of difference.

As for the nhs, the sacred cow treatment it gets ignores the failures, the premature deaths, the dragging out of treatment and so on. The idea of the nhs is fantastic, the current implementation is not.

Merit based value? Interesting term, so although Doctors provide a life saving service that no one else is able to provide, their merit based value is low because they are under a monopoly employer?

If Doctors wanted better pay they'd be out fighting for privatisation - no more monopoly employer, plenty of merit, plenty of cash.

On an different tangent, looks like no locum to work with me this weekend, so I'll be doing the work of two ITU registrars, yay! Welcome to the new safer, fairer and alround better NHS.

 

[Buddy]

On an different tangent, looks like no locum to work with me this weekend, so I'll be doing the work of two ITU registrars, yay! Welcome to the new safer, fairer and alround better NHS.

Hold on mate I thought Dolph said the NHS has a sufficient headcount? Also you're not allowed to complain because you work for a monopoly employer!

 

[Caged]

Dolph is a very sophisticated posting bot that serves only to mine the contents of posts for use of fallacies, and to then point this out.

 

[Minstadave]

Hold on mate I thought Dolph said the NHS has a sufficient headcount? Also you're not allowed to complain because you work for a monopoly employer!

Don't worry, all we need is Brexit and the EWTD protection can go out the window.

 

[Buddy]

Don't worry, all we need is Brexit and the EWTD protection can go out the window.

Have you seen some of the proposed rotas?
After nights same day 8am finish counts as "day off" straight to work next morning.

 

[Dolph]

Merit based value? Interesting term, so although Doctors provide a life saving service that no one else is able to provide, their merit based value is low because they are under a monopoly employer?

If Doctors wanted better pay they'd be out fighting for privatisation - no more monopoly employer, plenty of merit, plenty of cash.

On an different tangent, looks like no locum to work with me this weekend, so I'll be doing the work of two ITU registrars, yay! Welcome to the new safer, fairer and alround better NHS.

The value of doctors isn't actually that low, the average take home for foundation doctors is around £36k, for speciality training, it is over £50k according to NHS Employers. To put that into context, that puts foundation doctors in the top 30% of earners, and specialist doctors in the top 10% of earners.

I do agree thathat privatisation, or at least the end to national pay bargaining, would increase the earnings of some doctors, but like any occupation, not every employee is equal and it is just as likely that the value for some would drop. That is a driver for many to maintain the status quo.

Sorry to hear you are overworked this weekend, but currently the finance drives towards short staffing and agency workers rather than paying a pay premium on the doctors whole salary for unsociable working

 

[Dolph]

Hold on mate I thought Dolph said the NHS has a sufficient headcount? Also you're not allowed to complain because you work for a monopoly employer!

Read what I wrote again

 

[Buddy]

Read what I wrote again

You mean the cop-out second sentence?

 

[Dolph]

You mean the cop-out second sentence?

Or the attempt to defuse the loaded question that was asked. I gave the poster of the question the benefit of the doubt that this wasn't the intention. At least I don't have to give you the same and just address your dishonest quoting.

 

[Buddy]

Or the attempt to defuse the loaded question that was asked. I gave the poster of the question the benefit of the doubt that this wasn't the intention. At least I don't have to give you the same and just address your dishonest quoting.

Dishonest quoting? Really?

Your second sentence just demonstrated the lack of insight you have on staffing levels and how rotas work and i ignored it. Since you've voluntarily drawn attention to that please demonstrate how current wards and emergency care is rota'd and then explain what you would do different.

 

[Dolph]

Dishonest quoting? Really?

Your second sentence just demonstrated the lack of insight you have on staffing levels and how rotas work and i ignored it. Since you've voluntarily drawn attention to that please demonstrate how current wards and emergency care is rota'd and then explain what you would do different.

Who said we were just talking about front line staff? The nhs headcount includes all the support and management staff as well as front line. Saying the headcount is right but that it isn't in the right place doesn't just mean changing rotas

Furthermore, The current contracts will result in reduced scheduling of staff during times of high demand in order to meet staffing budgets, without addressing this flaw, fixing the rest of the problem is somewhat harder.

What I would do differently is start with the needs of the customer rather than the desires of the staff

I don't have the full information required to completely redesign the nhs rota process, but unless the nhs is exempt from the rules that apply to everyone other business in the world, the problems are clear from things like the doctors contract.

 

[Minstadave]

Sorry to hear you are overworked this weekend, but currently the finance drives towards short staffing and agency workers rather than paying a pay premium on the doctors whole salary for unsociable working

The new contract drives towards a further fall in recruitment and even more reliance on agency work that apparently we are no longer paying for - so this is to become the norm it would seem. Is it safe? Can't imagine it will be. Is it better for patients? Doubt it. Is it cheap? Yeah because there's nobody working half the shifts.

The locum caps are a farce - they have all been broken already, and we're not even at the lowest point, so that approach didn't work. This is before we start to provide "7 day care" which we still don't know what it will entail, how many staff we will need and how it'll be paid for.

I'm all for providing the care that patients want, but part of that care involves the longer term view of having the staff you need to provide it, not breaking the staff you've got to provide it in the short term - which is what seems to be the current plan.

As I've said this new contract won't have any effect on me directly (I'm on a run through contract) however I would love to have junior doctors working with me when I finish and an NHS left to work for. Neither of which seem to part of the Tory plan.

The BMA would have in all likelihood have rolled over had the government simply been honest and asked them to tighten their belts, they have done until now. The Government instead tried to tell them that 7 day working was vital, wanted to cut pay on the sly whilst selling it to the public as a "13% pay rise!", weaken hours protection and take total control of locum work and pay (without fixing the actual problem).Even now that slug Gummer still calls it fairer and better for doctors despite overwhelming evidence that doctors beg to differ. Worse than all that though they negotiated the BMA into a position of "90% agreement" - none of the agreed points were an improvement over the current contract apart from a reduction in consecutive days - got a cost neutral solution to 7 day working and then bailed out and imposed a contract. Why? So they could force the issue of Saturday pay, not Saturday working.

Now Dolph you may have an axe to grind against to Doctors, I don't know if it's jealousy or the idea we're entitled Toffs - I actually admire your idea of putting the patient first, I don't think anyone has an issue with that, but you seem very fixed on the short game. This contract doesn't seem to tagetting improved patient care, we still even know don't know what the government want changed about patient care, they won't tell us - it's very clear they want to cut he wage bill though and to hell with the consequences.

This is not a profession that will have people knocking on the door to train for at huge personal cost and a quality of life that is far below other options. It's utter madness. I suppose it'll all get better under Branson - but then patients will be second to profits.