Oo! Excellent point! It'd really sell those fa... I mean serious offenses that require a penalty if a doctor rushed on the pitch and supported the case. They should make sure they wear white coats and those headband lights to increase believability when they do that. That'd make sure they earn their bux for the week.
General / Off-Topic junior doctors - any facts?
- Thread starter beelbeebub
- Start date
A Junior Dr. is someone qualified in medicine but lacking the specialised training for specialised posts, such as GP, Surgeon, Physician, Psychiatry and so on. (There's also paediatrics, obstetrics, Haematology. The list goes on.)
Their hours are a matter for the consultant under whom they work. He is a bit like a slave driver. He expects them to be perfect, to have the instant answer to every and any questions, (Watching a Jr. Dr squirm while a bad tempered consultant grills them is not a pleasant experience for those of us with an ounce of empathy). They are also expected to preform flawlessly, never making mistakes and never having to call upon the consultant unless it is a case so interesting and unusual that the consultant has to know.
In practice, the nasty, EU has intervened and and a few years ago, outlawed continual shifts of longer than 48 hours without a break. Previously, some Jr. Drs could find themselves on their feet up to 100+ hours. But as a rather free thinking, old consultant I once had the displeasure of being near once said, that's what prescription pads are for!
It's a sad reality that what is really happening in the NHS as in most spheres is clouded in mystery. This results in situations such as these where we, the public are being asked to decide based entirely on emotive argument. (Poor Drs save our lives, Gov wants to cut costs because the country is broke and it's all our fault!).
Hence the joke continues.
Carry on laughing. Hopefully one side or the other will eventually grow up and satrt treating us, the general public like intelligent adults. But don't hold your breath.
sdf
Here is some real data, albeit from a single source.
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Here's the TLDR
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He lists his professional expenses (memberships to various organisations, training fees, insurance etc) as around £4700 per year of which some £2000 is allowable before tax expenditure and a further £1400 of which is (I assume) optional exam revision courses.
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He also says he gets a grant of £700 from his job for studying which goes towards a course (not sure if optional or not).
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His pay is:
Basic Pay £31,838
London weighting £2,162
Banding: 1A, 50%, (as far as I can work out this means his basic salary is boosted by 50% to account for his shift patterns)
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This equates to a gross of £49k
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His working rota is
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Standard Day. 08:30 – 17:00
Long Day. 08:30 – 21:00
Night 20:30 – 09:30
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Bank holidays are given as off if he is on a Standard day, but not for a LD or night shift.
Not shown: Annual leave (13.5 days) that can be taken on any day that is ‘Std’
Analysis:
Weeks = 26
Average (mean) hours per week = 46.75
Weekends worked = 6
Most hours worked in a week = 73
Fewest hours worked in a week = 25.5
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He works an average of just under 47hours a week giving an hourly rate of just over £20/hr.
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I did some more analysis on his rota and got some other issues.
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Out of the 25 Monday-Sunday weeks, 7 have hour totals above 48hours
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If we look at the "rolling" 7 day hours, 59 out of 180 days saw our doctor work more than 48hours over the preceding 7 days.
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So this doctor could say I work 75 hours a week for £942 a week, or £12.56 an hour (pretty poor).
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Alternatively, in his lightest 7 day stretch he worked 21.5 hours for £942 or £43.80 per hour (pretty good!)
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So simple hour comparisons are not really a great way to look at this issue.
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Ok, so lets take his £20/hr as a reasonable salary and say that he worked and was paid for 32hours a week. That would give him a salary of approx. £33k per year. Not too bad and crucially, very safe.
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In order to make up for the fact he is working 32 instead of 48 (or 47) hours a week we would need to employ another JD. In this case 1/2 a JD (in reality 3JD's would do the work of 2 current JD's) which would cost another £16k or so per year for the extra 16hours. This means that this JD's hours would be covered for a cost of some £48k (i.e. the same as his salary is now) but crucially in a much safer way.
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Looking at the chap above, I'm guessing that it would take 4 JD like him to provide 24/7 cover. This is a cost of some £200k per year in wages (if they are all like him).
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With my proposal the same 24/7 could be provided by 6 JD's each earning £33k (therefore costing the same £200k per year) but each JD would only be working 32hours a week. As there are more people covering the same job the effect of sickness or other vacancy is much less severe there are now 5 people sharing 1/6 extra hours rather than 3 sharing 1/4.
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The key thing is that JD's will need to get used to being paid less (but working less too).
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The argument about providing 24/7 NHS on the same budget is totally valid, however it does not automatically follow that the new contracts are a threat to patient safety.
Here is some real data, albeit from a single source.
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Here's the TLDR
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He lists his professional expenses (memberships to various organisations, training fees, insurance etc) as around £4700 per year of which some £2000 is allowable before tax expenditure and a further £1400 of which is (I assume) optional exam revision courses.
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He also says he gets a grant of £700 from his job for studying which goes towards a course (not sure if optional or not).
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His pay is:
Basic Pay £31,838
London weighting £2,162
Banding: 1A, 50%, (as far as I can work out this means his basic salary is boosted by 50% to account for his shift patterns)
.
This equates to a gross of £49k
.
His working rota is
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Standard Day. 08:30 – 17:00
Long Day. 08:30 – 21:00
Night 20:30 – 09:30
.
Bank holidays are given as off if he is on a Standard day, but not for a LD or night shift.
Not shown: Annual leave (13.5 days) that can be taken on any day that is ‘Std’
Analysis:
Weeks = 26
Average (mean) hours per week = 46.75
Weekends worked = 6
Most hours worked in a week = 73
Fewest hours worked in a week = 25.5
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He works an average of just under 47hours a week giving an hourly rate of just over £20/hr.
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I did some more analysis on his rota and got some other issues.
.
Out of the 25 Monday-Sunday weeks, 7 have hour totals above 48hours
.
If we look at the "rolling" 7 day hours, 59 out of 180 days saw our doctor work more than 48hours over the preceding 7 days.
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So this doctor could say I work 75 hours a week for £942 a week, or £12.56 an hour (pretty poor).
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Alternatively, in his lightest 7 day stretch he worked 21.5 hours for £942 or £43.80 per hour (pretty good!)
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So simple hour comparisons are not really a great way to look at this issue.
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Ok, so lets take his £20/hr as a reasonable salary and say that he worked and was paid for 32hours a week. That would give him a salary of approx. £33k per year. Not too bad and crucially, very safe.
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In order to make up for the fact he is working 32 instead of 48 (or 47) hours a week we would need to employ another JD. In this case 1/2 a JD (in reality 3JD's would do the work of 2 current JD's) which would cost another £16k or so per year for the extra 16hours. This means that this JD's hours would be covered for a cost of some £48k (i.e. the same as his salary is now) but crucially in a much safer way.
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Looking at the chap above, I'm guessing that it would take 4 JD like him to provide 24/7 cover. This is a cost of some £200k per year in wages (if they are all like him).
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With my proposal the same 24/7 could be provided by 6 JD's each earning £33k (therefore costing the same £200k per year) but each JD would only be working 32hours a week. As there are more people covering the same job the effect of sickness or other vacancy is much less severe there are now 5 people sharing 1/6 extra hours rather than 3 sharing 1/4.
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The key thing is that JD's will need to get used to being paid less (but working less too).
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The argument about providing 24/7 NHS on the same budget is totally valid, however it does not automatically follow that the new contracts are a threat to patient safety.
Read that back again.
Fewer doctors working. Fewer medical experts covering hospitals. Fewer people qualified and able to make fast decisions when someone in a cardiac ward crashes, or when there has been a serious motorway accident.
Not only are doctors supposedly going to be working less but more out of work hours are supposedly covered (weekends, evenings).
How is it possible to do this without compromising patent and doctor safety?
I run a small hedgehog hospital, it is staffed by one person Monday to Friday 24hrs, closed at weekends making for 120hours work a week.
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In order to do this I employ 2 people.
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Each works 60 hours a week (12hr shift every day) and is paid £60k per year (this works out at around £20 per hour). My wage bill is 120k.
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As each doctor is working 60hrs a week, they are very tired and make mistakes and I have aspirations about opening at weekends too.
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Step 1: I change the contracts so each employee is employed for 30hours a week and is paid £30k. This is the same rate per hour as before (£20ish) and I employ 4 people at the same overall cost of £120k.
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Each person works 5 x 6hr shifts for a total of 30h a week, so they are fresh and make no mistakes.
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So now my hospital is still costing the same and much safer. My employees are paid less, but still a decent wage plus they have loads more free time unlike my old employees who had pots of cash but no time to spend it.
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Now comes the move to 7day opening.
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Let's assume I'm tight and will spend no money. I just make my workers work more hours.
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So now my workers work 42h a week for the same money (I'm very persuasive and they do love working with hedgehogs). Their hourly rate has dropped from £20 to around £14, so they are worse off and they lose their weekends.
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BUT, they are still working less hours than my original 2 overworked employees. If I'd played the same trick with my original 2 they would be working insane 84 hour weeks (and their hourly rate would also drop to around £14).
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of course, if I was a more generous employer I would stump up the extra £50k to employ 2 extra people (one at part time hours) to cover the weekend without making my hedgehog loving employees work more hours for less money.
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Here is my critical point. At every point the hours worked under the new system are lower than the old system, even when I pile on extra weekend hours for no extra pay. So hedgehog safety is improved.
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The losers are the employees who in the first instance lose absolute pay from £60k to £30k but they do still earn a decent wage (better than most) and work a very light 30hr week (shorter then most). Might be difficult to get sympathy for that one.
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In the second instance they also have to take a per hour cut, that totally sucks 100%, but even then with the additional hours, the are still working fewer hours than the original two so from a hedgehog safety point of view its better.
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Obviously my simple example excludes effects like my original pair have the entire weekend to sleep, whilst my new 4 work every day with no break. This is an anomaly caused by me keeping the numbers simple. In a real situation with dozens or hundreds of employees the rotas would allow for days off etc. It also ignores the effect of talented hedgehog doctors deciding that £30k isn't enough even when taking into account the low hours so decide to become city bankers or move to the US to become cosmetic hedgehog surgeons in LA (bet that's actually a thing).
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As I said i have every sympathy with the BMA argument that the gov shouldn't try to increase the nhs opening hours without electing to pay more. If they try to do so it will be at the expense of the work force. If the gov wants more hours, the least it can do is stump up some of the extra cash needed even if the workforce also has to make some sacrifices.
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Its even likely that these contacts are the first step.
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However, if the new contracts (as they appear to) reduce the number of long hours JD will work, I'm not sure how the BMA can claim it's about patient safety. I think it's actually about JD's future pay both in absolute and hourly rate terms, which is also something worth getting angry and going on strike about but maybe harder to get sympathy from the public for.
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People are entitled to around 24 holiday days per year, plus a number of sick days. For two people that's 48 days a year of paid non-work time. Increase your workforce to 4 doctors and that's 96 six days a year.
That's also more work for human resources, more organizational work, recruiting costs, training costs, staff rotas, and other overheads that come from employment. Increased costs at a time of 10% cuts.
Each doctor must be individually insured against mistakes and malpractice. Each doctor needs their own tools and equipment. Each doctor must be individually taught and trained, with each doctor also finding time to specialize in a particular area. Each new doctor must go through a few years of medical training which also costs.
And where are all of these new doctors coming from all of a sudden?
You can not simply increase the workforce but keep the same base pay. Come on.
Please note: There is absolutely no mention of the government increasing our healthcare budget even though we pay less towards it than almost any other OECD nation and almost half of what they pay in the USA (as a proportion of GDP). In fact they are cutting it further.
I am asking you, again, to read your own words and apply mathematical logic.
If you have 60 hours per week of medical coverage, and a new contract is made that reduces that coverage to 40, that means there is 20 fewer hours of medical work being done. This means that there is a 33% drop in coverage.
Unless injuries, accidents, disease, and chronic conditions are also reduced by 33% then doctors will have a shorter time to diagnose and treat conditions during busier times.
That WILL cause an increase in complications, mistakes, and serious compromise of already strained patient care. That WILL, in turn, cause an increase in death and serious long term conditions such as amputations and organ failures.
This is not about the junior doctors, this is about gutting the service and rebuilding it into something more profitable. Unless you're intending to buy shares in a healthcare company then turkeys voting for Christmas springs to mind on this one.
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You're right but the cost remains the same (48 days at £X per day is the same as 96 days at 0.5X per day).
Yes there is potentially more HR effort, although the NHS is already one of the biggest employers in the world, hospital trusts are amongst the biggest employers in their area. It's not a case of the HR dept having to "step up a gear", they are already at the top end of HR. The addition of more staff will casue more work, but the procedures should already be in place to handle a staff of thousands. Things like rotas and scheduling are handled by software I would expect so no extra issues there. However those costs can be offset by (hopefully) less stress/overwork related issues (which are time consuming as they have to be handled individually) amd less impact when someone is ill/holiday/maternity etc. It's not just a case of increacing costs, there would be savings though I concede that the costs would overall increace.
Yes each doctor must be individually insured, but the overall insurance costs of the system are dictated by the likelihood of mistakes over the entire population. If lower hours means fewer mistakes then the overall insurance bill will reduce (or someone will take the profit, but lets ignore that for now). Each doctor also pays less for insurance (as there are now more doctors sharing the burden of fewer mistakes.
As for tools and equipment, I guess personal stuff like a stethoscope maybe, but isn't most of a doctors "tools" (computer, MRI scanner, blood pressure meter, laboratory) provided by his employers and most of it is taken out, used and returned for disposal/sterilization between patients so the number of items is not dictated by the number of doctors but more by the number of patients (which might go up for longer opening but is not related to the contracts)
You are absolutely right though about the cost of training and "producing" these extra doctors would be extra. Increasing the annual "yield" of doctors from medical school would increase the overall cost of training them.
There is also the question of actually getting the doctors to fill the vacancies (which might be harder if the headline wages drop, although you could argue the drop in hours might help increase recruitment) this would take time, at least 5 if not 10 years from £pushing the button" to a meaningful uptick in the supply of doctors. That being said, the lower hours (and in particular the possibility of rehiring women coming back from maternity) might help with retention.
Again you are right, and this "no more cash but open more hours" argument is compelling. It is highly likely that trying to increase opening hours without increasing the budget (to allow more doctors to cover those hours) would result in a drop in quality. it should be fought against, possibly even with strikes.
BUT, the "no more cash but open more hours" argument is not the same as "these new contracts are unsafe".
The BMA argument is that the new contracts are unsafe. The gov has responded by listing things reducing the max average hours from 56 to 48hrs, reducing the max shift length from 14 to 13 hours, reducing the number of consecutive nights or long days from 7 to 5 and so on. Many JD's have accused the gov of lying.
This is what kicked off this thread to begin with. On the face of it the gov position that the new contracts have better protection from long hours seems to be valid yet the JD's say the government is lying. So we have 2 groups saying different things, who do we believe? I've tried to dig up info on the current vs the old contracts. The BMA requires membership to see their briefing papers (I would love for JD to post these so I can see their arguments). The gov ones are visible (but could be biased).
What I can see is that the remaining sticking point with the BMA seems to be not the hours protection in the contract, they are not asking for the averaging time to be reduced, or the number of night shifts to be cut, but the principle that Saturday working be "antisocial hours". If you look at the BBC graphic of the two proposals, the main difference between the gov and BMA is that weekends are all "antisocial" rather than the gov position that Saturdays are "weekdays".
Given the BMA sticking point is not "the hours protection" but "keep Saturday special", how does that square with the "it's about patient safety, the new contract will make JDs work unsafe hours"?
Again, I see your point. Here's my rebuttal.
Under the current system, the max hours a JD can average (i'm not sure how big the "window" is or exactly how it is calculated) is 56 with an absolute max of 72 in a 7 day period. This means that a JD could work a 72hr week, but they would have to work a sub 56 hour week to compensate elsewhere (this then probably results in someone else having to work a 72 hour shift thus perpetuating the cycle).
Without, extensive running of the numbers it is difficult to tell if the new regulations would reduce the total number of hours available. However it is entirely possible that a system could reduce the maximum hours a JD could work whilst keeping the total hours worked the same.
As a simple example (going back to my hedgehog hospital).
I now have my 4 employees working 30hrs a week to give me 24 mon-fri coverage. However, due to a mix up with the rota, Alf works from 00:00 Monday to 06:00 Tuesday, then Betty from 06:00 Tuesday to 10:00 Wednesday. Charlie from 10:00 Wednesday to 16:00 Thursday and Dave from 16:00 Thursday to 24:00 Friday i.e. 4 x 30hr shifts
By the end of each person's 30hr shift they are knackered, hedgehog fatalities skyrocket in the latter half of each shift. My employees demand a limit of 8 hours per shift and no more than 12 hours in any 48 (or similar).
Then I realise my mistake and rota everybody on for a 6 hour shift every day, and hey presto, no more hedgehog mishaps! I've kept the same hours available but reduced the maximum hours any person could work in a given period.
It's not necessary that reducing the maximum hours employees work, reduces the hours available. Essentially what you are trying to do is reduce the peaks and troughs.
I'm 100% for the NHS being free at the point of use, and being a publicly owned and run organization, I would oppose any plans to "sell off" parts (or all) of it.
However, to get back to the main point, I have been able to see the link that the BMA are putting forward that the current strikes are justified because the new contracts would compromise patient safety.
Some of the actions that could be taken once the contracts are in place could compromise patient safety, but equally some actions taken after the new contracts are in place might improve it. The important point is not these contracts, but what happens (or does not happen) down the road.
Would this be the politicians that pushed through the health and social care act in 2012? Didn't get any press on the day it went through. I even went as far as searching the BBC's news site for stories relating to the NHS. The search, on the day the bill went through, simply for "NHS" returned nothing other than a suggestion I might have meant "NHS Reforms". No news stories at all for the NHS on any day is highly unlikely, on the day of such seismic changes being passed I'd say it's impossible.
That bill removes the responsibility for the government to provide healthcare. So now we have a Health Secretary with absolutely zero responsibility for health care but still with the authority to enforce a working contract over a large number of people without them having any say in it.
Think about for that for a while. Authority with no responsibility.
Also consider the risk register for the changes in the NHS has been withheld despite the Information Tribunal ruling that it should be released as it had such huge public interest. The first draft got leaked and outlined that the bill would create many of the problems the NHS is now facing.
Now you said you wanted facts so instead of replying with a wall of text with a whole slew of "maybe this would work" suggestions or hedgehog hospital analysis why not find an example, somewhere in the world, for healthcare system that is more efficient and has across the board better outcomes. I'm not interested in specifics illness outcomes I mean across the board.
You see it'd be so easy just to trial these new JD contracts instead of enforcing sweeping changes so I have to wonder why that hasn't even been tried.
So, absolutely 100%, I'd back the doctors over the politicians.
I've looked around the world and as far as I can see the NHS provides very good care and fantastic value. I'll say that again, the NHS is a world class health provider, too often it seems to be a national sport to do down the NHS, when actually using it can be, if not pleasant, then about as good as you could expect any health care to be.
I don't want the NHS to be privatised or sold off or shut down or anything like that, I have been and am a user of it's services and they have literally been life saving. I believe the NHS should be publicly funded, free at the point of use (and free generally) to all and it should cover the widest possible range of illnesses (including preventative, elderly and mental services) using the most effective drugs, equipment and techniques. It's even such great value, that I wouldn't mind spending more on it and paying more tax.
That being said, the NHS has many issues, some of which can be laid directly at the door of the Conservatives. I believe their "GP lead commissioning" idea was, frankly, stupid. Both Labour and the Conservatives have corked up when it comes to integrating private companies with the NHS and the PFI/PPI initiatives from providing facilities was an absolute shambles, poor value for the tax payer (and that was a Labour led party, albeit egged on by the Conservatives). Funding for the NHS has been cut too much IMHO.
However, the BMA sticking point seems to be that Saturday should not be considered a "core" day, full stop. The sticking point is not that the hour limits are unsafe, in fact the BMA proposal seems to have the same hour limits..
The BMA say the strikes are about patient safety and put out lots of examples of JD's working late and at weekends for long hours, yet it appears that it's really about wanting to keep Saturday and Sunday "time and a half" which would make running the NHS on a the weekend always more expensive (50% more).
I get the argument about not being able to provide 7 day services at 5 day cost, and agree with a lot of it but the BMA are not articulating things well.
Right, lets get this down to what happened. Two parties ended up at a negotiating table, one I'll call the BMA although they represent the Junior Doctors as well, the other is the Health Secretary (HS).
The HS side has no responsibility for health care but absolute power. The BMA side disagreed with the new contract and raised concerns over patient safety. The talks very rapidly reached an impasse at which point the HS side imposed their will and forced the contracts on the BMA side.
The BMA are now being blamed for this situation.
Now regardless of whether the BMA side had a valid point or not the safe thing to do would be a trial, initially on a small scale, to establish if the HS sides changes are viable. For one thing it'd trounce any BMA doubts if there were overwhelming evidence the changes worked. Even if the evidence was indecisive it'd still be worth expanding the trial.
Again regardless of the trial outcome or any impact that had on the BMA it should have gone to trial simply on the basis that making big changes to a nationally funded health care system should be done with caution. These are literally life and death decisions, they certainly shouldn't be decided without any attempt at an evidence based approach.
But then I don't believe making a co-author of a book about privatising the NHS the Health Secretary leaves us in much doubt of the direction the NHS is being lead.
The HS side has no responsibility for health care but absolute power. The BMA side disagreed with the new contract and raised concerns over patient safety. The talks very rapidly reached an impasse at which point the HS side imposed their will and forced the contracts on the BMA side.
The BMA are now being blamed for this situation.
Now regardless of whether the BMA side had a valid point or not the safe thing to do would be a trial, initially on a small scale, to establish if the HS sides changes are viable. For one thing it'd trounce any BMA doubts if there were overwhelming evidence the changes worked. Even if the evidence was indecisive it'd still be worth expanding the trial.
Again regardless of the trial outcome or any impact that had on the BMA it should have gone to trial simply on the basis that making big changes to a nationally funded health care system should be done with caution. These are literally life and death decisions, they certainly shouldn't be decided without any attempt at an evidence based approach.
But then I don't believe making a co-author of a book about privatising the NHS the Health Secretary leaves us in much doubt of the direction the NHS is being lead.
Not lead: Pushed.
Yep, fair comment.
AFAIK the negotiations over these contracts have been going on for 3 or so years, so not that fast! That being said there does seem to be a recent "rush" on this, probably for political reasons.
Def agree it would be good if there could be some trial or slow roll out. As you say, it's a big important thing, so monkeying needs to be done with caution.
but I keep coming back to the fact that the new hour limits seem better than the old limits and the sticking point seems to be the weekend, not the hour limits.
If we are to expand the number of doctors (which we would need to do if we wanted to cut hours and/or expand cover) we would need to impose the new contracts before the expansion otherwise we would end up where we are now but with even greater numbers!
Def agree it would be good if there could be some trial or slow roll out. As you say, it's a big important thing, so monkeying needs to be done with caution.
but I keep coming back to the fact that the new hour limits seem better than the old limits and the sticking point seems to be the weekend, not the hour limits.
If we are to expand the number of doctors (which we would need to do if we wanted to cut hours and/or expand cover) we would need to impose the new contracts before the expansion otherwise we would end up where we are now but with even greater numbers!
You keep coming back to this idea that weekends (a human creation) is the issue. What data are you basing that on? Most of the UK alters habits at weekends why would the NHS be any different?
You understand an imposition isn't a contract, it's not beneficial to both parties , it's control by one imposing on the other. That's what imposition is. A contract is an agreement between two or more parties - not an imposition.
Firstly this is very much about patient safety, for reasons explained to death in this thread.
Secondly Saturday is not a "core" day. Doctors are humans. Not only are they humans but they generally live in the country they work. They are part of society, the same as everyone else. They have kids, wives, husbands, and need to spend time with them as well. Most events held at towns and cities also occur at weekends (we just had the Chinese new year in Merseyside for example). When someone works at a weekend they are not only sacrificing some of their own family time but having their family sacrifice some of that too.
That is why pay is ALWAYS more of a weekend to reflect this, no matter the profession. It's common decency to do this.
Treating junior doctors like trash in order to further demoralize resistance to "modernizing" the NHS is a tactic so despicable I have no words for it that could be posted here without getting me an infraction.
Two things, the BBC graphic posted earlier that showed the BMA wanting weekends as entirely "antisocial", and this quote from the letter the BMA sent in response to the last gov offer
Many jobs regard weekends as "core". My sister ran bars for many years, she was salaried and had shift rotas that included evenings, Saturdays, Sundays and bank holidays. These were considered her "normal hours". She did get 1 weekend off in 4 (it might
have been 3 or even 5) but her job existed outside the normal M-F 9-5. If people only got sick M-F 9-5 then it would be rational for the NHS to follow that pattern but, if anything, weekends tend to yield more sickness and demand (much like and often linked to, the bar trade!).
I agree that imposition is a bad thing (though it can be contractual if the original contract allows for this, which I'm guessing it does) especially for morale and industrial relations.
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Yaffle
Volunteer Moderator
http://www.bbc.co.uk/programmes/b070hns3 has a look at the numbers behind the 7 day NHS thing.
May not be available in all countries.
May not be available in all countries.
sorry, I don't get it, JDs say overworking them with long shifts is dangerous for patients (agreed) and if the new contract has better limits on JD hours, how are the new contracts worse for patient safety?
This is a valid argument, essentially the BMA are making the same case. BUT how does Saturday working impact on patient safety? Would you rather be treated by a JD at the end of a 73hour week on a Friday lunch time or on a Saturday by a JD on a 46 hour week? Clinically Saturday or Sunday are the same as weekdays.
As I said, I get the idea why JDs want weekends special, and there would be an issue with two JDs paid the same, working the same hours but one's a hearing doctor and works 9-5 weekdays and the other is A&E, working nights and weekends. That doesn't sound fair.
But again, the issue of "keep weekends special" is separate from the hours JDs work and from the issue of patient safety.
The issue of providing 7 day care with 5 day's worth of JDs is also a valid one, but also not linked to the issue of hour limits in the current contracts and thus safety.
In fact the current contracts would make it easier to "stretch" the workforce thinner to cover the weekends, it would be expensive but doable. The new contracts, with better hour limits, would make it harder to do.
I read yet another report in the new today about the numbers of Agency staff and the cost to the NHS.
As a former NHS worker who, for a few years, left to work through an agency, I wonder when the press, the government and the NHS will figure out why this is happening.
Incidentally, it has nothing to do with money. I actually earned less, over all, working through an agency, simply because the work wasn't always available. More importantly, while I was paid barely more than other NHS staff with similar qualifications to mine, the agency charged over double that figure.
It's tempting to speculate. The notion that the NHS is being prepared for eventual sell off for example is preposterous because no private employer or investor in their right mind would want to take on the many empires that the NHS has become.
This dispute is a case in point. None of us really know what it going on. A lot of extreme slogans and claims, none backed up by any evidence or even details.
As a former NHS worker who, for a few years, left to work through an agency, I wonder when the press, the government and the NHS will figure out why this is happening.
Incidentally, it has nothing to do with money. I actually earned less, over all, working through an agency, simply because the work wasn't always available. More importantly, while I was paid barely more than other NHS staff with similar qualifications to mine, the agency charged over double that figure.
It's tempting to speculate. The notion that the NHS is being prepared for eventual sell off for example is preposterous because no private employer or investor in their right mind would want to take on the many empires that the NHS has become.
This dispute is a case in point. None of us really know what it going on. A lot of extreme slogans and claims, none backed up by any evidence or even details.
