Junior doctors protest
September 28, 2015 2:48 PM Subscribe
So are there lots of private doctors and the goal is just to drive people out of the NHS until it doesn't work at all anymore and can easily be abolished? Or is it "merely" a cost-saving measure?
I have to say, I was shocked to see that as a senior secretary I actually make almost as much as what the junior doctors say they'll end up with. Now, I'm a pretty darn good secretary and can turn my hand to many things that would normally have to be sent out to higher-paid people, but - as long as we're saying that pay should be differentiated by job at all - I would tend to assume that an actual medical doctor should make at least somewhat more than I do. I mean, if I mess up the website, no one actually dies.
posted by Frowner at 3:02 PM on September 28, 2015 [9 favorites]
I have to say, I was shocked to see that as a senior secretary I actually make almost as much as what the junior doctors say they'll end up with. Now, I'm a pretty darn good secretary and can turn my hand to many things that would normally have to be sent out to higher-paid people, but - as long as we're saying that pay should be differentiated by job at all - I would tend to assume that an actual medical doctor should make at least somewhat more than I do. I mean, if I mess up the website, no one actually dies.
posted by Frowner at 3:02 PM on September 28, 2015 [9 favorites]
I admit I am confused about a doctor who regularly works in A&E complaining that they have to work during antisocial hours. (I understand complaining about not getting a pay supplement for working overnight, but that seems like a really basic part of working on emergency patients.)
It does sound like a completely horrid deal that is going to cause a lot of pain to the NHS and patients, but there are some weird choices of people to quote there.
posted by jeather at 3:09 PM on September 28, 2015
It does sound like a completely horrid deal that is going to cause a lot of pain to the NHS and patients, but there are some weird choices of people to quote there.
posted by jeather at 3:09 PM on September 28, 2015
Funny how these right wing "capitalist" types seem to have no understanding that the job market is still capitalist, even for public sector employees.
posted by Zalzidrax at 3:40 PM on September 28, 2015 [3 favorites]
posted by Zalzidrax at 3:40 PM on September 28, 2015 [3 favorites]
So... Please correct me if I'm wrong here, conservatives throw a hissy when they discover that the rules they voted for other people, also apply to them? Well, that's about the saddest thing ever.
posted by evilDoug at 3:45 PM on September 28, 2015 [9 favorites]
posted by evilDoug at 3:45 PM on September 28, 2015 [9 favorites]
So... Please correct me if I'm wrong here, conservatives throw a hissy when they discover that the rules they voted for other people, also apply to them? Well, that's about the saddest thing ever.
No, here's the saddest thing ever: (pardon me while I put on my tinfoil conspiracy hat...)
If driving down wages and increasing costs is a way to move the best doctors offshore, then it's also a way (a few years from now) to demonstrate that public healthcare has failed, and maybe Britain should consider moving toward a move privatized solution.
posted by parliboy at 4:35 PM on September 28, 2015 [13 favorites]
No, here's the saddest thing ever: (pardon me while I put on my tinfoil conspiracy hat...)
If driving down wages and increasing costs is a way to move the best doctors offshore, then it's also a way (a few years from now) to demonstrate that public healthcare has failed, and maybe Britain should consider moving toward a move privatized solution.
posted by parliboy at 4:35 PM on September 28, 2015 [13 favorites]
you knew i was a scorpion when you let me climb on your back, etc., etc.
posted by indubitable at 4:37 PM on September 28, 2015 [4 favorites]
posted by indubitable at 4:37 PM on September 28, 2015 [4 favorites]
Seems like straight of of the US playbook: "Starve the beast", undermine public services until we don't believe in them anymore and you can get away with cutting them more because no one believes in them.
Fuck this shit. The whole point of having an organized society is so we can share resources and take care of each other. There is otherwise no point.
posted by latkes at 6:39 PM on September 28, 2015 [27 favorites]
Fuck this shit. The whole point of having an organized society is so we can share resources and take care of each other. There is otherwise no point.
posted by latkes at 6:39 PM on September 28, 2015 [27 favorites]
No, here's the saddest thing ever: (pardon me while I put on my tinfoil conspiracy hat...)
If driving down wages and increasing costs is a way to move the best doctors offshore, then it's also a way (a few years from now) to demonstrate that public healthcare has failed, and maybe Britain should consider moving toward a move privatized solution.
I really don't think that's TFH territory at all. It's literally what they've been doing over here in the US. Prove that government doesn't work by doing a shitty job of it. At this point, I think the burden of proof is on those who think otherwise -- that they're actually making a good faith effort to make things better.
posted by tonycpsu at 7:24 PM on September 28, 2015 [5 favorites]
If driving down wages and increasing costs is a way to move the best doctors offshore, then it's also a way (a few years from now) to demonstrate that public healthcare has failed, and maybe Britain should consider moving toward a move privatized solution.
I really don't think that's TFH territory at all. It's literally what they've been doing over here in the US. Prove that government doesn't work by doing a shitty job of it. At this point, I think the burden of proof is on those who think otherwise -- that they're actually making a good faith effort to make things better.
posted by tonycpsu at 7:24 PM on September 28, 2015 [5 favorites]
I'm a bit confused by this:
The Department of Health decided earlier this week to impose the new contract after the British Medical Association’s junior doctors committee refused to re-enter negotiations over it, despite the independent Doctors’ and Dentists’ remuneration review body recommending the new system.
My American university employer is unionized, so I'm familiar with brinksman's negotiation. Our contract ran out in August and we're only now, three days into the beginning of the semester, getting a contract ratified. If the DoH can impose a new contract without consent, how does the BMA's choosing not to negotiate help their cause?
posted by pwnguin at 8:35 PM on September 28, 2015
The Department of Health decided earlier this week to impose the new contract after the British Medical Association’s junior doctors committee refused to re-enter negotiations over it, despite the independent Doctors’ and Dentists’ remuneration review body recommending the new system.
My American university employer is unionized, so I'm familiar with brinksman's negotiation. Our contract ran out in August and we're only now, three days into the beginning of the semester, getting a contract ratified. If the DoH can impose a new contract without consent, how does the BMA's choosing not to negotiate help their cause?
posted by pwnguin at 8:35 PM on September 28, 2015
I do think it's a shame that the Guardian didn't provide the actual numbers, however. So...
"Junior doctors in their first year of postgraduate foundation training earn a basic salary of around £22,636. The basic salary in Foundation Year 2 increases to £28,076. They also receive a supplement or banding according to the rotation. This is based on the intensity of work and the number of hours worked in excess of 40 hours per week and/or work outside the hours of 7am - 7pm, Monday - Friday."
That deal does not strike me as particularly generous for junior doctors who have already spent years qualifying. It's roughly comparable for renumeration for newly qualified teachers and solicitors. The argument that doctors have consistently made is that the proposed contract changes would result in an effective pay cut for those working antisocial hours. I must admit that I've not looked at the numbers in great depth as yet, but on the face of it the outcry seems reasonable, for the reasons outlined in the article.
posted by howfar at 12:00 AM on September 29, 2015 [3 favorites]
"Junior doctors in their first year of postgraduate foundation training earn a basic salary of around £22,636. The basic salary in Foundation Year 2 increases to £28,076. They also receive a supplement or banding according to the rotation. This is based on the intensity of work and the number of hours worked in excess of 40 hours per week and/or work outside the hours of 7am - 7pm, Monday - Friday."
That deal does not strike me as particularly generous for junior doctors who have already spent years qualifying. It's roughly comparable for renumeration for newly qualified teachers and solicitors. The argument that doctors have consistently made is that the proposed contract changes would result in an effective pay cut for those working antisocial hours. I must admit that I've not looked at the numbers in great depth as yet, but on the face of it the outcry seems reasonable, for the reasons outlined in the article.
posted by howfar at 12:00 AM on September 29, 2015 [3 favorites]
It's not about the numbers, the hours, etc - it really isn't.
If you look at the general direction of travel since the Tories came into power in 2010, particularly since the Health and Social Care Act of 2012, it's all about forcing the general public to accept private healthcare. Oliver Letwin, Minister for Something Mysterious (seriously, he's a senior minister but no-one seems to know what he does), wrote a leaflet back in 1988 that outlines how to privatise most public services including the NHS - the Health and Social Care Act of 2012 follows that blueprint closely.
Nick Seddon, Cameron's own healthcare advisor, comes from Circle, a private health provider.
The CQC, one of the "health market monitors" is stuffed full of either Tories, or Mckinsey/Sachs/ management consultants, or consultants from the big four accountancy firms. The Dept of Health is particularly stuffed full of management consultants. Mckinsey have in fact published a paper on how to introduce charges into Northern Ireland.
The Tories are privatising *everything*, with zero evidence it benefits anyone (apart from those taking over the public sector service). So this has to fit into that model.
As others have said - it's a simple plan: make the NHS really crap, then throw up your hands and say "pff, just doesn't work, we've got all these management consultants involved, and even they can't make this work. we'll just have to pay".
So stand-by for the vast majority of the population receiving "healthcare" from untrained folks working for peanuts for the likes of G4S, Serco and others - whilst the 1% receive quality healthcare from the few remaining doctors.
Oh, and of course, this happens without any mandate.
There is another side-thought: this is all being brought in by a bunch of men, supposedly well-educated (Eton/v expensive private school, Oxbridge) - who you would have thought would have been taught the value of consensus, reason, and logic. Instead, it seems that all their fantastic education has taught them is the value of obtaining power and how to use it for ones own good. Not that good education then is it?
RE: junior doctors - and their contracts - it's just another case of "first they came for ... then they came for ...". So v best of luck to the junior doctors. Fight!
posted by rolandroland at 1:46 AM on September 29, 2015 [9 favorites]
If you look at the general direction of travel since the Tories came into power in 2010, particularly since the Health and Social Care Act of 2012, it's all about forcing the general public to accept private healthcare. Oliver Letwin, Minister for Something Mysterious (seriously, he's a senior minister but no-one seems to know what he does), wrote a leaflet back in 1988 that outlines how to privatise most public services including the NHS - the Health and Social Care Act of 2012 follows that blueprint closely.
Nick Seddon, Cameron's own healthcare advisor, comes from Circle, a private health provider.
The CQC, one of the "health market monitors" is stuffed full of either Tories, or Mckinsey/Sachs/ management consultants, or consultants from the big four accountancy firms. The Dept of Health is particularly stuffed full of management consultants. Mckinsey have in fact published a paper on how to introduce charges into Northern Ireland.
The Tories are privatising *everything*, with zero evidence it benefits anyone (apart from those taking over the public sector service). So this has to fit into that model.
As others have said - it's a simple plan: make the NHS really crap, then throw up your hands and say "pff, just doesn't work, we've got all these management consultants involved, and even they can't make this work. we'll just have to pay".
So stand-by for the vast majority of the population receiving "healthcare" from untrained folks working for peanuts for the likes of G4S, Serco and others - whilst the 1% receive quality healthcare from the few remaining doctors.
Oh, and of course, this happens without any mandate.
There is another side-thought: this is all being brought in by a bunch of men, supposedly well-educated (Eton/v expensive private school, Oxbridge) - who you would have thought would have been taught the value of consensus, reason, and logic. Instead, it seems that all their fantastic education has taught them is the value of obtaining power and how to use it for ones own good. Not that good education then is it?
RE: junior doctors - and their contracts - it's just another case of "first they came for ... then they came for ...". So v best of luck to the junior doctors. Fight!
posted by rolandroland at 1:46 AM on September 29, 2015 [9 favorites]
rolandroland: "supposedly well-educated (Eton/v expensive private school, Oxbridge) - who you would have thought would have been taught the value of consensus, reason, and logic. Instead, it seems that all their fantastic education has taught them is the value of obtaining power and how to use it for ones own good. Not that good education then is it?"You don't go to Oxbridge for the education, you go there for the connections.
posted by brokkr at 2:36 AM on September 29, 2015 [1 favorite]
The whole point of having an organized society is so we can share resources and take care of each other.
There is no such thing as society.posted by grouse at 3:50 AM on September 29, 2015 [4 favorites]
—Margaret Thatcher
I assume that British doctors don't have the staggering amount of debt that US doctors do, but still, this seems like pretty low pay (esp for 10+ years). At what point can someone leave for private practice? Can you moonlight while you're a junior doctor?
posted by n. moon at 5:28 AM on September 29, 2015
posted by n. moon at 5:28 AM on September 29, 2015
I assume that British doctors don't have the staggering amount of debt that US doctors do, but still, this seems like pretty low pay (esp for 10+ years). At what point can someone leave for private practice? Can you moonlight while you're a junior doctor?
If you literally have time to moonlight as a junior doctor doing 48 hour standard weeks you must have some magical time compression device. At which point you should commercialize that technology and get even richer instead.
posted by Talez at 6:18 AM on September 29, 2015
If you literally have time to moonlight as a junior doctor doing 48 hour standard weeks you must have some magical time compression device. At which point you should commercialize that technology and get even richer instead.
posted by Talez at 6:18 AM on September 29, 2015
I moonlit when I was a resident working far more hours than that. It wasn't super pleasant, but the extra money made my life a lot more livable. I'm not recommending it or suggesting that it's a good fix to a bad system--just curious if there's any recourse for people who may not have the option to leave the country or go to private practice right away.
posted by n. moon at 6:42 AM on September 29, 2015
posted by n. moon at 6:42 AM on September 29, 2015
It's also worth saying that all the junior doctors I know do lots of unpaid overtime beyond the 48 hours they're meant to do - mostly because if they don't, they feel that patients' health will be at risk.
posted by adrianhon at 6:44 AM on September 29, 2015 [1 favorite]
posted by adrianhon at 6:44 AM on September 29, 2015 [1 favorite]
Oh, thanks, adrianhon, that makes sense. Pretty hard to schedule other things if your shifts turn out to be a lot longer/unpredictable.
posted by n. moon at 6:52 AM on September 29, 2015
posted by n. moon at 6:52 AM on September 29, 2015
I had a huge angry rant written here but it was more about me venting and less about adding to the conversation.
Basically: juniors usually moonlight within their own department, covering rota gaps. They may or may not be paid for this - we have an "emergency cover" clause in our contracts designed for unexpected sickness but misused to make people cover empty slots. I have been in departments where I and one other colleague provided 24/7 resident cover between us for several months - ie an old school 1:2 rota. I was being paid a 1b, ie "less than 48 hours a week with occasional out of hours cover"; the hours I was actually doing were completely illegal. When it came to diary carding (checking rota compliance) HR said the exercise wasn't valid because only two of us had completed it. There were only two of us, period. That's not an unusual or particularly remarkable story.
Juniors have had a huge amount of shit thrown at them over the years. I lived through MMC, saw a third of my cohort of middle-grade doctors basically told to fuck off out of medicine (they substantially cut the number of posts, eliminated a whole training grade overnight and just ripped up our existing contracts) - that's when the emigration really started, it was unheard of before then but we all, all looked into where we could possibly go to if we were one of the unlucky ones who ended up with no job (my husband still sings "Oh Canada" when I'm moaning about work, because that was my backup plan). Luckily I did get one of the 13 jobs in my specialty in the whole of the UK, albeit several hundred miles away from my friends and family. Most of my friends went to Aus and NZ.
I also saw 25% knocked off my pension last April, overnight (and a near doubling in my contributions). After all, austerity.
I earned more per hour as a medical secretary in my university summer holidays than I do now, at the very top of the registrar payscale. When I see the phlebotomists starting work at 7am, as I am just finishing a nightshift covering a tertiary renal centre, I know that they are earning substantially more than me per hour. My SHO last night worked out she was earning less than the London living wage.
Given that, why the fuck should we come in every Saturday morning to do a routine outpatient clinic? (Which is what is being suggested by Jeremy Hunt - the emergency work is already very much 24/7). Why wouldn't we want more of a work/life balance if we're being paid the same as the cleaners?
It isn't the cash itself, it is the constant message that we're disposable and they don't give a single shit about what happens to us as long as the work gets done. We've had enough. Morale is at absolute rock bottom at the minute. We are beginning to realise that the only way to get some traction is for the work to NOT get done for a change, ie we need to strike.
posted by tinkletown at 7:34 AM on September 29, 2015 [16 favorites]
Basically: juniors usually moonlight within their own department, covering rota gaps. They may or may not be paid for this - we have an "emergency cover" clause in our contracts designed for unexpected sickness but misused to make people cover empty slots. I have been in departments where I and one other colleague provided 24/7 resident cover between us for several months - ie an old school 1:2 rota. I was being paid a 1b, ie "less than 48 hours a week with occasional out of hours cover"; the hours I was actually doing were completely illegal. When it came to diary carding (checking rota compliance) HR said the exercise wasn't valid because only two of us had completed it. There were only two of us, period. That's not an unusual or particularly remarkable story.
Juniors have had a huge amount of shit thrown at them over the years. I lived through MMC, saw a third of my cohort of middle-grade doctors basically told to fuck off out of medicine (they substantially cut the number of posts, eliminated a whole training grade overnight and just ripped up our existing contracts) - that's when the emigration really started, it was unheard of before then but we all, all looked into where we could possibly go to if we were one of the unlucky ones who ended up with no job (my husband still sings "Oh Canada" when I'm moaning about work, because that was my backup plan). Luckily I did get one of the 13 jobs in my specialty in the whole of the UK, albeit several hundred miles away from my friends and family. Most of my friends went to Aus and NZ.
I also saw 25% knocked off my pension last April, overnight (and a near doubling in my contributions). After all, austerity.
I earned more per hour as a medical secretary in my university summer holidays than I do now, at the very top of the registrar payscale. When I see the phlebotomists starting work at 7am, as I am just finishing a nightshift covering a tertiary renal centre, I know that they are earning substantially more than me per hour. My SHO last night worked out she was earning less than the London living wage.
Given that, why the fuck should we come in every Saturday morning to do a routine outpatient clinic? (Which is what is being suggested by Jeremy Hunt - the emergency work is already very much 24/7). Why wouldn't we want more of a work/life balance if we're being paid the same as the cleaners?
It isn't the cash itself, it is the constant message that we're disposable and they don't give a single shit about what happens to us as long as the work gets done. We've had enough. Morale is at absolute rock bottom at the minute. We are beginning to realise that the only way to get some traction is for the work to NOT get done for a change, ie we need to strike.
posted by tinkletown at 7:34 AM on September 29, 2015 [16 favorites]
Thanks, tinkletown--that's just what I was wondering about. Sounds awful--I'm sorry you & your cohort are going through this. Do you have one union that will organize a strike & would then negotiate a new contract?
posted by n. moon at 7:43 AM on September 29, 2015
posted by n. moon at 7:43 AM on September 29, 2015
You don't go to Oxbridge for the education, you go there for the connections.
Plenty of those junior doctors fighting the government went to Oxbridge for their education. Oxbridge may have had the misfortune of counting much of the unpleasantness in government among their alumni, but they're a pretty small fraction of the perfectly decent people that have come out of there.
posted by edd at 7:49 AM on September 29, 2015 [1 favorite]
Plenty of those junior doctors fighting the government went to Oxbridge for their education. Oxbridge may have had the misfortune of counting much of the unpleasantness in government among their alumni, but they're a pretty small fraction of the perfectly decent people that have come out of there.
posted by edd at 7:49 AM on September 29, 2015 [1 favorite]
We have the BMA - they are sort of a union, but since they actually fucking supported MMC and our pensions being raided, I and many other juniors do not trust them at all (they supported those things because they didn't affect BMA top brass, and they were keen to avoid upsetting the government).
There is a consultant contract negotiation going on at the minute which WILL affect BMA grandees, so perhaps they will stick up for us at the same time. Or perhaps they'll throw us under a bus. I'm not holding my breath. The social media stuff (#I'minworkJeremy, the protests last night, etc) seem to be getting more attention than the halfhearted BMA press releases have.
The other option is to join Unite or Unison, but they have so many other members affected by even worse cuts to public spending that I'm not sure how much energy they would devote to doctors (and rightly so - we aren't badly paid in terms of total salary, it's just the final straw for lots of us).
posted by tinkletown at 8:26 AM on September 29, 2015
There is a consultant contract negotiation going on at the minute which WILL affect BMA grandees, so perhaps they will stick up for us at the same time. Or perhaps they'll throw us under a bus. I'm not holding my breath. The social media stuff (#I'minworkJeremy, the protests last night, etc) seem to be getting more attention than the halfhearted BMA press releases have.
The other option is to join Unite or Unison, but they have so many other members affected by even worse cuts to public spending that I'm not sure how much energy they would devote to doctors (and rightly so - we aren't badly paid in terms of total salary, it's just the final straw for lots of us).
posted by tinkletown at 8:26 AM on September 29, 2015
Mod note: A couple of comments deleted. If you want to say something about Cambridge vs Oxford that is pertinent to the linked article it's better to go ahead and make it clear what you are talking about rather than a terse cryptic snark.
posted by taz (staff) at 4:25 AM on September 30, 2015
posted by taz (staff) at 4:25 AM on September 30, 2015
Cameron, Osborne, May, Hammond, Gove and Hunt are all Oxford educated. I think that there are two Cambridge educated members of the Cabinet, but none in the great offices of state, or really even in the more senior Cabinet jobs. The same pattern can be found elsewhere.
Cambridge is a great university that happens to be a hotbed of privilege and advantage. Oxford is a hotbed of privilege and advantage that happens to be a very good university. "Oxbridge" is a lazy shorthand employed by our Oxford dominated media to pretend that what we have is a cultural problem with elitism, rather than a specific cabal of privileged individuals dominating our country. The problem is not "Oxbridge". The problem is Oxford.
posted by howfar at 10:41 AM on September 30, 2015 [2 favorites]
Cambridge is a great university that happens to be a hotbed of privilege and advantage. Oxford is a hotbed of privilege and advantage that happens to be a very good university. "Oxbridge" is a lazy shorthand employed by our Oxford dominated media to pretend that what we have is a cultural problem with elitism, rather than a specific cabal of privileged individuals dominating our country. The problem is not "Oxbridge". The problem is Oxford.
posted by howfar at 10:41 AM on September 30, 2015 [2 favorites]
There is a very old saying, the history of which is interesting (and, if you're a Catholic in particular, horrifying): "Cambridge makes martyrs. Oxford burns them."
Plus ça change.
posted by howfar at 10:43 AM on September 30, 2015 [1 favorite]
Plus ça change.
posted by howfar at 10:43 AM on September 30, 2015 [1 favorite]
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It's almost like making a deal with the devil is a bad thing. How any health worker in their right mind could think that David Cameron wasn't going to fuck them is beyond me. Maybe they thought they'd fuck the cleaners and lunch ladies with privatization and minimum wage contracts and leave the highly trained people alone?
posted by Talez at 2:59 PM on September 28, 2015 [32 favorites]