Junior doctors to escalate industrial action to all-out strike next month

drew said:

Isn't the point that there aren't enough doctors to cover the hours that are needed to have a genuine 7 day NHS? If the answer is there are enough then are we also suggesting that currently doctors are not working 2/7 of the time?

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accepting the issue that we should probably bring in more doctors (and nurses etc), the point is there are the doctors to cover but they cost more at the weekend. its about budgets, a doctor at the weekend cost 1.5 times the doctor on a weekday, if you can remove/reduce their overtime cost you can afford more doctors at the weekend. as far as i can tell option 2 is actually what is being pursued.

beorhthelm said:

accepting the issue that we should probably bring in more doctors (and nurses etc), the point is there are the doctors to cover but they cost more at the weekend. its about budgets, a doctor at the weekend cost 1.5 times the doctor on a weekday, if you can remove/reduce their overtime cost you can afford more doctors at the weekend. as far as i can tell option 2 is actually what is being pursued.

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Not quite. Under the current contract there is an enhancement based on antisocial hours but it costs basically the same to have someone work 1 in 2 weekends as 1 in 10. It isn't paid by an hourly rate.

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beorhthelm said:

accepting the issue that we should probably bring in more doctors (and nurses etc), the point is there are the doctors to cover but they cost more at the weekend. its about budgets, a doctor at the weekend cost 1.5 times the doctor on a weekday, if you can remove/reduce their overtime cost you can afford more doctors at the weekend. as far as i can tell option 2 is actually what is being pursued.

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It's actually both. The NHS has both a budget shortfall (not enough money to pay the overtime for weekend working) and a staffing shortfall (not enough staff to fill a 7 day roster even if they had the money to pay for it).

The other side to this is that the NHS aren't the only ones recruiting doctors and nurses etc. So they need to pay enough to make sure they can fill the rosters. This is especially true for weekends, as those who commit to working weekends are often giving up time with family and friends to do so. My wife was (until recently) a nurse. When we first met, she was working regular weekends. And, at the time, she was happy to do so - she was quite happy as a single lady, and didn't need her weekends for socialising (especially as her friends group was mostly made up of nurses working similar schedules to her). After we met, that changed rapidly and within a year she'd moved jobs to one where she wasn't working weekends. Because I work a regular 5 day week with weekends off, getting our work schedules to match became important.

Anyway, all that is building up to the realities of the workplace: if you want sufficient doctors, nurses, and other required staff to be available to cover a full 7 day roster then you will need to be willing to pay for it. Firstly so that you can lure in enough staff away from the big-bucks private enterprises who are competing for the same staff, and secondly so that you have enough of those staff who are willing to work weekends. Historically, the way they've ensured that is by paying more for weekend / anti-social hours. But with nurse pay being frozen in recent years, and trusts having their budgets squeezed, the NHS has found it increasingly difficult to prevent staff from choosing to go to private companies instead.

The NHS is under huge amounts of staffing pressure at the moment, and the new junior doctor contract (which is a precurser to rolling out similar changes across the whole NHS) is not going to solve that problem. Not in and of itself, not with the NHS falling apart at the seams due to lack of budget as a direct result of Tory austerity policies.