Maybe i went a bit far in ascribing a call for higher wages to the BMA, for all that i think their leadership has become too fond of politics. I have certainly certainly heard junior doctors make such a call though, and at a time when we simply don't have the money to spare (not with the need for increased recruitment or increasingly expensive treatments).
I must also confess to being somewhat sceptical of the claim that we are suddenly moving into unsafe territory: which is not to say that i dispute the basis of the argument, but rather that the BMA has chosen now to draw the line. The situation has been a potentially dangerous one for years, yet they held fast.
Do you refute the conclusions reached in the following articles:
https://fullfact.org/health/why-government-accusing-bma-lying/
http://blogs.channel4.com/factcheck/factcheck-junior-doctors-pay-cut/21890
Yes I think that's rather fair considering it's never been a consideration during these negotiations. How has the leadership become too fond of politics? Indeed, how can a leadership of a union not become involved in politics when one party is consistently and persistently attacking and undermining it's members?
I know, imagine junior doctors wanting to earn a fair wage. Those scoundrels, they should be quiet and accept the pay and conditions the government gives them. The free market principle works so well in other areas (we can't do X to these people because it will drive them out of the country) but not at all to doctors?
Nobody says we're suddenly moving into unsafe territory. With all due respect, this is an almost exact repeat of the conversation that we had in the other thread. The bma (and doctors) have raised this point in the past. Repeatedly. They're raised the point about unsafe hours and unsafe levels of staffing. They've raised the point that perhaps the rise of locums is due to the fact that going all the way though the training programme has become so unappealing to many and that many drop out to locum, which costs trustsa lot of money. Unsurprisingly, the general public doesn't tend to hear about it because it's not exactly exciting news. And you can't have it both ways. You've accused the union of being too political for finally choosing a place to draw the line about safety but if they were constantly making a fuss, constantly threatening strike, then what would you be accusing then off?
So what exactly are the doctors so angry about then? You're skeptical that they care about patient safety. You're skeptical that pay will go down. You think doctors, a group that I'd like to think are generally intelligent and generally quite able to think for themselves, voted almost unanimously because of what?
Hunt tells us that most doctors will see a pay rise and only a very small minority will see a pay cut. He says that this proposal is cost neutral. You do the maths there and think about if this is a logical statement.
Hunt and the conservatives have latched onto this idea of a seven day NHS and decided that the place to start is the junior doctors and to demonise them. He's chosen a random soundbite for a service that we already have and chosen to start on junior doctors, who, outside of a few very very select specialties (such as ophthalmology? perhaps, though not sure about even that one) already pretty much uniformly provide a 24/7/365 service for the NHS. It is strange therefore to focus on junior doctors as the problem, when we are already there.
It is especially strange as we are not omnipotent. We may work on the weekends already (and Hunt may try to get more of us on the weekend, gutting our already skeletal week teams) but where are the support staff? Where are the radiologists? The phlebotomists? The physios? The adult social care services (which the conservatives have gutted, making discharge of patients excruciatingly slow). The mental health crisis teams (which only work Monday to Friday, partly again due to lack of funding. The receptionists? Ward clerks?
One might suggest therefore that in the face of this, the conservatives aren't actually that interested in a seven day NHS (which is already there) but perhaps are interested in cutting down on the Costs of the NHS?
The lies about weekend statistics by the government have been especially galling to see because it shows either a health Secretary that is misusing statistics purposely and dangerously for his own ends (I encountered my first patient a few weeks ago who had waited until Monday to come in because he had been convinced that there were no doctors over the weekend. Unsurprisingly, he was more unwell than he would have been had he come in at the onset of his problems) or a health Secretary who cannot read statistics at all. Not sure which one is worse.
Which conclusions are they? The ones specifically about pay? I will try to answer as briefly as I can (and I apologise for the essay I've already written).
Doctors pay is an incredibly complicated thing that is quite difficult to comprehend because it depends on a lot of factors. I'll be completely honest, I can't remember if the bma themselves ever used the 30% figure. If they did, they were wrong. I remember other doctors using it (through their own calculations, not any provided by the bma) which I urged them to do with caution and to check their figures.
I think it's now clear, hopefully to everybody, that nobody's pay will go down by 30%. I will say a few things though.
I've used the ddrb calculator and the NHS employers one. To say that the figures there are misleading is an understatement. Once I did my own calculations, I calculated it as if I was st6 (essentially a very senior registrar, with 10 years of experience, just a couple of years away from potentially being a consultant) who was retraining and moving to an fy1 or fy2 job (very recently graduated doctors). It told me that pay would be the same? How? Pay protection.
This is the magic wand for the tories. Pay protection. Your pay will be protected for 3 years if it is going down. Ok great, what happens after those three years? What happens to those poor medical students now? Do we screw them over for 3 years of pay protection? And why the need for pay protection if, as they implausibly claim, most doctors pay will go up and it will still somehow be cost neutral?
There are other factors too. Currently, if you do the situation above and retrain (for example a very senior surgeon decides they want to be an a&e doctor and so retrains) they get an added supplement to account for the fact that the experience they'll be bringing will be more than other trainees at their stage. This will disappear now.
The new contract is also felt to be worse for taking time off to do research or be a parent.
In fact, if you follow through on one of the links that you sent, it shows an NHS employers calculator where a trainee has input their rota and been told that their £54,500 salary will stay the same. With pay protection to bring it up to the value of £7500 or so. What happens to that doctor after those three years are up? What happens to the doctor coming up into that post who won't have pay protection? That's not a 30% pay cut but I think you'll agree it's a pretty hefty one. Around 13%.
Indeed, while doctors may (apparently) not witness a pay cut from this year onto next year, many may witness a pay cut if you compare what they would have earnt on the new rotas with this current contract.
The final point about pay is with the new rotas NHS employers released a few days after imposition. Now imagine that these are supposed to be the optimal rotas, that they've spent a long term preparing to show the best the rota can be. Broke multiple of their own 'rules' about why this is better than the old (for example one had three weekends in a row) and I'm sorry but as I said, I'm not working this new rota for any period of time.
I'm not working Monday twilight, Tuesday long day, Wednesday night shift, Thursday night shift, Saturday and Sunday long days, Monday off, Tuesday back etc. I have a family and work is not my entire life. Pay won't go up to account for how unsociable an already very unsociable job is and frankly, I wouldn't care even if it did (same for many of my colleagues). I'd rather be at home with my children that spending most of the time they're awake in the hospital.
