NHS doctors strike

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MikeyB
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Re: NHS doctors strike

Post by MikeyB » Sun May 01, 2016 12:04 pm

Hi Stuart

The 7 day NHS already exists, at least as far as hospital doctors go, and it always has. Same with nurses. The problem with the concept is not the problem with doctors, it is the army of support -the radiologists, haematologists, pathologists and so forth where the service at weekends is often reduced. You can't have a complete 7 day service until all these services are running 7 days a week. That will never happen until enough money is given to the NHS to provide all these services. For some reason the government is highlighting the doctors as an obstruction to 7 day working, but it it isn't their problem, it's all the support services I mentioned which is the overwhelming problem.

But maybe the government doesn't see that as a problem, because all those services are those which can most easily be outsourced to private companies. No surprise there, then.

As far as a 7 day GP service goes, all I can say is we've managed as a society to exist with a 5 day GP service (some practices have Saturday morning surgeries), for the last 50 odd years. Up till now, nobody seems to have complained much about it, but if you will make stupid election promises, you have to be willing to put the money in to pay for it.

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Janey Dal
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Re: NHS doctors strike

Post by Janey Dal » Sun May 01, 2016 12:30 pm

stuart13 wrote:
I'm not posting on this subject to make political points or to promote my elegance to the communist party but to start a dialogue/debate on the subject.
Fab typo Stuart :lol: :lol: . Sorry - pedant alert! :lol: :lol:

You have some very interesting and valid points there Mikey about the non-clinical hospital staff. As for 24/7 GP opening hours (I've mentioned this on another thread somewhere), there was a pilot study done in this area (Darlington) and for Saturdays there was some interest. Sundays - none at all! Apparently people don't get ill on a Sunday!

I do genuinely think that hospitals need to be completely 24/7 - I agree with one of Stuart's earlier comments about trying to get discharged or see a doctor at a weekend. Alan and I have also been on the receiving end of this when he was admitted to hospital some years ago with an AP attack in the middle of the night. The nurse in charge was reluctant to give him morphine because she didn't have access to his records.

I genuinely cannot believe that when the technology is so easily available to change it we are still relying on admin staff to find a patient's records. And remember, at the moment, when you are admitted to hospital as an emergency they only have the hospital records to use - nothing at all from your GP. It is insane!

Hugs

Jane xx

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stuart13
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Re: NHS doctors strike

Post by stuart13 » Sun May 01, 2016 1:43 pm

Ok my experience is of my hospital stay 9 years ago where there was a distinct rundown of doctors, nurses and ancillary staff from about 2.30 on a Friday afternoon until the pieces were picked up again at about lunch time on Monday. Perhaps, things have changed.

Emergency care is fine, except for large numbers of people filling A&E because they can't see their GP. Its everyday on the ward that doctors are also needed.

Yes my GP's surgery tried Saturdays and yes, there was no call for it. But there is a need for contact 7 days per week with your own GP and who has your health records available, not someone on the phone who directs you to an agency doctor who invariably shows little interest.

In the strike by NHS frontline doctors the BMA has totally failed to put across the reason has to what the issues are. All we are getting from them is mixed messages, with you and I putting our own interpretation on why they are on strike and for what.

The vile slang, inverted snobbery, personal assassination messages that are being put about in the media are not giving credence to their cause.

I can understand things when explained to me properly so please BMA can you tell me the reason for your dispute and perhaps then I can then support you?

Stu :)

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MikeyB
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Re: NHS doctors strike

Post by MikeyB » Sun May 01, 2016 5:44 pm

The sticking point ( or as the bma put it, the "red line") is the contracted hours on standard pay. Until now, work was paid at standard rate up to 12.00 midday Saturday. The new contract amends this to 7.00pm. In other words, that is the standard contracted working week. Very few junior doctors work a neat 9 to 5 working day - if you get an acute emergency at 4.30 you won't see doctors looking at their watches waiting for the next shift to arrive. Given this, the BMA consider the contracted hours to be dangerously high, for the health of the doctors but more importantly the health of the patients being treated on a Saturday afternoon by an exhausted doctor, doing these hours week after week either only 4 days off per month.

Whether anybody agrees with the BMA that this is an issue worthy of striking is a moot point. The last time any workers were subjected to such a contract was in the cotton mills of the north in the 19th century, and even the Victorians came to the view that this was unacceptable. Of course, that only considered the risk to life and limb of the exhausted workers. In the BMA's view in this case it is the life and limbs of the patients being treated by exhausted doctors, as well as the doctors themselves.

There is a legal action in hand which questions whether the new contract is specifically prejudicial to female doctors, I assume because of family issues. If the contract cannot be applied for legal reasons, I guess that Jeremy Hunt will try to make it illegal for doctors to strike, as is the case with the police. But maybe that's me just being cynical!

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stuart13
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Re: NHS doctors strike

Post by stuart13 » Sun May 01, 2016 8:19 pm

Cynical!

Never. :wink:

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louhar
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Re: NHS doctors strike

Post by louhar » Sun May 01, 2016 11:46 pm

stuart13 wrote:I hear what you say, but I don't understand the longer hours bit.

If they have a Monday or any other day of the week off because they work a Saturday or Sunday, why are they working extra hours? It's just working different hours to cover 7 days.

The new contract is supposed to reduce the total number of hours that they might have to work.

:)
But...if the point of all this is to make a 7 day a week service out of a 5 day a week service with the same number of staff, how else do you work the maths? Something doesn't add up!
Louise xx

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stuart13
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Re: NHS doctors strike

Post by stuart13 » Mon May 02, 2016 8:21 am

That is something that needs clarifying.

At the moment we have a stop start system with Monday's picking up the pieces of minimum cover over the weekend, so effectively 3 days out of 7 not giving a proper service.

If it means trimming some cover off the other days of the weeks, whilst we train up more doctors, to give a smooth consistent safer cover for 7 days, then, to my mind, this should be better for the patient.

If the objective is to treat more patients without increasing staff, then yes, I agree, the maths don't work.

Mikey commented on the 4 days off a month. The new contract is supposed to address the maximum number of hours per week that a doctor can work and reduce this to about 70. This is still excessive but do the doctor want to work less than this or are they concerned about the lost opera unity to earn extra overtime.

If working extra hours are dangerous? Does paying paying extra in overtime make that work safer?

We need to train more doctors and nurses. This is an issue for us as citizens. Withdrawing our health cover by going on strike is not helping us I would suggest

Is it the imposition of the contract because of an impass in negotiations?

Is it because of the threat of privatisation?

Is it to bring down the government?

Is it reduction in possible pay for working overtime?

Is it because they are being asked to work, as many millions of people do, on a Saturday and/or Sunday for a standard hourly rate?

If the measures in the new contract make my time in hospital more unsafe, how does resigning from the NHS or emigrating help me, the patient?

Etc., etc.

What is it?

Why can't the BMA put their issues in black and white such that I, an ordinary citizen, can understand them? I, and most people that I ask, although we morally feel that we should support the doctors, don't understand.

What are the issues?

Stu :)

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MikeyB
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Re: NHS doctors strike

Post by MikeyB » Mon May 02, 2016 11:01 am

I can well understand your frustration Stuart. I can only repeat something I mentioned earlier. In Scotland and Wales doctors have been contracted with no complaint from the BMA. Why is this. What is different in NHS England?

The most obvious difference is Jeremy Hunt, who is far from a natural champion for the NHS. There is something afoot, but with all the smoke and mirrors and the rather odd lack of BMA spokespersons on the media it's difficult to tell what is going on. in some of the Scottish papers this issue is seen as a shadow of Mrs Thatcher's handling of the miners - in other words, Mr Hunt sees this as his own personal challenge to break down the doctors. It's ideological, and overlying it all is getting all his pals in the American health service providers to have a chance to get their hands on the NHS in England.

The other thing that is happening in Scotland is the hospitals advertising specifically to attract disaffected doctors in England, so NHS Scotland solves its recruitment. Sorry.

(And I will mention this as a side issue. The doctors in England don't want to bring down the government, but if the result of all this is more privatisation of NHS England, with resultant reduction of direct costs to the NHS, that reduction wil be reflected in a reduction of the funding of the NHS in Scotland and Wales. This would not go down well, to say the least.)

So I don't think you'll get any answers to all your questions until it all plays out, but I suspect it'll all end in tears for somebody. I pray that it is not the patients of NHS England.

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stuart13
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Re: NHS doctors strike

Post by stuart13 » Mon May 02, 2016 11:44 am

MikeyB wrote:
So I don't think you'll get any answers to all your questions until it all plays out, but I suspect it'll all end in tears for somebody. I pray that it is not the patients of NHS England.

We can certainly agree on that Mikey. :wink:

Ps I'm not very popular in my family over this. One of my granddaughters is hoping to go to Medical School in September and she is standing up for the doctors. :roll:

:)

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Re: NHS doctors strike

Post by unclemorris67 » Mon May 02, 2016 12:25 pm

Junior doctors work over 7 days already, admin tend not to, as well as very few consultants. Nurses seem to prefer not to work them as there seems to be lots of agency staff in at weekends.
The last A&E admission I had over a weekend , the doctor and nurses I saw were from the next nearest hospital but did agency work on days off, the whole A&E was run by agency staff.
My sister is a nurse in Scotland she worked in a hospice, now at a care home as the money is better than NHS, if she went agency she would only have to work 2 days instead of 5 for same money.
One of Jack's friends is a qualified GP, his wife is a qualified gastroendologist, he re trained to become a pilot, she works in a pub, why, they say conditions were horrendous, not enough time with patients, quantity over quality, and mounds of paperwork, stress levels sky high. That is just 2 people lost from NHS, crazy and these 2 weren't junior so had better contracts.

Someone who works in a shop on a Sunday for the same amount of money as a Tuesday isn't the same as the person who has your life in their hands, otherwise we would all be on the same pay for same hours.
Doctors have trained for 7 years, not 2 hours if anything I don't think we pay them enough, nor do they get enough time off. If they want double pay for working after 5pm give it to them, if it means the CE cannot get pay of £200,000 then that's OK.
Sharon

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stuart13
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Re: NHS doctors strike

Post by stuart13 » Mon May 02, 2016 1:05 pm

There is a difference, but how far do you want to go down that line? It's not only shopworker who work Saturdays and Sunday's. How do power supply, hospitals, shops, supermarkets, theatres, cinemas, restaurants, garages, road works, transport, police, emergency services, service personnel, etc., etc., operate?

Who is more important to society? I'm not going to judge.

I don't think that Saturday and Sunday are special anymore in our 24hr 7 day society. Should we be saying to some that it's ok for you to work as long as it's not me that has to?

If we all were to decided that we don't didn't want to work or don't need to work because of financial security, society would fall apart.

If there is an issue around working and family life for women doctors, not that it's a problem for many others, then more male doctors will have to cover this.

You locum doctor could well be one, and they do, who works full time in a hospital but because he wants to earn extra, does so.

Some junior hospital doctors do volunteer to do extra shift, not just to live, but to earn extra for holidays, marriage, cars, etc. Are they unsafe because they work extra?

Stu :)

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Re: NHS doctors strike

Post by unclemorris67 » Mon May 02, 2016 6:12 pm

Firemen, police (remember when they striked) all get enhancements for unusual hours, firemen do a 2day/2night, 12 hour 4 days off shift pattern and are allowed to work on the 4 days off. The railways are introducing this shift pattern, with the exception of safety critical positions as they are only allowed 35 hour contracts, though in reality they work more if they want with enhancement. No one wants to work on Christmas more so when it is a weekend when week is short due to bank holidays.
Bearing in mind trains dont run on Christmas Day. The people on duty depending on contract can be paid quadruple time or get very large bonus.

Try getting a trades person on weekends or out of office hours, how much more to they charge for call out. I worked for LA and every person bar those in my office got enhancements for unsocial hours.
(We were on a totally different contract doing firemen hours)

How much does a duty solicitor get for unsocial hours (lots it is a scoop to get that gig).

I have worked over weekends, bank holidays, days when council went home due to snow (my office never goes home or close)

During the floods 2 years ago over Christmas it was hellish trying to get power companies, government agencies etc as on call officers were only working via phones, not on site, we were doing jobs of council directors, why because we were paid to be there with enhancement and the decision makers have 36 hour contracts.

Last year the floods oop north, very slow reaction (la, government never learn) and volunteers making the difference.

I do know since the south east floods, there is an action plan, re organising help bet your life if any senior management is involved payments are paying made.
Sharon

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stuart13
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Re: NHS doctors strike

Post by stuart13 » Mon May 02, 2016 7:18 pm

I agree with you that many don't work weekends, but my argument is that many do.

Why can't a doctors week be Tuesday, Wednesday, Thursday, Friday, Saturday or any other combination of the 7 days? And yes, if they work extra hours or days it's at overtime rate, as it is with many employees.

Saturdays and Sundays aren't unsocial hours for many that you list, only the hours that are over and above their normal week have enhanced pay. Many people who work on Saturday and/or Sunday enjoy having time off during the week.

:wink: :)

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MikeyB
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Re: NHS doctors strike

Post by MikeyB » Tue May 03, 2016 10:18 am

The problem isn't working antisocial hours. Hospital junior doctors have always worked weekends and nights, public holidays and Christmas Day. One of Mr Hunt's changes in the new contract was the change in the definition of antisocial hours in relation to enhanced payment. The old contract used 12 midday on Saturday as the time that enhanced payment started. The new contract changes this to 7.00pm. (It's worth noting here that if Mr Hunt had to attend parliament on a Saturday he would be getting enhanced allowances whatever the time).

But the simple point is that if you want the same number of doctors to work in hospitals at weekends then either these doctors have to work longer hours in the whole week, or you need more doctors. Since there is no chance of more doctors being employed, the doctors who remain are necessarily going to be working much longer hours. The reason Mr Hunt has changed the antisocial hours start to 7.00pm on Saturday is to make the payment to these doctors working longer hours cheaper. There can't be any other reason.

And that is what is bugging the BMA. Jeremy Hunt with his private health care doesn't care if hoi polloi are treated by knackered doctors, but the folk of England should.

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stuart13
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Re: NHS doctors strike

Post by stuart13 » Tue May 03, 2016 10:43 am

I do agree that we need more doctor and also nurses.

I the mean time there should be a financial penalty on doctors who leave and join the Scottish health service.

:wink: :)

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