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[MikeInWimbledon]

so what's the point!?

"Shaming professionals who strike for a £50k pay rise on a 35 hour week, while others work for a living."

I know a 70 year old who died this month because he was foolish enough to get cancer complications during a period of industrial unrest. Over eight weeks he got bounced from 111 to A&E to GP to local hospital, to other hospital, to back home, to back in to be seen by a consultant (for the first time), who said "I can fix this," to "no, I can't," to be returned home, who couldn't cope because he was in such intense pain, to be returned to hospital, who said they couldn't do anything, to be returned home for hospice care. He's dead but his wife is now in a complete mess.

But you're not interested in that story of NHS incompetence and Consultant supervision so let's leave that.

Then there's the 52 year old who "did the splits" on wet grass during the Ambulance strike. They got him to A&E by wheelchair - 2 miles - hospital said "go home take paracetamol." He did. A week later he got into a private doctor who said "Jeez.. How did this happen? I can't repair this at this stage. You'll be able to walk a bit, but you'll never be able to walk an hour or two again."

But you're not interested in that story of NHS negotiation and A&E incompetence, so let's leave that.

 

[Chrishazle]

On the other side of the story, the NHS CAN kick into gear. A good friend of ours, 84 years old and with a history of major abdominal surgery in the past, was blue lighted to A&E about 3 weeks ago, has (a) gall stone(s) causing intense and unbelievable abdominal pain. Hospital messed her around and sent her home, GP go involved, she was seen by a surgical registrar (following phone call from GP) and admitted straight away, had numerous tests, MRI's etc and tomorrow goes into theatre for an endoscopy that will hopefully remove the gall stone causing the problem. She'd previously been told she needed her gall baldder removed and the NHS waiting list was 52 weeks, so had started things to go private (£200+ for first appointment to review, then about £6500 for op) - same consultant, he told her to cancel her private appointment as he'd sort it under NHS, plus private hospital probably would not do op as she'd need high dependancy ward before and after op. Will be anxiously awaiting news from her or her husband tomorrow.

 

[MikeInWimbledon]

On the other side of the story, the NHS CAN kick into gear. A good friend of ours, 84 years old and with a history of major abdominal surgery in the past, was blue lighted to A&E about 3 weeks ago, has (a) gall stone(s) causing intense and unbelievable abdominal pain. Hospital messed her around and sent her home, GP go involved, she was seen by a surgical registrar (following phone call from GP) and admitted straight away, had numerous tests, MRI's etc and tomorrow goes into theatre for an endoscopy that will hopefully remove the gall stone causing the problem. She'd previously been told she needed her gall baldder removed and the NHS waiting list was 52 weeks, so had started things to go private (£200+ for first appointment to review, then about £6500 for op) - same consultant, he told her to cancel her private appointment as he'd sort it under NHS, plus private hospital probably would not do op as she'd need high dependancy ward before and after op. Will be anxiously awaiting news from her or her husband tomorrow.

No-one's suggesting that the 1,500,000 are incapable of doing medical stuff.

I just pointed out two close friends whose lives have been changed for the worse this Summer, by incompetence and medics striking for more money.

Be fair, doctors in France, who are paid significantly less than medics in the UK, have also been striking for more money, on and off since January. It's just that their medical service, response times, facilities and speed to see a consultant and get treatment is measurably better than ours. Obviously.

 

[AnnasMerc83]

"Shaming professionals who strike for a £50k pay rise on a 35 hour week, while others work for a living."

I know a 70 year old who died this month because he was foolish enough to get cancer complications during a period of industrial unrest. Over eight weeks he got bounced from 111 to A&E to GP to local hospital, to other hospital, to back home, to back in to be seen by a consultant (for the first time), who said "I can fix this," to "no, I can't," to be returned home, who couldn't cope because he was in such intense pain, to be returned to hospital, who said they couldn't do anything, to be returned home for hospice care. He's dead but his wife is now in a complete mess.

But you're not interested in that story of NHS incompetence and Consultant supervision so let's leave that.

Then there's the 52 year old who "did the splits" on wet grass during the Ambulance strike. They got him to A&E by wheelchair - 2 miles - hospital said "go home take paracetamol." He did. A week later he got into a private doctor who said "Jeez.. How did this happen? I can't repair this at this stage. You'll be able to walk a bit, but you'll never be able to walk an hour or two again."

But you're not interested in that story of NHS negotiation and A&E incompetence, so let's leave that.

The shortcomings in care you have listed have been ongoing for many years, are not new and not caused by the strikes.

These are all due to severe (possibly purposeful) underfunding, cuts, top down red tape, lack of staffing (thanks brexit) and so on and on and on.

You should be angry at the government for allowing the service to get to such a state, not angry at those working in it who are crying out for a better environment where they can care for their patients properly.

 

[Bobby Dazzler]

Unfortunately I was in A&E and admitted just over a week ago. The staff were doing their very best in very very challenging conditions and all but one person I spoke to from cleaner to surgeon were wonderful.

When I was admitted I had been sat beside a lady 79 years old who had been sat on the same cold metal bench for 21 hours with a broken back. The average wait time to see a someone was 10h 48m.

Describing it as like being in the middle of a a war zone was only a slight exaggeration, and that’s only down to the the relative lack of visible and bloody injuries. There were people sat any and everywhere.

Whilst I’m sure the NHS would benefit from more resources, visiting during the Junior Doctor Strike was a completely different experience from every other visit where service is usually quick. A world apart.

Despite some being in huge amounts of pain, all patients were remarkably gracious and patient (no pun intended). There were people from all walks of life but many didn’t have two buttons to rub together.

Naturally the doctors strike came up in conversation serval times. Whilst all were gracious, they all said that they had all lost any sympathy they had for the Junior Doctors and that was well before visiting A&E.

Interestingly, whilst similarly gracious, the staff who were working - working very hard and extended hours - seemed to share a similar sentiment. All were professional about it, but made appropriate comments.

The general sentiment seemed to be that all in the NHS and elsewhere deserved an exceptional pay rise but can’t - or are not prepared to - strike, and so the fairest thing would be to have no exceptional raises.

The other point often made was “35% WTF?”. Again, sentiment seemed to be that most people’s pay had not kept pace with inflation over the last decade, including those on minimum wage and benefits.

I received great care but the pace of being seen to could easily mean that people were helped too late, and will have suffered complications or maybe even died as a result. Inevitable I guess.

 

[MikeInWimbledon]

The shortcomings in care you have listed have been ongoing for many years, are not new and not caused by the strikes.
These are all due to severe (possibly purposeful) underfunding, cuts, top down red tape, lack of staffing (thanks brexit) and so on and on and on.

Exactly, giving consultants a 35% pay rise will harm the funding of services, as some of the highest paid medics in Europe steal another few billion from "this awfully nice health bureaucracy with a Government attached."

We've poured billions into technology and productivity tools, which in any other profession would have made staff more productive. In the NHS they are drowning in their own faxes, doctor dictated letters and absurd paper files.

Brexit doubled inward migration since 2016, with doctors, nurses and support staff arriving from all over the world to work in the NHS How would stopping the recruitment of Asian, Chinese and East European medical staff ease the current situation?

Visas are easily available to medics from the EU: it just takes a form. But the EU has a shortage of one million medical staff already, with our closest neighbour France busily closing down medical centres because of lack of staff.

One million unfilled medical vacancies across the EU. Yes, that's ten times the number of unfilled vacancies in Our NHS. Detail here: Health-EU newsletter 250 - Focus.

If only British doctors would start working a five day week, paying top rate tax on their six figure incomes. Not only would it provide more medical help it would also bring in more taxes to fund the NHS.

But will they ever reduce bureaucracy in the organisation that is the 5th biggest employer in the world, and a global laughing stock?

 

[MikeInWimbledon]

You should be angry at the government for allowing the service to get to such a state, not angry at those working in it who are crying out for a better environment where they can care for their patients properly.

How much more tax would you like to pay to give people on six figure incomes a 35% salary increase?

Can we put you down for 25% VAT and 25% base rate income tax?

 

[Gollom]

The shortcomings in care you have listed have been ongoing for many years, are not new and not caused by the strikes.

These are all due to severe (possibly purposeful) underfunding, cuts, top down red tape, lack of staffing (thanks brexit) and so on and on and on.

You should be angry at the government for allowing the service to get to such a state, not angry at those working in it who are crying out for a better environment where they can care for their patients properly.

Not sure I totally agree with this. Maybe "inefficient utilisation of funds" would perhaps be more accurate?

And as for "possibly purposeful"? Please!!! This aimed at the old chestnut of "they want to privatise the NHS so the politicians and their friends can all make lots of money and the lower classes can suffer" perchance?

IMHO what would work is a system more akin to France where I understand that people also contribute a small element at point of delivery depending on income?

 

[ChrisHGTV]

Not sure I totally agree with this. Maybe "inefficient utilisation of funds" would perhaps be more accurate?

And as for "possibly purposeful"? Please!!! This aimed at the old chestnut of "they want to privatise the NHS so the politicians and their friends can all make lots of money and the lower classes can suffer" perchance?

IMHO what would work is a system more akin to France where I understand that people also contribute a small element at point of delivery depending on income?

For sure i think if everyone had to make some kind of payment at source (on top of taxes) it might deter a small % but i guess that can be both a good and bad thing. If people need care you want them to be able to access it without thought.

However i personally think where there is a big issue is in what is covered by the NHS. It seems there has been significant mission creep from its initial intended purpose. There are many treatments i don't believe should be covered - IVF, correction of bodged plastic surgeries...there are also some grey areas such as lifestyle related treatment (obesity, smoking etc). I know there is an argument for some preventative treatments being cheaper in support of obesity and smoking etc (gastric bands and the like) but i think it sends the wrong message to have this covered by the NHS. You want the NHS to be a safety net, but not so safe that people don't take responsibility for their own health.

 

[Bobby Dazzler]

Unfortunately I was in A&E and admitted just over a week ago. The staff were doing their very best in very very challenging conditions and all but one person I spoke to from cleaner to surgeon were wonderful.

When I was admitted I had been sat beside a lady 79 years old who had been sat on the same cold metal bench for 21 hours with a broken back. The average wait time to see a someone was 10h 48m.

Describing it as like being in the middle of a a war zone was only a slight exaggeration, and that’s only down to the the relative lack of visible and bloody injuries. There were people sat any and everywhere.

Whilst I’m sure the NHS would benefit from more resources, visiting during the Junior Doctor Strike was a completely different experience from every other visit where service is usually quick. A world apart.

Despite some being in huge amounts of pain, all patients were remarkably gracious and patient (no pun intended). There were people from all walks of life but many didn’t have two buttons to rub together.

Naturally the doctors strike came up in conversation serval times. Whilst all were gracious, they all said that they had all lost any sympathy they had for the Junior Doctors and that was well before visiting A&E.

Interestingly, whilst similarly gracious, the staff who were working - working very hard and extended hours - seemed to share a similar sentiment. All were professional about it, but made appropriate comments.

The general sentiment seemed to be that all in the NHS and elsewhere deserved an exceptional pay rise but can’t - or are not prepared to - strike, and so the fairest thing would be to have no exceptional raises.

The other point often made was “35% WTF?”. Again, sentiment seemed to be that most people’s pay had not kept pace with inflation over the last decade, including those on minimum wage and benefits.

I received great care but the pace of being seen to could easily mean that people were helped too late, and will have suffered complications or maybe even died as a result. Inevitable I guess.

I forgot to add, apparently the number of people visiting A&E was much reduced compared to a usual Friday - the staff assumed it was because people were aware of the junior doctor’s strike and avoided A&E.

That does make me wonder whether those “missing” visitors would have actually been subject to either an accident or emergency though if you could decide to put it off until after the strike.

 

[TC350]

Be fair, doctors in France, who are paid significantly less than medics in the UK, have also been striking for more money, on and off since January. It's just that their medical service, response times, facilities and speed to see a consultant and get treatment is measurably better than ours. Obviously.

Visas are easily available to medics from the EU: it just takes a form. But the EU has a shortage of one million medical staff already, with our closest neighbour France busily closing down medical centres because of lack of staff.

I'm confused (easily done I know.) If the medical service in France is "measurably better than ours", why are they having to "busily close down medical centres"?

Also, whatever statistics are being used to measure the differences between services in France and the UK, are like for like being compared or apples with oranges?

 

[TC350]

Further to my questions above, I found this interesting comparison of health care systems by The King's Fund. Their conclusion was that

the UK does better than comparable countries in some areas, and worse in others. There is little evidence that one individual country or model of health care system performs better than another across the board. Countries improve health care for their populations mainly by reforming their existing model of health care rather than adopting an alternative. Rather than unwinding the NHS, we should seek to improve it, and there is a lot to learn from other countries when doing so.

Comparing NHS Internationally In 5 Charts | The King's Fund

Saoirse Mallorie pulls out just five measures to illustrate the mixed bag of findings from our new report, which analyses how the NHS compares to the health care systems of other countries.

www.kingsfund.org.uk

 

[MikeInWimbledon]

I'm confused (easily done I know.) If the medical service in France is "measurably better than ours", why are they having to "busily close down medical centres"?
Also, whatever statistics are being used to measure the differences between services in France and the UK, are like for like being compared or apples with oranges?

It's straightforward. The French health system is measurably better than the NHS on many fronts: speed of access, quality of service, access to clinical tests, speed of access to consultants, speed of access to surgery, quality of hospital care. Points persistently made by anyone who has used that system

However, they are closing down medical centres because of insufficient numbers of doctors and medical staff.

Fifty years ago,The numerus clausus — closed number — set out the number of students who could make it past the first year of medical studies. The idea being to improve quality and reduce cost for the health system. This reduced the number of doctors in the system. The French, being French, don't normally let other nationalities become doctors.

Is a GP on £75k in France comparable to a British GP ? It's an interesting question. Housing can be much cheaper in some areas, like Glasgow, but more expensive in other areas, like Paris, Lyon or Nice.

There's also a Pharmacy in every village, with the Pharmacist acting as a first contact in the medical chain in a way that the British wouldn't recognise. There's always someone asking the Pharmacist for medical advice, whereas we just use them to pick up medicines without advice. Do the French over-prescribe and over-medicate, by British standards? Most would say Yes.

 

[MikeInWimbledon]

Further to my questions above, I found this interesting comparison of health care systems by The King's Fund. Their conclusion was that

Comparing NHS Internationally In 5 Charts | The King's Fund

Saoirse Mallorie pulls out just five measures to illustrate the mixed bag of findings from our new report, which analyses how the NHS compares to the health care systems of other countries.

www.kingsfund.org.uk

The problem with the Kings Fund analysis is that it can be summarised as the UK spends less than its peers, but quite efficiently (see use of drugs and facilities), unfortunately the health outcomes are measurably worse.

Which takes us back to how do we get medical staff to accept realistic salaries and taxpayers to accept bigger taxes, or at least token payments for services at point of use, as is standard in the EU ?

 

[AnnasMerc83]

I will be making one last reply as it’s impossible to explain the intricacies of the state of the NHS to those that have not or do not work within it.

1. Nhs funding on average increases 3.4% pa (however is still not enough in real terms). During the last decade under the conservatives this was closer to 1.4% pa (prior to the pandemic, when it was significantly increased not of the tories choice but of absolute necessity). Even now the funding increase isn’t enough to touch the sides, when you take into account our ageing population (50% more people over 80years than 30 yrs ago) increase in chronic illness and change in demographics.
2. The nhs is 18% less well funded than similar national health services in the eu. France isn’t all roses either.
3. Brexit annihilated read-to-work docs/nurses as their medical degrees were immediately accepted by the gmc in the uk, meaning they could start work the day they arrived. Non-eea healthcare professionals have to sit complex and expensive exams before they can join the nhs, taking months if not years (the pass rate is something like 30%). Eu graduates no longer want to come back as the quality of living standards are better on the continent.
4. I would happily pay more tax if I saw the benefits of this. Unfortunately, a few middle class individuals paying a few more pennies a year will make zero difference. How about, again, being angry at the gov for allowing all these tax loopholes that the uk is so well known for? Maybe crack down on Jacob Rees-moggy, the royal family types and big business from stashing their uk earned millions In offshore accounts?
5. Your disdain at doctors fighting to finally reverse a decades long pay cut is misplaced. Maybe you should be asking why your wages aren’t rising?

Doctors, who hold your life in their hands, should be better paid and deserve their £70-80k a year (which is the average income for 90% of docs in the NHS, working 70hr weeks with unsocial shift patterns).
They are highly trained professionals, for heavens sake!

 

[JHS]

I forgot to add, apparently the number of people visiting A&E was much reduced compared to a usual Friday - the staff assumed it was because people were aware of the junior doctor’s strike and avoided A&E.

That does make me wonder whether those “missing” visitors would have actually been subject to either an accident or emergency though if you could decide to put it off until after the strike.

GPs do refer people to A&E in order to get tests and scans, or at least mine did!

 

[MikeInWimbledon]

I will be making one last reply as it’s impossible to explain the intricacies of the state of the NHS to those that have not or do not work within it.

1. Nhs funding on average increases 3.4% pa (however is still not enough in real terms). During the last decade under the conservatives this was closer to 1.4% pa (prior to the pandemic, when it was significantly increased not of the tories choice but of absolute necessity). Even now the funding increase isn’t enough to touch the sides, when you take into account our ageing population (50% more people over 80years than 30 yrs ago) increase in chronic illness and change in demographics.
2. The nhs is 18% less well funded than similar national health services in the eu. France isn’t all roses either.
3. Brexit annihilated read-to-work docs/nurses as their medical degrees were immediately accepted by the gmc in the uk, meaning they could start work the day they arrived. Non-eea healthcare professionals have to sit complex and expensive exams before they can join the nhs, taking months if not years (the pass rate is something like 30%). Eu graduates no longer want to come back as the quality of living standards are better on the continent.
4. I would happily pay more tax if I saw the benefits of this. Unfortunately, a few middle class individuals paying a few more pennies a year will make zero difference. How about, again, being angry at the gov for allowing all these tax loopholes that the uk is so well known for? Maybe crack down on Jacob Rees-moggy, the royal family types and big business from stashing their uk earned millions In offshore accounts?
5. Your disdain at doctors fighting to finally reverse a decades long pay cut is misplaced. Maybe you should be asking why your wages aren’t rising?

Doctors, who hold your life in their hands, should be better paid and deserve their £70-80k a year (which is the average income for 90% of docs in the NHS, working 70hr weeks with unsocial shift patterns).
They are highly trained professionals, for heavens sake!

Excellent.

So you don't want to pay more for the NHS. Yes, we thought as much. You want someone else to come up with the 35% salary increase for Consultants.

Doctors, who are often unavailable to patients, "hold their lives in their hands." Yet nationally everyone is saying that they can't see their doctor.

"Doctors work 70 hour weeks with unsocial shift patterns." That's strange, because they still play a lot of mid-week golf at my club, always talking shop afterwards, the GP's don't even work four days at my GP surgery, and South West London hospitals are eerily empty on Fridays, Saturdays and Sundays.

Actually, thinking about it, the 30 year old doctors I know and see regularly don't work 70 hour weeks. My daughter occasionally does, but she's not a doctor, and all her friends know that she works far longer than they do - 50 hours being the absolutely maximum that "the smartest fast track graduates" are prepared to work in the modern soft era.

"The average income for a doctor is £70-80k" As previously discussed, many doctors certainly choose not to work five days a week>

But does this mean that the BMA exaggerating or just lying when it quotes these higher salary scales on its own website?
How Much Do Doctors Really Earn?

Note that the BMA carefully says that in addition to base salary, there are extras for hours, out-of-hours, and expertise awards.

 

[MikeInWimbledon]

GP numbers only.

Bear in mind that most salaried GP's work three or four days because of other interests, young children, phased entry to retirement, and - at this point - a desire to avoid the pension cap on retirement "pots" worth over a million pounds.

Averages are skewed by the high earning individuals. The highest earning GP in the UK earns £700k.

Source: extracted from the NHS itself, here:
Main Findings - NDRS

 

[Bobby Dazzler]

Personally I would be prepared to pay more income tax to increase spending on healthcare especially, although I suspect that I’d be in the minority.

Whilst there are many forms of taxation, if you look at income tax in isolation - which is what most people consider to be the main tax they pay - they pay very little.

In reality the majority of people don’t pay anywhere near enough income tax to meet even the cost of educating their children, let alone pay for other public services.

I posted the following back in 2020 and so the information in it os now three years out of date now, but it’s sufficiently recent to illustrate the point.​

==========​

During the period that the average person’s children are being educated, I suspect that they don’t pay enough income tax to cover the cost of their children’s education, nevermind contribute towards the cost providing any other public services.

I believe that the cost of educating a primary school child is currently around £5,000 per annum. To pay £5,000 in income tax, one must earn £37,500 per annum.

The average person has two-ish children, and when those children are in secondary school the cost increases to £6,500 per annum. The average family will have children in education for almost 20 years. The average income in the UK is £30,420 per annum.

It costs £85k to educate a child to the age of 18, so the average family with two children will cost £170k. It would take someone earning the average salary 48 years to pay enough income tax to meet the cost of their children’s education, before contributing a penny towards other public services. Around the time they retire.

==========​

It certainly opened my eyes to how much of the National tax burden must be met by a minority of people, and by companies, and how little is met by the majority.

 

[MikeInWimbledon]

"The shortage of GPs is exacerbated by the number of doctors choosing to work part time.

In August 2022, just 23.2% of doctors in general practice worked full time, and

in 2021 58.4% worked three days a week or less."

House of Commons report "The future of General Practice."
https://publications.parliament.uk/pa/cm5803/cmselect/cmhealth/113/report.html