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A black day for the NHS, and it shouldn't surprise anybody in the least that it's happened under a Conservative government.

Up here in Scotland, we're lucky that NHS Scotland is a separate entity, although some cross-border services might be affected.

Anyway, I hope none of my fellow dakka members in England are affected by this.

I don't like doctors going on strike, but I do sympathise with their reasons for doing so.

Emergency care still covered but some folks will be pissed having oporations and such cancelled on them.

 jhe90 wrote:
Emergency care still covered but some folks will be pissed having oporations and such cancelled on them.

Even though we're separate up here, it has a knock on affect on us. Scottish patients sometimes get their operations done in England (with NHS Scotland footing the bill) so they'll be up in smoke.

God knows how long this is going to last. Might see an exodus of junior doctors to other parts of the UK.

Luckily, being Welsh, I am unaffected.


But both sides really need to sit down and sort this situation out. There are support for doctors at the moment, but if these strikes cause a death due to lack of cover. Then the tables will turn really quickly against them.

Yeah, working for NHS England hardly seems to be a great move, junior doctors have it pretty rough already.

Though this probbly is not chnage it needs however NHS needs a very large amount of change to ever be effective again.
Right now it has deep issues and wastes a fortune on consultants, locums and pays a fortune for simple things.

 welshhoppo wrote:
Luckily, being Welsh, I am unaffected.


But both sides really need to sit down and sort this situation out. There are support for doctors at the moment, but if these strikes cause a death due to lack of cover. Then the tables will turn really quickly against them.

Jeremy Hunt's out of his depth on this one - he seems determined to fight to the death.

The sensible thing to do would be to trial new working hours and get the feedback, but Hunt seems hell bent on full steam ahead, and to hell with the consequences.

 Do_I_Not_Like_That wrote:

 welshhoppo wrote:
Luckily, being Welsh, I am unaffected.


But both sides really need to sit down and sort this situation out. There are support for doctors at the moment, but if these strikes cause a death due to lack of cover. Then the tables will turn really quickly against them.

Jeremy Hunt's out of his depth on this one - he seems determined to fight to the death.

The sensible thing to do would be to trial new working hours and get the feedback, but Hunt seems hell bent on full steam ahead, and to hell with the consequences.

Agreed, any sensible soldier would have walked behind the bins and shot himself already, the fact that no one in government seems to care either isn't a good sign.

The problem is that the NHS needs a total overhaul, it is such a terrible mess at the moment and it is only going to get worse.

 welshhoppo wrote:

 Do_I_Not_Like_That wrote:

 welshhoppo wrote:
Luckily, being Welsh, I am unaffected.


But both sides really need to sit down and sort this situation out. There are support for doctors at the moment, but if these strikes cause a death due to lack of cover. Then the tables will turn really quickly against them.

Jeremy Hunt's out of his depth on this one - he seems determined to fight to the death.

The sensible thing to do would be to trial new working hours and get the feedback, but Hunt seems hell bent on full steam ahead, and to hell with the consequences.

Agreed, any sensible soldier would have walked behind the bins and shot himself already, the fact that no one in government seems to care either isn't a good sign.

The problem is that the NHS needs a total overhaul, it is such a terrible mess at the moment and it is only going to get worse.

Agreed. Everybody knows that the NHS has problems and needs an overhaul to cope with the new health challenges of the next 50-60 years, but the Tory approach seems to be driven by ideological needs, rather than what's best.

Make no mistake, this is the opening shot of a battle that will rumble on for months, even years.

I believe the ultimate aim of the Tories is to open up the NHS to their friends in private healthcare companies.

So overhaul the NHS but NHS workers don't want to accept change so strike.

Not impress.

Yes Jnr Doctors work hard but the UK needs a 7 day a week service and they are nore than recompensed for the time they work plus the imore than adequate remuneration that they receive when the move on to consultant and other specialist sectors.

Like farmers, I've never met a poor doctor. No problem with that but they need to cut their teeth first and this is how the NHS does it.

 notprop wrote:
So overhaul the NHS but NHS workers don't want to accept change so strike.

Not impress.

Yes Jnr Doctors work hard but the UK needs a 7 day a week service and they are nore than recompensed for the time they work plus the imore than adequate remuneration that they receive when the move on to consultant and other specialist sectors.

Like farmers, I've never met a poor doctor. No problem with that but they need to cut their teeth first and this is how the NHS does it.

I thought it was more about that to get the 7 day cover it would mean spreading the cover thinly over the week? So ok weekends improve but the rest of the week sees a dip in levels in cover.

 Wolfstan wrote:

I thought it was more about that to get the 7 day cover it would mean spreading the cover thinly over the week? So ok weekends improve but the rest of the week sees a dip in levels in cover.

Nah, this is purely about the money. Currently, they can get between 1.2 and 2.0 times the pay rate for evenings and weekends. The Gov have set the standard pay for those hours at 1.6 times their pay rate. The Dr's are striking because they want more than the 1.6 offered...

So 1.6 rather than time and a half or less as is standard in most other industries/trades.

Yeah, my sympathy wanes.

 notprop wrote:
So overhaul the NHS but NHS workers don't want to accept change so strike.

Not impress.

Yes Jnr Doctors work hard but the UK needs a 7 day a week service and they are nore than recompensed for the time they work plus the imore than adequate remuneration that they receive when the move on to consultant and other specialist sectors.

Like farmers, I've never met a poor doctor. No problem with that but they need to cut their teeth first and this is how the NHS does it.

There is 7 day cover at the moment. The issue is not down to what working hours are wanted, or how much they are being paid, but about unilateral changes to contracts. Junior Doctors are not demanding more pay, or less hours. The government are trying to change the employment contract they currently have without agreement. Its as simple as that. Or do you believe it is acceptable for an employer to unilaterally change an employment contract? Would you accept it if your manager came to you and said "Your getting a 10% pay cut and working evenings and weekends"? What people have now, or may get in the future is irrelevant. Nor is what other industries get, or that retail workers work weekends, or that oil rig workers work 6 on 4 off, or anyone else's contracts.

 Steve steveson wrote:

 notprop wrote:
So overhaul the NHS but NHS workers don't want to accept change so strike.

Not impress.

Yes Jnr Doctors work hard but the UK needs a 7 day a week service and they are nore than recompensed for the time they work plus the imore than adequate remuneration that they receive when the move on to consultant and other specialist sectors.

Like farmers, I've never met a poor doctor. No problem with that but they need to cut their teeth first and this is how the NHS does it.

There is 7 day cover at the moment. The issue is not down to what working hours are wanted, or how much they are being paid, but about unilateral changes to contracts. Junior Doctors are not demanding more pay, or less hours. The government are trying to change the employment contract they currently have without agreement. Its as simple as that. Or do you believe it is acceptable for an employer to unilaterally change an employment contract? Would you accept it if your manager came to you and said "Your getting a 10% pay cut and working evenings and weekends"? What people have now, or may get in the future is irrelevant.

This. I get that British health care system is drastically different from ours, but when people agreed to become Doctors in Britain, did they sign some legally binding contract that they have no say in their pay system? That the government can change it however they want without input?

No.

There are three separate types of contracts. NHS hospital doctors have contracts directly with the NHS in some form or other. GPs are employed by their practices, which are partnerships or companies that have contracts with the NHS. Finally there are private health companies.

The thing the government is ignoring is that British trained doctors are extremely employable overseas and in non-NHS positions of many types, and it isn't possible to get a load of Polish doctors over here at short notice if the native doctors get pissed off and leave the NHS.

There is already a crisis in doctor staffing, with numbers enrolling at medical school falling, numbers applying for their international certificates increasing, and numbers opting for early retirement also increasing.

Thus, whatever the pros and cons of the claims on either side, the government isn't going to solve the problems by being hardnosed fethers.

 notprop wrote:
So 1.6 rather than time and a half or less as is standard in most other industries/trades.

Yeah, my sympathy wanes.

It's not quite that simple. Hunt says they're getting a pay increase, the doctors say they're getting a pay cut. They're both right and wrong, because it's an oversimplification.

It essentially boils down to the fact that doctors get paid overtime rate past a certain point in the evening (5PM, I think). Hunt is going to increase that overtime rate by a tiny amount (hence the the pay is technically going up), but is going to shift the point at which overtime pay starts applying over to something like 8PM. Hence the claim that the doctors are getting a pay cut (which is true in real terms, because if they'd worked the same hours under their current contract, they'd have earned more). What's more, surgeries are now expected to be open later on every single day (up until 8pm instead of 5pm).

I don't believe the doctors have an issue with working weekends or the newly extended hours (I've read several statements to that effect) or even the new contracts so much (although it has hacked them off), but they've requested that the scheme be more extensively trialled before being made country-wide, as trials to date have shown that there simply aren't enough staff to run at those levels (around half the trials ended up having to cut open hours due to lack of staff and only quieter branches succeeded in staying open for the full range of hours).

Hunt however, has refused. He's slagged them off as being ideologically driven, said that he will now be imposing the new contracts on any people who have renewals/join fresh regardless of what anyone else says, and generally acted like a bit of an arsehole. He doesn't want to trial it appropriately in case it ends up not working out (which would be a black mark against his future political career and the Tories generally). He's also determined to slash the total amount of money being paid to doctors for Osborne, as opposed to paying even more for more doctors for appropriate coverage (which is what the scheme requires). So he's busy 'forging his own narrative', in layman's terms, going on about greedy inflexible doctors and taking the more draconian route.

I have no dog in the fight either way (I suspect it will adjust to the new service in due course regardless. But I think Hunt is seriously going about this the wrong way. Trying to push through disguised budget cuts along with a service expansion and ideologically denouncing the health service for querying this is not the sign of a particularly competent planner.

How can doctors go on strike? They are not bus drivers. Frazzled confused.

The other problem is that the research that this change is based on doesn't even say what Hunt (or my preferred spelling *unt) says it does. The person who wrote the paper says is is being misrepresented:

http://www.independent.co.uk/news/uk/home-news/jeremy-hunt-misrepresenting-data-on-mortality-at-nhs-hospitals-doctor-who-conducted-study-says-a6872281.html

He is the Gove of the health service.

 Steve steveson wrote:
The other problem is that the research that this change is based on doesn't even say what Hunt (or my preferred spelling *unt) says it does. The person who wrote the paper says is is being misrepresented:

http://www.independent.co.uk/news/uk/home-news/jeremy-hunt-misrepresenting-data-on-mortality-at-nhs-hospitals-doctor-who-conducted-study-says-a6872281.html

He is the Gove of the health service.

Eh. Gove kind of had a point when he said the teachers were ideologically driven in their opposition, the teaching unions have been a massive left wing bloc for a long time now. The Unions woo them when they're training at uni, and the very courses themselves have a slight left leaning style approach to their methodology (probably as a result of the social background a lot of teachers these days come from).

When Hunt talks about it here though, he's talking rubbish, there's none of that on a medical degree.

The primary concern of the doctors is that the new service hours are unsustainable, because we don't have enough staff, and the public will suffer as a result. They're also hacked off about their pay cut, but that's the secondary concern. Hunt is determined to label it as their primary concern though for pr reasons, and thus ignore their actual main concern.

 Frazzled wrote:
How can doctors go on strike? They are not bus drivers. Frazzled confused.

Its a very limited strike, only junior doctors are striking from 8-5 on 2 consequtive days, medical cover wil be provided by consults (and junior doctors if the NHS Trust genuinely needs them). Emergency and critical care will still be provided at normal levels throughout the strike.

There already is a 7 day service (for patients who actually need 7 day treatment) and the only way that there can be a full 7 day service for all speciallities is to fund a lot more staff, not just doctors but also allied health professionals and nurses.

All Jeremy 'rhymes with' is doing here is massively antagonising doctors, who have public support, by trying to slip in yet another cut under the guise of improving patient care. If this new contract does get forced through patient care is exactly what will be affected as the same resources, if not less, will just be spread thinly over 7 days rather then 5.

How this has been allowed to get so far is beyond me.

It's worth mentioning that for whatever reasons, the general public aren't interested in 24/7 hospital operating except for A&E and continuing care of currently resident patients, both of which we've already got.

None of Hunt's stated reasons for this new contract make any sense, especially his claim that doctors would be better off given the Conservative government's commitment to reduction of public spending. We are forced to the conclusion that either Hunt genuinely is irrational, or that he has a hidden agenda, possibly to do with making doctors worse off in order to reduce public spending.

He seems to be taking a number of different issues and applying them to the junior doctors.

As Kilkrazy has mentioned, must of us don't actually worry what day we have our operation and most likely would prefer to go in after the weekend.

People would like to be able to see their GP at the weekend or not have to wait 4 weeks for an appointment.

If we go to A&E we'd prefer not to wait 4hrs + to be seen (but that ties in with above due to no emergency cases turning up)

We'd also like to know that if we did need to be operated on over the weekend, that qualified staff are there and you don't have to suffer agony for 48hrs

A&E operations are available over the weekend, always have been.

My problem with GPs is that I have to decide two weeks in advance when to be ill because so many appointments are filled up well in advance by routine consultations for the elderly, young mothers and children, and so on.

There are various reasons for this, most of which don't involve GPs refusing to work on Sundays. My local surgeries open on Saturdays already.

 Kilkrazy wrote:
A&E operations are available over the weekend, always have been.

My problem with GPs is that I have to decide two weeks in advance when to be ill because so many appointments are filled up well in advance by routine consultations for the elderly, young mothers and children, and so on.

There are various reasons for this, most of which don't involve GPs refusing to work on Sundays. My local surgeries open on Saturdays already.

Two weeks in advance? Bloody hell!

A few weeks ago, I phoned my GP and got an appointment the same day. The previous time was only a 3 day wait. And I'm in a fairly rural location.

The problem is, for any party. If they are seen as the people who caused the destruction of the NHS, it is basically an auto-lose at the next election, and probably the next few after that too.

 Do_I_Not_Like_That wrote:
The previous time was only a 3 day wait. And I'm in a fairly rural location.

My wife's old GP required her to make an appointment for a telephone consultation before she could make an actual appointment.....

The end result is that she never bothered going to the doctor at all.

At least you have GPs, I can't even get one, let alone an appointment with one, I can barely get a dentist.

 welshhoppo wrote:
At least you have GPs, I can't even get one, let alone an appointment with one, I can barely get a dentist.

Where do you live? The extreme edge of the Outer Hebrides?


Automatically Appended Next Post:

 Silent Puffin? wrote:

 Do_I_Not_Like_That wrote:
The previous time was only a 3 day wait. And I'm in a fairly rural location.

My wife's old GP required her to make an appointment for a telephone consultation before she could make an actual appointment.....

The end result is that she never bothered going to the doctor at all.

A change of surgery should fix that.

 notprop wrote:
So overhaul the NHS but NHS workers don't want to accept change so strike.

Not impress.

Yes Jnr Doctors work hard but the UK needs a 7 day a week service and they are nore than recompensed for the time they work plus the imore than adequate remuneration that they receive when the move on to consultant and other specialist sectors.

Like farmers, I've never met a poor doctor. No problem with that but they need to cut their teeth first and this is how the NHS does it.

The new contract will do nothing (by its self) to get a 7 day a week NHS, as you'll also need to have all the technical staff, cleaners, nurses etc in at the weekends in sufficient numbers and there is no sign of this happening

If the government had guaranteed that this would happenen at the same time as the changing contracts i'd have less sympathy for the doctors, but they won't as it would cost significant money, and the whole new contract thing is basically about arranging things so money can be saved in the future