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Junior Doctor Strike

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View susmik's Profile susmik Flag PLYMOUTH -But Made in Old Coulsdon... 28 Apr 16 10.07am Send a Private Message to susmik Add susmik as a friend

Originally posted by dannyh

May I suggest you read the following and in future try to gather some information other that what you read in the Daily Mail.

This is direct from the horses mouth, from a junior doctor who has taken the time to explain in laymens terms why they are striking.

Read. Digest. Then please stop spouting drivel.


I have kept quiet on here until now about the junior doctor's strike but the time has come to stand up and say what needs to be said. Apologies in advance for the long essay, I will try to keep it simple. This is aimed at those of you who are not medical; those who are will know exactly what I am talking about.

If you simply believe what is said in the media, you might think that this is all about Saturday pay or even that junior doctors don't want to work at nights or weekends. It is depressing to overhear people express these views but hardly surprising given the public coverage of the issue.

So what exactly is going on? A junior doctor is any doctor who is not a GP or consultant who is in training to be one of those two. Most doctors spend 8-9 years as a junior but many stay as juniors for longer, especially female doctors who may take time out for families, academics who take time out to do research and doctors in specialities where training in two specialties is needed such as paediatric intensive care. I myself spent 14 years as a junior doctor so was still one aged 37. Junior doctors are the doctors you will see first when you go to A&E or get admitted to a ward and will be responsible for delivering your day to day care when you are in hospital. Junior doctors are covering the hospital 24/7, 365 days a year and always have done. And contrary to what you might believe from the papers, they don't have any choice in the matter, their contracts say they have no choice in working evenings, nights and weekends.

So what is all the fuss about? Well it is about being able to be safe. When I was a JD, I used to work ridiculous hours. In one job in my 1st year, every 3rd weekend I would go to work at 9am on a Saturday and leave at 5pm on a Tuesday. That was 80 hours in a row with sleep grabbed when the chances arose. It was dangerous and dehumanising and the even crazier thing was that I was actually paid at a lower rate for the unsocial hours than basic pay (1/3 of basic in fact).

Fortunately my generation of juniors was amongst the last to have to do that and things slowly changed. Now junior doctors get paid at a higher rate than basic for unsocial hours, that rate determined by the intensity of work in that specialty e.g. emergency room work would be a higher rate than dermatology. Standard hours are defined as 7am-7pm Monday to Friday (which are not exactly standard working hours for most people) and there are rules on the maximum number of hours per week and consecutive hours that can be worked. There are also safeguards in place so that if employers are consistently making juniors work beyond these rules, they can be fined; hence there is a disincentive for employers to overwork junior doctors, therefore they are not tired and dangerous 1990-style.

But work done outside standard hours is NOT overtime. These hours are contracted hours and have to be worked and, quite rightly, are paid at a higher rate than basic pay. In specialties where there is not a lot of emergency work, the majority of work is in routine hours, but areas like A&E, paediatrics, intensive care have a lot of work done in unsocial hours and attract a higher rate of pay for those hours. I stress again that this is not overtime; overtime is work done in addition to contracted hours. All doctors and nurses do overtime - staying late to complete work and ensure patient safety and very rarely if ever does anyone claim for these overtime hours.

But Jeremy Hunt wants to change the contract for junior doctors, his logic being that doing this will help to deliver the “7-day NHS”. Nobody is really sure what exactly this means. It may mean that he wants routine services such as outpatient clinics and planned surgery or scans for non-urgent problems to take place on Saturdays and Sundays, not just Monday to Friday. If this is the case then changing the juniors’ contract is not going to make this happen as without doing the same for (deep breath) consultants, nurses, porters, receptionists, pharmacists, operating department assistants, radiographers, physiotherapists and many other staff these things won’t be able to happen at weekends.

The 7-day NHS may refer to emergency work. If this is the case then it already exists. Junior doctors are already there at night and at weekends. The proposed contract changes are not going to change the numbers who are there as there is no plan to increase the total number of junior doctors. What is proposed is that the definition of normal time changes from 7am-7pm to 7am-10pm Monday to Friday and from 7am to somewhere between 5pm and 10pm on Saturday. This means that employers could make junior doctors work more unsocial hours as they have redefined as standard hours. It is true that the basic rate of pay for standard hours will be increased by 13%, which sounds great doesn’t it? Except that for the emergency specialties as above that routinely have a lot of evening, night and weekend work, what is currently paid at an enhanced rate will be paid at standard rate; even at 13% higher for standard rate, total pay for junior doctors in these specialties will drop considerably, maybe by as much 30% for some. Doesn’t sound so good now really.

And, of course, there will be the same number of doctors but spread over 7 days rather than 5 so there will be weekdays where there will be fewer juniors than there are now. A great analogy I heard was to imagine that you have a 10-inch pizza cut into 5 slices. You decide that 5 slices isn’t going to fill you up so your mum cuts the same pizza into 7 slices and tells you that you’ll be full with that. But she won’t get you a bigger pizza.

So same number of junior doctors spread more thinly is going to reduce cover on weekdays as compared to now. And weekdays are when not only emergency work but also routine planned work that also needs input from junior doctors takes place so this will have a detrimental effect on waiting lists for clinics and operations as well.

Junior doctors with children will be hit particularly hard, especially those who have junior doctors spouses, as more unsocial hours will be worked. Childcare is generally difficult to get hold of outside of 8-5 on weekdays; the department of health have actually said (with no hint of irony) that in this situation, family members who are non-medical and don’t work evenings or weekends should be asked to provide child care to get over this problem! It is very likely that couples could go several days without actually seeing each other or their families if rotas do not coincide.

But what about the increased deaths at weekends we have been hearing about? Actually, the statistics have been completely misrepresented and even the authors of the research paper that gets quoted regularly have pointed this out. The statistic was that if you are admitted to hospital on a weekend, your risk of dying within 30 days of that admission was higher than if admitted midweek. Your risk of dying is very low anyway and that very low risk is marginally higher (but still very low) if admitted on weekends. This is probably because admissions to hospital in the week consist of not only sick people but also well people coming in for routine things, whereas at weekends you would tend to avoid hospital unless you were desperately unwell and most likely would leave things as long as possible and so be sicker when you got there. Interestingly they also showed that if you were already in hospital on a weekend, having been admitted in the week, your risk of death within 30 days was lower than it would have been. Either way, there is no evidence of cause and effect in terms of numbers of junior doctors around at weekends. The so-called weekend effect has also been seen in the USA and Australia too so it isn’t peculiar to state-funded health as opposed to private insurance-based systems.

Interestingly the misrepresentation of this study has led to ill people actually avoiding hospitals on weekends and delaying presenting till Monday with potentially devastating consequences. Have a look online for the #hunteffect. Scary.

Another worrying thing about the proposed new contract is that it takes away the safeguards against juniors being made to work ridiculously long hours. Whereas currently there is a mechanism that makes it in the interests of an employer to ensure the hours are not exceeded, the new contract removes these safeguards. It does suggest that each hospital trust has a “guardian” to whom junior doctors can flag up concerns about their hours but this “guardian” will also be a senior member of the trust who has no obligation to actually do anything about these concerns. I think back to my days as an exhausted junior doctor and it scares me to think that such unsafe and dangerous hours could make a return.

The pay scales are also changing. There has been automatic pay progression as you gain experience and seniority until now. The new system means that there are fewer points where pay is raised. This is not necessarily a bad thing as it can be argued that you shouldn’t get a pay rise unless you deserve it. But remember that over 10 years can be spent as a junior doctor in which time you are likely to acquire husbands, wives, children and mortgages; many existing junior doctors have made their financial plans for the next few years based on the expectation that there will be pay progression. One part-time junior doctor who has worked with me told me that if the new contract came in she would no longer be able to pay her mortgage and would have to sell her home. Bear in mind that these are young people who have spent at least 5 years at university accruing debts from both student loans for living expenses and now also £45000 in tuition fees before even starting work. The new pay scales do not reflect the levels of responsibility taken by junior doctors at different stages of their training at all which makes no sense whatsoever. For female doctors who are likely to take time out to have children and then return to work part-time, the consequences on their income will be huge. The department of health actually acknowledged that women would be hit unfairly but suggested that this had to be accepted as an unfortunate consequence.

The BMA junior doctors committee walked out of talks with the department of health because the DH’s definition of negotiation was that they would reserve the right to do what they wanted if they didn’t agree with what the committee was suggested. In other words, they did not want to negotiate so there was not point in the BMA trying. This is why industrial action was proposed because there was no other way to try to get Jeremy Hunt to talk. Sadly, even when negotiations restarted, he could not see that without a bigger pizza nothing was going to improve patient care and in fact things would be worse and so talks stopped. He has now said he is imposing the contract and that is that, he won’t talk anymore. When a strike ballot (of, let’s face it, intelligent reasonable and educated people) has a 75% turnout and 98% vote in favour, it is clear that there is a serious problem with the DH’s thought processes and they need to listen. It is highly improbable that a small bunch of radical lefties have brainwashed 50000 intelligent doctors who have been trained to analyse information and draw conclusions, much as the press like that idea.

If you have read this far, please take it on board and share with your friends. I’ve tried to keep it simple (even though it may not seem that way!) The public is not getting the full story from the TV and newspapers and if this contract is imposed then we will all be on the receiving end of the consequences eventually.

I’ll stop there for now but will write some more about what will happen on the days of the full strike (April 26th and 27th) and why you should not have to worry about what may happen on those days if you or your family have to come to hospital.

Firstly I do not read the Daily Mail so where you dug that up from god only knows. ALL my posts are due to reading the FULL contract (I posted the link) that is being imposed due to the doctors being even more greedy. If most people were offered what the young doctors are being given they would jump at the chance. What this all boils down to is the fact that the BMA is trying to bring the Government down which will not happen. So get real and read the entire contract on the table instead of posting reams of rubbish that you have. READ THE CONTRACT >>>I POSTED THE LINK!

 


Supported Palace for over 69 years since the age of 7 and have seen all the ups and downs and will probably see many more ups and downs before I go up to the big football club in the sky.

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View Rudi Hedman's Profile Rudi Hedman Flag Caterham 28 Apr 16 10.53am Send a Private Message to Rudi Hedman Add Rudi Hedman as a friend

Thanks for the JD explanation, dannyh. Where did it come from? I understand it a lot more now. It looks to me like it is about pay and working conditions, JD and patient health and safety concerns. Nothing wrong with pay protest if they think it could be cut by as much as 30%, more if a part-timer. I'm concerned about people not wanting to study and practice medicine too.

The 7-day NHS may refer to emergency work. If this is the case then it already exists. Junior doctors are already there at night and at weekends. The proposed contract changes are not going to change the numbers who are there as there is no plan to increase the total number of junior doctors. What is proposed is that the definition of normal time changes from 7am-7pm to 7am-10pm Monday to Friday and from 7am to somewhere between 5pm and 10pm on Saturday. This means that employers could make junior doctors work more unsocial hours as they have redefined as standard hours. It is true that the basic rate of pay for standard hours will be increased by 13%, which sounds great doesn’t it?

Except that for the emergency specialties as above that routinely have a lot of evening, night and weekend work, what is currently paid at an enhanced rate will be paid at standard rate; even at 13% higher for standard rate, total pay for junior doctors in these specialties will drop considerably, maybe by as much 30% for some. Doesn’t sound so good now really.

And, of course, there will be the same number of doctors but spread over 7 days rather than 5 so there will be weekdays where there will be fewer juniors than there are now. A great analogy I heard was to imagine that you have a 10-inch pizza cut into 5 slices. You decide that 5 slices isn’t going to fill you up so your mum cuts the same pizza into 7 slices and tells you that you’ll be full with that. But she won’t get you a bigger pizza.

So same number of junior doctors spread more thinly is going to reduce cover on weekdays as compared to now. And weekdays are when not only emergency work but also routine planned work that also needs input from junior doctors takes place so this will have a detrimental effect on waiting lists for clinics and operations as well.

 


COYP

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View dannyh's Profile dannyh Flag wherever I lay my hat....... 28 Apr 16 10.54am Send a Private Message to dannyh Add dannyh as a friend

Originally posted by susmik

Firstly I do not read the Daily Mail so where you dug that up from god only knows. ALL my posts are due to reading the FULL contract (I posted the link) that is being imposed due to the doctors being even more greedy. If most people were offered what the young doctors are being given they would jump at the chance. What this all boils down to is the fact that the BMA is trying to bring the Government down which will not happen. So get real and read the entire contract on the table instead of posting reams of rubbish that you have. READ THE CONTRACT >>>I POSTED THE LINK!

Reams of rubbish ? that sums you up in a nutshell. You have not counter argued anything that I posted other than to call it rubbish, which is a lazy, weak minded, juvenile attempt at dismissing valid and factual counter arguments to your simplistic, and almost child like "greedy Junior Doctors" comments.

Instead of harrumphing about the fact I may have got your chosen media wrong, why don't you try arguing the FACTS the Jnr doctor put in my post. My guess is you can't, so it's easier to dismiss out of hand rather than call upon the required brain power to answer with a coherent counter argument.

So unless you have anything other to offer (apart from a link to a contract that has obviously been well read and taken apart by a Jnr Dr themselves) I am done trying to converse with an obvious Jeremy Hunt disciple who makes Norman Tebbit look like Mahatma Ghandi.

 


"It's not the bullet that's got my name on it that concerns me; it's all them other ones flyin' around marked 'To Whom It May Concern.'"

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View Y Ddraig Goch's Profile Y Ddraig Goch Flag In The Crowd 28 Apr 16 10.56am Send a Private Message to Y Ddraig Goch Add Y Ddraig Goch as a friend

Originally posted by Rudi Hedman


And, of course, there will be the same number of doctors but spread over 7 days rather than 5 so there will be weekdays where there will be fewer juniors than there are now. A great analogy I heard was to imagine that you have a 10-inch pizza cut into 5 slices. You decide that 5 slices isn’t going to fill you up so your mum cuts the same pizza into 7 slices and tells you that you’ll be full with that. But she won’t get you a bigger pizza.

But currently you don't get pizza at weekends, barely a slice of garlic bread.

 


the dignified don't even enter in the game

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View -TUX-'s Profile -TUX- Flag Alphabettispaghetti 28 Apr 16 11.14am Send a Private Message to -TUX- Add -TUX- as a friend

Originally posted by susmik

Firstly I do not read the Daily Mail so where you dug that up from god only knows. ALL my posts are due to reading the FULL contract (I posted the link) that is being imposed due to the doctors being even more greedy. If most people were offered what the young doctors are being given they would jump at the chance. What this all boils down to is the fact that the BMA is trying to bring the Government down which will not happen. So get real and read the entire contract on the table instead of posting reams of rubbish that you have. READ THE CONTRACT >>>I POSTED THE LINK!

Wrong.
This is about the government COTINUING to bring the NHS down. YOUR NHS!

Take your blinkers off as it's you who needs to ''get real''.

 


Time to move forward together.

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View Kermit8's Profile Kermit8 Flag Hevon 28 Apr 16 11.20am Send a Private Message to Kermit8 Add Kermit8 as a friend

Hunt has co-authored a book calling for the NHS "to be replaced by a new system of health provision in which people would pay money into personal health accounts, which they could then use to shop around for care from public and private providers."


The NHS to be replaced. He said it. Not me.

Edited by Kermit8 (28 Apr 2016 11.20am)

 


Big chest and massive boobs

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View Superfly's Profile Superfly Flag The sun always shines in Catford 28 Apr 16 11.24am Send a Private Message to Superfly Add Superfly as a friend

Well said Danny (but you're in 'reasoning with a brick wall' territory)

And cheers for posting the JD's insights. Any link you can share? My other half is a hospital pharmacist - I'm interested to see what she thinks.

 


Lend me a Tenor

31 May to 3 June 2017

John McIntosh Arts Centre
London Oratory School
SW6 1RX

with Superfly in the chorus
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View susmik's Profile susmik Flag PLYMOUTH -But Made in Old Coulsdon... 28 Apr 16 11.53am Send a Private Message to susmik Add susmik as a friend

Originally posted by dannyh

Reams of rubbish ? that sums you up in a nutshell. You have not counter argued anything that I posted other than to call it rubbish, which is a lazy, weak minded, juvenile attempt at dismissing valid and factual counter arguments to your simplistic, and almost child like "greedy Junior Doctors" comments.

Instead of harrumphing about the fact I may have got your chosen media wrong, why don't you try arguing the FACTS the Jnr doctor put in my post. My guess is you can't, so it's easier to dismiss out of hand rather than call upon the required brain power to answer with a coherent counter argument.

So unless you have anything other to offer (apart from a link to a contract that has obviously been well read and taken apart by a Jnr Dr themselves) I am done trying to converse with an obvious Jeremy Hunt disciple who makes Norman Tebbit look like Mahatma Ghandi.

Most Junior doctors have admitted they have not FULLY read the contract as no doubt from your "intelligent" quotes against me and my so called childish attitude I think it is YOU that should read it as it comes from the government website and not a media source as you imply. Please do not post your points before having read the OFFICIAL CONTRACT. As a last thought I am not a Jeremy Hunt disciple far from it all my comments are made after I read the complete document put out by the Dept of health.

 


Supported Palace for over 69 years since the age of 7 and have seen all the ups and downs and will probably see many more ups and downs before I go up to the big football club in the sky.

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View susmik's Profile susmik Flag PLYMOUTH -But Made in Old Coulsdon... 28 Apr 16 12.01pm Send a Private Message to susmik Add susmik as a friend

Originally posted by -TUX-

Wrong.
This is about the government COTINUING to bring the NHS down. YOUR NHS!

Take your blinkers off as it's you who needs to ''get real''.

Are YOU for real Tux you obviously do not listen to the news or read the news. The BMA are totally out to bring the Government down and that was from the guy who was interviewed last night who is pushing the strike forward. he was asked if he would resign as it has not gone the way he wanted and his answer was " If I have made the wrong call I shall resign"... He was asked this question as the government did not cave in as he expected with the total all out strike.. Many young doctors did not go on strike as they put patients first and not the money and said they did not believe in the strike anyway.

 


Supported Palace for over 69 years since the age of 7 and have seen all the ups and downs and will probably see many more ups and downs before I go up to the big football club in the sky.

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View dannyh's Profile dannyh Flag wherever I lay my hat....... 28 Apr 16 12.26pm Send a Private Message to dannyh Add dannyh as a friend

Originally posted by susmik

Most Junior doctors have admitted they have not FULLY read the contract as no doubt from your "intelligent" quotes against me and my so called childish attitude I think it is YOU that should read it as it comes from the government website and not a media source as you imply. Please do not post your points before having read the OFFICIAL CONTRACT. As a last thought I am not a Jeremy Hunt disciple far from it all my comments are made after I read the complete document put out by the Dept of health.

Your posts are as empty in fact as they are in intelligence. You have still not answered ONE point from my post written by a very intelligent junior doctor, who has read your precious contract (said in a Gollem-esq tone), and literally put it in real terms as to how it will affect patient care (foremost) belay any fears the public my have about being left to die at weekends, and to explain to anyone with half a brain, in plain English what the new contract entails for at the coal face junior doctors and what it translates to in real terms.

This seems to be something you are either to dim to be able to understand, or through a Jeremy Hunt Style (your poster boy hero it would seem) bloody mindedness you are physically unable to admit you are wrong.

Either way it's pretty sad.

 


"It's not the bullet that's got my name on it that concerns me; it's all them other ones flyin' around marked 'To Whom It May Concern.'"

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View dannyh's Profile dannyh Flag wherever I lay my hat....... 28 Apr 16 12.30pm Send a Private Message to dannyh Add dannyh as a friend

In answer to few questions on here, it came from a colleague of the man that penned the "essay" he then posted it on his face book page.

My partner works at the same hospital as the originating Jnr Dr.

 


"It's not the bullet that's got my name on it that concerns me; it's all them other ones flyin' around marked 'To Whom It May Concern.'"

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View susmik's Profile susmik Flag PLYMOUTH -But Made in Old Coulsdon... 28 Apr 16 12.49pm Send a Private Message to susmik Add susmik as a friend

Originally posted by dannyh

Your posts are as empty in fact as they are in intelligence. You have still not answered ONE point from my post written by a very intelligent junior doctor, who has read your precious contract (said in a Gollem-esq tone), and literally put it in real terms as to how it will affect patient care (foremost) belay any fears the public my have about being left to die at weekends, and to explain to anyone with half a brain, in plain English what the new contract entails for at the coal face junior doctors and what it translates to in real terms.

This seems to be something you are either to dim to be able to understand, or through a Jeremy Hunt Style (your poster boy hero it would seem) bloody mindedness you are physically unable to admit you are wrong.

Either way it's pretty sad.

In your long drawn out anti government post you said I have not answered one single point and that is because it is mainly about ONE doctor who spouted off of why the strike is on and his reasons. What about all the other Junior doctors who stayed at their job instead of putting patients at risk and going on strike. Here in Plymouth the strike did not get the turnout they wanted and our hospital carried on doing what they are paid to do by US. You stick with your side of the fence and I will stick on my side which is the side that thinks of all the sick people who need constant care 24/7. I think it is disgraceful that supposed intelligent people who took the job in the first place and could end up earning more than you and I could ever hope for downing tools for reasons they have been brainwashed with.
Please do not attack me on the intelligence side as I could say the same about you, but I do not. I have my reasons to be against the strike and you have yours agreeing with the striking doctors. This does not make me dim as you have said. Personal attacks are not needed only our opinions on the subject matter and mine do not make me wrong so why should I admit I am wrong. Stop taking your nasty pills and get a life!

 


Supported Palace for over 69 years since the age of 7 and have seen all the ups and downs and will probably see many more ups and downs before I go up to the big football club in the sky.

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