Save the NHS!

Minstadave · 28 Feb 2016 at 08:13

Halfmad said:
Low locum rates? depends what you consider low I guess.

Low locum rates are those that are too low to get anyone to come and do the job. The government seems to think capping them will magically get around simple market forces.

Destination · 28 Feb 2016 at 09:35

Minstadave said:
You're probably more likely to find them going out currently.

Indeed, in norn iron, 66 gp finished their gp training final placement year last year.
61 of them are no longer in norn iron, england got some, canada and australia got the majority.

Buddy · 28 Feb 2016 at 09:56

Halfmad said:
Low locum rates? depends what you consider low I guess.

Scenario.

If you're a specialist doctor about to do a night shift on sunday in a hospital such as Basildon where they are understaffed and you will get no support (because there isn't any) plus you'll likely be treated like **** (because you're a locum) and have to cover all emergency care what out of curiosity is a fair £/hr?

Serious question. What would you like to be paid?

Meanwhile.Jeremy Hunt urged to 'come clean' on how Government will pay for seven-day NHS

Freakbro · 28 Feb 2016 at 10:01

Turn that around, why don't you tell us what the locum rate was, what it is now and we'll assess whether we think that's too low to bother doing the job for.

Because we keep getting told it's not about the money...

Dis86 · 28 Feb 2016 at 10:03

Freakbro said:
Turn that around, why don't you tell us what the locum rate was, what it is now and we'll assess whether we think that's too low to bother doing the job for.

Because we keep getting told it's not about the money...

Go on reed.co.uk and you get a very good idea of what the locum rate is. I was browsing yesterday and it was up to £900 a day.

Freakbro · 28 Feb 2016 at 10:19

Dis86 said:
Go on reed.co.uk and you get a very good idea of what the locum rate is. I was browsing yesterday and it was up to £900 a day.

God yea, why would anyone bother to get out of bed for less than that...

Dis86 · 28 Feb 2016 at 10:22

Freakbro said:
God yea, why would anyone bother to get out of bed for less than that...

Just to add I've seen it bother higher and lower. Never what I would call low though.

Buddy · 28 Feb 2016 at 10:37

Freakbro said:
Turn that around, why don't you tell us what the locum rate was, what it is now and we'll assess whether we think that's too low to bother doing the job for.

Because we keep getting told it's not about the money...

I don't know what Basildon are offering because I don't work there. I'm a GP I've heard variable figures from my hospital colleagues - including £25/hr for a registrar (several years training) for an AE shift.

Tell me how much it costs for a lawyer/hr ?plumber ?electrician on a Sunday night? Or is this all about driving everyone to the ground? Tube drivers then teachers then... **** them because it's not me

You mentioned safety. Do you think 13 doctors doing the work of 22 is safe? Forget last minute cover. Why are these long term positions not filled?

Dis86 if a doctor job has ended up on reed of all sites and not succeeded getting an employee from pulse or bma websites it tells you as much about the job as it does about the £/hr. Link?

And now I will get the inevitable. "What's wrong with £25/hr???!"

Minstadave · 28 Feb 2016 at 10:38

Freakbro said:
Turn that around, why don't you tell us what the locum rate was, what it is now and we'll assess whether we think that's too low to bother doing the job for.

Because we keep getting told it's not about the money...

You're going to assess the rate based on what?

Remember we're not talking about regular night shift rates these are usually short notice vacancies outside your regular job (unless you're purely a locum doctor). Even £900 is less than a plumber or electrician would charge for 12hrs night work.

Dis86 · 28 Feb 2016 at 10:46

Minstadave said:
You're going to assess the rate based on what?

Even £900 is less than a plumber or electrician would charge for 12hrs night work.

A plumber of electrician would be supplying travel, tools and consumables. Which is made up in that cost. A locum has travel expensed and no consumables.

Dis86 · 28 Feb 2016 at 10:47

Buddy said:
Dis86 if a doctor job has ended up on reed of all sites and not succeeded getting an employee from pulse or bma websites it tells you as much about the job as it does about the £/hr. Link?

And now I will get the inevitable. "What's wrong with £25/hr???!"

Here's one of many

http://www.reed.co.uk/jobs/locum-gp/29043347#/jobs?keywords=locum

Minstadave · 28 Feb 2016 at 10:48

Dis86 said:
A plumber of electrician would be supplying travel, tools and consumables. Which is made up in that cost. A locum has travel expensed and no consumables.

Yes but you're missing the slight difference in risk, work intensity and skill level.

I don't do external locums but do internal locums semi regularly. There is significant risk involved to me professionally undertaking extra work and it is time away from my family (which is already slim as it is). The government can cap locum rates but I simply won't undertake locums for pocket money rates - like it or not they can not force people to work locums, certainly not by reducing the rates anyway.

The idea of first refusal in the new contract is laughable too. It'll just be ignored.

Freakbro · 28 Feb 2016 at 10:49

Buddy said:
I don't know what Basildon are offering because I don't work there

Then don't say it's too low if you don't know what it is

Tell me how much it costs for a lawyer/hr ?plumber ?electrician on a Sunday night?

And how much does a footballer earn / hr? It's not always about equivalency, because in our world, there doesn't seem to much of that anymore

Or is this all about driving everyone to the ground? Tube drivers then teachers then... **** them because it's not me

We are trying to ascertain what your definition of 'driving wages into the ground is', so less of the appeals to emotion and more actual facts on pay please.

Because we keep getting told it's not about the money, so we're interested in what you think is not enough to work a shift for, in a profession that is more vocational, about caring and helping others, and not about the money, remember? (See we can all make appeals to emotion

)

You mentioned safety.

No I didn't

Do you think 13 doctors doing the work of 22 is safe?

No I don't

Forget last minute cover. Why are these long term positions not filled?

I'm sure there are complex reasons why, some of it being the location, the reputation of the hospital....please don't tell me it's about pay, because if the trust can spend millions on completely over the top inflated pay for locum cover, then they have the money for a permanent position.

Dis86 · 28 Feb 2016 at 10:51

Minstadave said:
Yes but you're missing the slight difference in risk, work intensity and skill level.

Plumber or electrician buggers up and someone dies. Can be themselves!

I've personally known two electricians killed on the job. Don't know any doctors that have died from work related accidents though!

Minstadave · 28 Feb 2016 at 10:55

Dis86 said:
Plumber or electrician buggers up and someone dies. Can be themselves!

I've personally known two electricians killed on the job. Don't know any doctors that have died from work related accidents though!

Depends what you mean as work related:

- risk of blood born infection from taking blood
- assaulted in A&E by drunks
- suicide related to stress
- car accidents on the way home after a shift

I have met colleagues who have suffered all of the above.

Risk isn't only personal. There is professional risk too. I will regularly see abused children and be expected to give an expert opinion, landing myself defending that opinion in a criminal court, I can balls up and be hauled up on a manslaughter charge losing my job and possibly my freedom.

Minstadave · 28 Feb 2016 at 10:59

Freakbro said:
I'm sure there are complex reasons why, some of it being the location, the reputation of the hospital....please don't tell me it's about pay, because if the trust can spend millions on completely over the top inflated pay for locum cover, then they have the money for a permanent position.

Many trusts are forced to pay huge locum rates due to fundamental problems with modern medical work:

- not enough recruitment
- poor working conditions
- loss of staff overseas

The government seem blind to that and simply want to get the wage bill down by imposing a crap contract and capping locum rates. This will only worsen all of the above.

Locum spending is not the problem, it is a sticking plaster over the fundamental mess we're in. Taking that plaster away won't make it better.

Dis86 · 28 Feb 2016 at 11:00

Minstadave said:
Depends what you mean as work related:

- risk of blood born infection from blood tests
- assaulted in A&E
- suicide related to stress
- car accidents on the way home

I have met colleagues who have suffered all of the above.

Risk isn't only personal. There is professional risk too. I will regularly see abused children and be expected to give an expert opinion, I can balls up and be hauled up on a manslaughter charge losing my job and possibly my freedom.

I think we can discount car accidents on the way home. Everyone has that risk that travels by car, and even those who don't.

Suicide related to stress, again that can affect everyone.
In my home town a well known, well liked painter and decorator killed himself last year from work related stress - his business was growing very quickly, he'd taken on new staff and just couldn't cope.

Assaulted in A&E, yes, there is a strange trend in that isn't there? However what's to stop a plumber or electrician turning up at someones house and being assaulted? (Nothing, though as I say there's definitely an odd trend for medical staff to be assaulted!)

Infection from blood born infections - ok so then why aren't the police on the same rates? If the medical professional is doing their job properly and doesn't screw up there should be NO risk of infection via blood. I can obviously accept the risk of air born infection however these illnesses tend to be less severe.

Minstadave · 28 Feb 2016 at 11:04

Suicide rates in the medical profession are amongst if not the highest of all jobs. So I'm not sure comparing it to your decorator works.

I don't get the analogy to the police either? They don't take blood tests dozens of times a night. Simply saying if you're doing your job properly you won't get a needle stick is a decades old way of thinking about risk.

I wouldn't get too caught up on personal risk though, professional risk is a far greater worry in this job.

Dis86 · 28 Feb 2016 at 11:16

Minstadave said:
Suicide rates in the medical profession are amongst if not the highest of all jobs. So I'm not sure comparing it to your decorator works.

I don't get the analogy to the police either? They don't take blood tests dozens of times a night. Simply saying if you're doing your job properly you won't get a needle stick is a decades old way of thinking about risk.

The police frequently interact with drug users. Violent drug users. Violent drug users with infections who like to do anything to prevent themselves being arrested.

As for the way of thinking about risk, the correct way is to think about mitigation. If you are working in accordance with the correct mitigation then risk is minimised or eliminated.
Follow correct procedure, use the correct equipment in the correct manner, wear appropriate PPE. The trouble arises when you get someone who is in a hurry, gets sloppy or gets lazy - they don't follow the correct procedure or use the correct equipment properly and that's when they stick themselves.

I'm responsible for the safety of over 500 people at one of our sites - Myself as well as our HSE department are responsible for assessing the risks involved in every single thing we do there. I've had safety failings, I've sadly had injuries. In every single case it has been because the correct procedures were not followed, in most cases it was by the injured party.
Safety starts with the individual.

As for your suicide stats

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642721/

Paints a very different picture. The results section (broken down in fig. 1) quite clearly shows suicide rates to be highest amongst a variety of manual trades.

Buddy · 28 Feb 2016 at 11:24

Freakbro said:
Then don't say it's too low if you don't know what it is

I gave you an example of £25/hr which I note you've ignored.

And how much does a footballer earn / hr? It's not always about equivalency, because in our world, there doesn't seem to much of that anymore

Are you seriously comparing to footballers as an excuse to not comparing directly to something more reasonable like a lawyer/electrician - you know a professional? And is your next reply then "oh we can't directly compare because we don't live in that kind of world anymore"?

We are trying to ascertain what your definition of 'driving wages into the ground is', so less of the appeals to emotion and more actual facts on pay please.

Hardly emotional. You're approach is "footballers earn ££££ therefore be happy with what you get." I gave you an example figure. Also are you aware of the new rules on locums with the new contract?

Because we keep getting told it's not about the money, so we're interested in what you think is not enough to work a shift for, in a profession that is more vocational, about caring and helping others, and not about the money, remember? (See we can all make appeals to emotion )

Your initially post was about locum pay which to many doctors in optional and extra hours on top of their usual contracted hours.

With regards to altruism just walk on to any ward and you'll see it on a daily basis. Altruism is likely to disappear though with demands being placed on the upcoming contract.

FYI - some doctors are set to gain pay (majority lose) so why are they still united?

What do you think is going to happen to doctors pay once the nhs collapses and is privatised?

No I didn't

"Not Safe, Not Fair" is the current slogan touted by junior doctors. You suggested this was all about pay.

I'm sure there are complex reasons why, some of it being the location, the reputation of the hospital....please don't tell me it's about pay, because if the trust can spend millions on completely over the top inflated pay for locum cover, then they have the money for a permanent position.

Minstadave has already answered this one.