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Should NHS doctors and nurses be paid more?

Discussion in 'Speaker's Corner' started by ver01@, Mar 7, 2019.

  1. The_Abyss

    Capodecina

    Joined: May 15, 2007

    Posts: 11,084

    Location: Ipswich / Bodham

    Now that the pension stuff is out of the way...

    I'm not sure that I can answer whether or not doctors should be paid more. I'm not a doctor and I don't know what their market is.

    However, if the question is should additional pay be considered as a tool to retain doctors as there's an issue in this area, then of course it should be, just like any other profession. However, from what I read elsewhere and hear, there's a fundamental staffing shortage irrespective of pay, and if I had the choice between paying doctors twice as much to ensure that they can be retained to continue working their 80 hour weeks or could I have another doctor instead and pay them both the same and let them work 'just' 40 hour weeks then I'd choose the latter.

    But I can't really choose, can I, because I'm not a medical professional or medical manager. So if the question moves on towards the direction of whether or not I'm prepared to pay more to improve our health services and the conditions of those that work in the profession then the answer is yes.

    I'm sure there'll be someone along to say that we need to eliminate waste first. Of course we need to improve efficiency, but things will never improve if we deny funding because we insist on efficiency gains first - there clearly simply isn't the available resource to improve without extra funding.

    The overall burden of taxation in this country is disproportionately low in comparison to the expectations of the standard of public services that we receive.
     
  2. Minstadave

    Capodecina

    Joined: Jan 8, 2004

    Posts: 24,071

    Location: Rutland

    I don't think most of us doctors want to be paid more. The general consensus among my colleagues is:

    1. Stop paying us less year on year. Years of pay freeze followed by a minuscule pay rise that were delayed 6 months for "reasons" are just whittling away good will. It makes going overseas much more attractive.
    2. Stop treating doctors like shift workers. Imposed contracts on the junior doctors was a real low blow, poor working conditions in the early years has seen a big increase in drop out rates and speciality training numbers fall.
    3. Put the money in to train enough home grown staff to really improve care and working conditions. This is just not happening currently.
    4. Treat substantive staff well. This is largely ignored in every trust at all levels. Parking, staff facilities, poor training and support, awful IT systems all grind you down.
    5. Let people that want to work more work without penalty. The tapering annual allowance is really hitting this hard in primary care and surgery.
     
    Last edited: Mar 8, 2019
  3. Steampunk

    Soldato

    Joined: Jun 1, 2013

    Posts: 6,053

    That is correct. The NHS work overtime differently. Rather than getting paid a multiplier of your standard rate, you get paid "bank". This is like an in house agency. Instead of someone working an extra shift on their day off via an external agency (and getting paid a rate and the agency taking a cut from the Trust that overall costs the NHS a lot more) nearly all trusts operate as if they have an in-house agency for overtime. The rates are set at given points, and this can be less per hour than a normal rate.

    So you can have a senior, highly skilled nurse who might earn 40K a year before tax, but if she works extra hours, she gets paid less per hour than she does on her normal 37.5 hour week. There's no financial incentive to work extra hours, and yet they will because without them patients would suffer.

    That's why you get nurses burning out, retiring early, going to work abroad (many of them might be immigrants working here for a couple of years to upgrade their qualifications, before going out to the middle east and getting paid more), or going completely to more highly paid agency work.

    I don't know what you do for a living, but would you use your highly specialised skills to work extra hours, and get paid less per hour for doing so than your normal time?
     
  4. Kermit

    Wise Guy

    Joined: Oct 27, 2002

    Posts: 2,201

    Location: UK

    many of us in the private sector do work extra hours and often for no extra money, its often expected ;)
     
  5. Pudney

    Soldato

    Joined: Sep 6, 2005

    Posts: 5,172

    Location: Essex

    Amusingly this is incorrect. An independent body sets MPs' salaries.

    It's amusing as the setting of salaries was passed over into the independent body after the expenses scandal (along with expenses and other matters), which is chaired by civil servants. MPs actually have no control over their salaries, which now means people get upset with MPs over their salary increases but MPs can't actually do much about it other than getting rid of the independent body and taking back control. But MP control was part of the reason for the expenses scandal, which people rightly got upset about...
     
  6. Nasher

    Capodecina

    Joined: Nov 22, 2006

    Posts: 11,857

    haha..."independent"

    My arse.

    It was to begin with, but MPs got those civil servants removed and installed ex-MPs and their mates. Because they kept recommending what they didn't want to hear. It's a front basically.
     
  7. Minstadave

    Capodecina

    Joined: Jan 8, 2004

    Posts: 24,071

    Location: Rutland

    I'm not sure the solution to the NHS is to ask people to work for free. Its a lovely idea though.
     
  8. Minstadave

    Capodecina

    Joined: Jan 8, 2004

    Posts: 24,071

    Location: Rutland

    MPs do seem to do disproportionately well out of this "independent body" - 17.7% increase since 2010.
     
  9. Kermit

    Wise Guy

    Joined: Oct 27, 2002

    Posts: 2,201

    Location: UK

    I wasn't suggesting that.

    I have however noticed a tendancy for consultants (surgeons) that often work 2 or 3 days for the NHS and the other days private which seems a bit like going for one steady salary and pension (NHS) then creaming what they can from the likley more lucrative private sector. I think there needs to be a case where Doctors (& dentists) commit to 100% of their working time to the NHS or go 100% private, no middle ground.

    I wouldn't be surprised if some of the "private" work is contracted in locum work for the NHS although I say that with no conviction.
     
  10. tamzzy

    Sgarrista

    Joined: May 26, 2012

    Posts: 8,577

    you say that as if public sector workers don't put in extra unpaid hours too?
    doctors get paid at 48h/wk
    outside of official "work" work, everything else is unpaid.
    there's no such thing as finishing on time, with the number of rota gaps too...i work an extra 1-1.5h a day (on top of an 8-5 working day) on average. my friend goes into work at 5am (he's supposed to start at 9am).
    exams and studying for said exams (i know other industries have these too)
    portfolio work - audits, all done in own time unpaid, teaching junior colleagues/medical students, research/publications etc
    (some) courses that won't be reimbursed by hospital nor "health education" england

     
  11. Nasher

    Capodecina

    Joined: Nov 22, 2006

    Posts: 11,857

    Yes while everyone else has been denied anything since about 2008. To claim it's independent or not bias is just ridiculous.
     
  12. D.P.

    Caporegime

    Joined: Oct 18, 2002

    Posts: 29,902

    Indeed, I get precisely $0 an hour working over time.

    I dont; think think paying nurses more for over-time is the issue, there needs to be more staff and no need for over-time. In-fact, the mere concept of over-time for someone working in health care is really just bonkers.
     
  13. Tony Edwards

    Wise Guy

    Joined: Feb 4, 2018

    Posts: 2,173

    It really is quite scandalous how governments treat public service workers. It almost seems thoughtless if you didnt know that a lot of thought went into those problems.
     
  14. OLDPHART

    Soldato

    Joined: Jun 19, 2004

    Posts: 6,490

    Location: n/east-the toon

    Not GP's as they had a nice little perk of being able to see private patients in a NHS funded practice.

    This will stop under the new contract.
     
  15. Minstadave

    Capodecina

    Joined: Jan 8, 2004

    Posts: 24,071

    Location: Rutland

    May be possible but certainly not common place. The vast majority of GPs dont do private work.
     
  16. SPG

    Soldato

    Joined: Jul 28, 2010

    Posts: 5,225

    Dr`s, GP`s earn enough as is.

    Put the money into training, stop the stupid requirement for Nurses to need a degree for anything more than putting on a plaster.

    Ban private healthcare in the UK, you want to pay for it then go to America or some other backwater without a public health system and take the greedy consultants along with you.
     
  17. Amp34

    Caporegime

    Joined: Jul 25, 2005

    Posts: 28,521

    Location: Canada

    If you stop treating doctors/nurses like shift workers (i.e. working x hours, then over that you get paid more) then it means (in the private sector) that you're salaried. If you're salaried you usually have a nominal weekly hour amount, but when you're busy you may well work over those hours for no extra pay...

    Choose wisely. You can't do bank/overtime if you're salaried...
     
  18. Pudney

    Soldato

    Joined: Sep 6, 2005

    Posts: 5,172

    Location: Essex

    The Board has one ex-MP and has since the inception. Because the Act that created IPSA required there to be one ex-MP. The members are:

    1. An experienced charity executive,
    2. The former Head of Audit at Grant Thornton (ex auditor required by the Act),
    3. A former Justice of the High Court (a member who has held high judicial office required by the Act),
    4. An ex-Lib Dem MP (an ex-MP required by the Act),
    5. The Chairman of Resolver, the company that provides access to free and easy dispute resolution e.g. PPI claims,
    6. A senior Civil Servant.
    Who else do you expect to benefit from IPSA? The body's only function is to oversee and regulate MPs' pay and expenses. Literally no-one else is going to benefit from the body.

    I get anger from public servants about pay, but vent your frustrations the right way.
     
  19. Evangelion

    Capodecina

    Joined: Dec 29, 2007

    Posts: 21,619

    Location: Adelaide, South Australia

    Doctors, no. Nurses, yes.
     
  20. heeeed

    Hitman

    Joined: Dec 11, 2002

    Posts: 658

    Location: Newcastle

    Actually they are specifically not allowed to offer private services to their patients, and would be a breach of the GMS contract. The private work they are allowed to do is simply form filling in stuff like insurance reports which is generally poorly paid and nobody likes to do it. It’s done in many ways to help patients as if you had a private occupational health doctor these things would cost a lot more, and everyone’s insurance would go up.