Junior doctors strike.

[Seagull27]

I was led to believe that one of the arguments (from Junior Doctors) against the new contracts was that they were already offering a seven day service ? If so, isn't this just a contract that matches existing working practices (not necessarily everywhere has it at present ? but in some places?)

Using the "it's about patient safety" is designed to gain public support (for both sides when they have both used this claim)

The Health secretary won't set staffing levels or sort out the shift patterns for hospitals once these contracts are introduced (should they ever be) - that will be down to the managers of the various trusts and hospitals to set and budget for (as it should be) and although the contracts will allow for greater flexibility in providing staffing over the 7 days, cover may continue to be at the same levels they are now, and therefore it may result in very little change from the existing shifts and cover that exists now in some places. (It does create the ability for change (in the future) should it be needed for wanted in particular areas should the managers feel it is appropriate and affordable)

The new contracts will hit some junior doctors financially as the high premiums they get for unsociable hours drops, and this seems to be a cause of a lot of the resentment towards the contracts (who wouldn't complain if you work level stayed the same / increased, but your money was cut, affecting your household budgets and possibly things like your mortgage payments) - but lower costs for existing staffing (due to reductions in those premiums) could mean they can afford more staff to help spread the load.

No - their argument is that they already work shifts that cover all 7 days of the week. But no-one denies that there are some services that only have 5 day coverage at the moment.

How can the new contracts possibly have the same levels of cover as the current ones, when no extra doctors have been hired? It doesn't matter who decides the shifts, the maths doesn't add up.

 

[Guy Fawkes]

No - their argument is that they already work shifts that cover all 7 days of the week. But no-one denies that there are some services that only have 5 day coverage at the moment.

How can the new contracts possibly have the same levels of cover as the current ones, when no extra doctors have been hired? It doesn't matter who decides the shifts, the maths doesn't add up.

Paying 100 people at 1.5 time = the same wage as paying 150 flat time? = extra 50 staff members for the same cash spent could be the logic behind it? -- By reduce these premiums that some Junior Doctors currently get from working unsociable hours, it may cut their pay, but help fund other doctors to help extend the hours that can be covered?

 

[drew]

No - their argument is that they already work shifts that cover all 7 days of the week. But no-one denies that there are some services that only have 5 day coverage at the moment.

How can the new contracts possibly have the same levels of cover as the current ones, when no extra doctors have been hired? It doesn't matter who decides the shifts, the maths doesn't add up.

Agree. Not sure why people can't appreciate the math. We have a shortage of doctors to cover the existing 5 day NHS (7 days for emergency). The government haven't funded the provision of more places at medical schools.

Also, let's not forget that this 7 day NHS is not just about JDs. The government/NHS employers will need to reach agreement with all the other staff that currently work only 5 days a week. No doubt there will not be extra money for that either.

 

[drew]

Paying 100 people at 1.5 time = the same wage as paying 150 flat time? = extra 50 staff members for the same cash spent could be the logic behind it? -- By reduce these premiums that some Junior Doctors currently get from working unsociable hours, it may cut their pay, but help fund other doctors to help extend the hours that can be covered?

So the government just click their fingers and magically they can increase the number of trained JDs by 50%

 

[Guy Fawkes]

Agree. Not sure why people can't appreciate the math. We have a shortage of doctors to cover the existing 5 day NHS (7 days for emergency). The government haven't funded the provision of more places at medical schools.

Also, let's not forget that this 7 day NHS is not just about JDs. The government/NHS employers will need to reach agreement with all the other staff that currently work only 5 days a week. No doubt there will not be extra money for that either.

So the government just click their fingers and magically they can increase the number of trained JDs by 50%

Hire them in already trained from Europe, thanks to the free movement of people agreement that comes with EU membership ...oh

 

[Hampster Gull]

Communists

 

[barchetta]

I see this quiet simply using 5 days resources and 2 days minimum cover spread over 7 days, no extra money to fund this fantasy so junior doctors are the first to be told you've got to do more with less.

the junior doctors say what do you want to lose from the 5 day service to provide an improvement for the other 2 days? answer comes back nothing.
those on part-time contracts seem to be losing out, those wanting to work weekends losing out, those working nights losing out.

why would you want to allow a new contract where there are no incentives and you have to work more unsocial hours?

those patients coming in monday - friday are going to get a worse service because some health minister who is in the pockets of private healthcare providers thinks it is a good idea.

you couldn't make it up but the papers and media continue its the junior doctors being irresponsible.

 

[Westdene Seagull]

This is a separate debate, but a lot of consultants won't be found on call or in the hospitals on a weekend.

I'm likely to get slated for this BUT here goes ..... I work in IT and for many years at the beginning of my career I worked weekends and nights ( for some reason businesses object to downtime between 9 and 5 ! ). I've gradually worked my way up the ladder and one of the benefits of that is that I no longer need to work weekends and nights. I'm sure it's the same in any business - I now expect my engineers to work those times ..... not me. I'm sure that's how NHS consultants feel as well.

 

[Westdene Seagull]

That's still a bigger mandate than the one that is taking us out of the EU!

- I guess a thread wouldn't be a thread without some reference to Brexit.

 

[pb21]

If you take 35 doctors who currently work Monday to Friday only, that means you have seven doctors working per day. They currently just about cope with this.

If you then spread them out over the full week you will have five doctors working per day, or 30% less doctors working per day, albeit every day.

The second situation doesn't seem as safe to me.

 

[Neville's Breakfast]

It might be more sensible for the Government to deal with the cost of locums throughout the NHS rather than upsetting full time staff. Locum use is on the increase which is a consequence of poor strategic planning. The staffing agencies and locums are doing very nicely and who can blame them given the inability of the Government ,NHS managers and commissioners to organize a proper full time service.

 

[Wardy's twin]

Maybe Bloom should have imposed a new contract on Stephens that would have solved the problem ( and no i don't believe that for one moment).

 

[Brian Fantana]

I'm likely to get slated for this BUT here goes ..... I work in IT and for many years at the beginning of my career I worked weekends and nights ( for some reason businesses object to downtime between 9 and 5 ! ). I've gradually worked my way up the ladder and one of the benefits of that is that I no longer need to work weekends and nights. I'm sure it's the same in any business - I now expect my engineers to work those times ..... not me. I'm sure that's how NHS consultants feel as well.

Except that in the IT industry if senior managers and directors don't work at weekends there is no life and death risk to anyone. In the NHS, people are still getting unwell and having accidents at the weekends, so for consultants to not work those hours doesn't make any sense whatsoever.

 

[BLOCK F]

Except that in the IT industry if senior managers and directors don't work at weekends there is no life and death risk to anyone. In the NHS, people are still getting unwell and having accidents at the weekends, so for consultants to not work those hours doesn't make any sense whatsoever.

Yup, largely agree with this and,of course, there is the 'vocational' aspect to a career in medicine.
However, it must be said that consultants are often 'on call', when not actually in the hospital.

 

[drew]

Except that in the IT industry if senior managers and directors don't work at weekends there is no life and death risk to anyone. In the NHS, people are still getting unwell and having accidents at the weekends, so for consultants to not work those hours doesn't make any sense whatsoever.

I think you will find that consultants are available for life or death situations at the weekend, ie emergency healthcare. What they aren't available for at the weekends is the elective surgery which is scheduled during the 5 day week.

 

[Brian Fantana]

I think you will find that consultants are available for life or death situations at the weekend, ie emergency healthcare. What they aren't available for at the weekends is the elective surgery which is scheduled during the 5 day week.

That doesn't chime with my personal experience at all.

 

[Brighton Mod]

I don’t see anyone referring to the fact that the National Insurance Contribution was introduced to pay for the NHS and Old Age Pensions. That is what it is for. Last figures that I found on Google showed that NIC produced a “surplus” of 400 billion pounds. This while we have the lowest pensions in Europe and an underfunded NHS.
It is a political decision to take those funds from their intended purpose. We are being conned. I even heard someone suggest we raise an extra tax to pay for the NHS! Unbelievable how we are lied to. We have a tax to pay for the NHS and Pensions but politicians refuse to honour it. Don’t compare it to Road Tax as if that makes it right.

I'm pretty sure my NICs are paid out the following week to current pensioners and not saved away for me to take out when I retire. there is no surplus!

 

[drew]

That doesn't chime with my personal experience at all.

I don't know your experience but are you saying you, or someone you knew, needed emergency surgery on a weekend but was delayed until a weekday?

 

[Brian Fantana]

I don't know your experience but are you saying you, or someone you knew, needed emergency surgery on a weekend but was delayed until a weekday?

It was an emergency that required urgent quite complicated and specialist intervention, rather than surgery, which very nearly went wrong because there was no consultant cover in place in that hospital. The doctor who did the job, whilst being incredibly nice, competent and caring, struggled because by his own admission he'd have a consultant supporting if the same thing needed to be done Monday-Friday.

 

[Alex Alex Dawson oo! oo!]

I'm pretty sure my NICs are paid out the following week to current pensioners and not saved away for me to take out when I retire. there is no surplus!

Some bits 'n pieces from an HoC Briefing Paper - December 2015

National Insurance contributions (NICs) raised an estimated £109 billion in 2014/15, receipts from income tax £163 billion, from VAT £111 billion and from corporation tax £42 billion.
In their survey of the UK tax system, the Institute for Fiscal Studies comments,
“The NI Fund is notionally used to finance contributory benefits, but in years when the Fund was not sufficient to finance benefits, it was topped up from general taxation revenues, and in years when contributions substantially exceed outlays (as they have every year since the mid-1990s), the Fund builds up a surplus, largely invested in gilts: the government is simply lending itself money. These exercises in shifting money from one arm of government to another maintain a notionally separate Fund, but merely serve to illustrate that NI contributions and NI expenditure proceed on essentially independent paths. The government could equally well declare that a quarter of NICs revenue goes towards financing defence spending, and no-one would notice the difference.”
NI contributions are paid into the National Insurance Fund, kept separate from all other revenue raised by national taxes. A fixed proportion of NI receipts are not paid into the Fund but go to the National Health Service. The National Insurance Fund is used exclusively to pay for contributory benefits, and operates on a ‘pay as you go’ basis: broadly speaking, this year’s contributions pay for this year’s benefits.
Total spending on contributory benefits in Great Britain is around £98 billion this year (2015/16). Around £90 billion of the contributory spend is accounted for by the State Pension. Working-age people receive around £8 billion of contributory benefit spend this year (consisting of contributory ESA, Statutory Maternity Pay and Maternity Allowance, Bereavement benefit and contributory JSA).
The balance on the fund at 31 March 2014 has decreased by £5,887 million to £23,196 million (31 March 2013, £29,083 million); the balance represents 26 per cent of annual benefit expenditure (31 March 2013, 33 per cent). This decrease results from the increase in benefit payments (£5,107 million) together with the effect of historically low interest rates on the NIF working balance.