Junior Doctors' Pay Claim Poll

[turbobloke]

Bearing in mind what you think is deserved, what's affordable and any other factors you think are relevant, is the 35% claim appropriate, and if so or if not, what % band is closest to your view?

[turbobloke]

ATG said:

julian64 said:

Already medics are the best and brightest in our society and should be rewarded as such. If they hadn't chosen medicine when they left school they could have the choice of ANY other job in the country. They are the best of us.

This "they're the best and the brightest" stuff is often said, and clearly believed by quite a few young medics anyway. It isn't true and it is profoundly unhelpful to think that it is. Loads of people are bright and academically able. Some choose to do medicine, others choose to do other things. The idea that medics are a rarefied elite is an absolute fantasy. And it's a problem because it starts you down a path of "exceptionalist" thinking in which you start thinking it's normal for the normal rules NOT to apply because "doctors". Why do junior doctors have to work insane hours with no sleep so they make mistakes?? "Because, doctors" said the old guard. Going back a little further, why should hospitals be managed by people with clinical skills but no managerial aptitude? "Because, doctors." Etc, etc.

It's also ironic that, due to there being fewer Vet Schools in the UK than Med Schools,and given the demand for both, the academic entry requirements to be a Vet are often higher than to be a Doc. Vet courses commonly offer (on predictions) at A*AA / AAA compared to AAA / AAB for Medicine (Buckingham quotes ABB).

Obviously it varies, for example Cambridge look for A*A*A for medicine. Like or loathe Oxbridge, that's where what julian64 described can generally be found and as you point out, across all subjects and destined for a variety of professions. The argument for paying doctors well is a wider one, and their abilities need to go beyond school exam measures as per aspects of UCAT or BMAT (e.g. Section 3) and similar. I do voluntary work with a couple of local schools supporting prep / applications for science and vet/medicine so get to see some of this in action.

[turbobloke]

Killboy said:

Biggy Stardust said:

That's a very long way from answering his statement that "fair" is a massively subjective term (& impossible to achieve in reality).

I dont think its for you to answer. Its for the doctors to answer. Pay them what they think is fair, or they leave. I dont think they care what you think

Every other employer has to do this.

Of course every other employer doesn't have to do that, and paying what a group of workers demands isn't negotiation it's a diktat holding others to ransom, in this case including the public. If anyone thinks their pay is unreasonable they can look for and take employment elsewhere including abroad if they wish and have an offer. In a thread on strikes there was mention of 30% to 40% of junior doctors thinking of leaving, also of turnover of junior doctors being around 10% from available data, which is quite a mismatch. If 40% do actually beluga off, then politically no government could survive the NHS having nearly half staffing at junior doctor level, so something would be done for sure.

[turbobloke]

Killboy said:

turbobloke said:

Of course every other employer doesn't have to do that, and paying what a group of workers demands isn't negotiation it's a diktat holding others to ransom, in this case including the public. If anyone thinks their pay is unreasonable they can look for and take employment elsewhere including abroad if they wish and have an offer. In a thread on strikes there was mention of 30% to 40% of junior doctors thinking of leaving, also of turnover of junior doctors being around 10% from available data, which is quite a mismatch. If 40% do actually beluga off, then politically no government could survive the NHS having nearly half staffing at junior doctor level, so something would be done for sure.

Sorry what? What employers do not have to pay fair wages for staff? Lol as usual.

I'm not sure if you've noticed, but I think we may have reached a critical point with doctor

You snipped your own post, which contained the statement I replied to, allow me to remind you.

Killboy said:

I dont think its for you to answer. Its for the doctors to answer. Pay them what they think is fair, or they leave. I dont think they care what you think

Every other employer has to do this.

So, every other employer has to pay their employees "what that think is fair" or they leave, which is clearly not so,

After my reply, you shifted your own goalpost and claimed it was about "employers do not have to pay fair wages for staff?" which is totally different. Your post claimed it had to be what the workers thought was fair aka a diktat not negotiation.

Lol at yourself if you thought nobody would spot this. Have you defined "fair" any other, more objective way as yet? Apologies in advance if I missed it.

[turbobloke]

Killboy said:

turbobloke said:

So, every other employer has to pay their employees "what that think is fair" or they leave, which is clearly not so,
.

Explain how this works?

Weird.

You need to explain it. it's what you claimed.

At 12:04 Killboy said:

I dont think its for you to answer. Its for the doctors to answer. Pay them what they think is fair, or they leave. I dont think they care what you think

Every other employer has to do this.

Over to you,if you wish, though after the rhetorical gymnastics in your posts it's not worth participating further.

Junior Doctors have a claim for a reasonable pay rise, there's some discussion about what's reasonable, now that would be worth participating in

[turbobloke]

Dixy said:

clockworks said:

The "junior doctor" title seems to encompass far too many pay grades. Do they really go straight from being junior doctors to being consultants, GPs, surgeons, etc?
.

No a Junior doctor can be a surgeon, if you have a hip replacement it will probably be done by a junior doctor paid less than a train driver but doing twice as many hours.

How probably?

IANAD and only have this NHS source to go on.

NHS on hip replacement surgery said:

Most people would have seen their surgeon at a pre-assessment clinic and had the chance to talk about the operation. A senior-level surgeon, consultant or registrar will do the operation. They may be helped by junior doctors. You should be told at your pre-operative assessment who will be doing the operation.

https://www.nhs.uk/conditions/hip-replacement/what-happens/#:~:text=Most%20people%20would%20have%20seen,will%20be%20doing%20the%20operation

Which is a bit curious itself as I thought a registrar was a senior junior doctor.

[turbobloke]

ATG said:

In my humble opinion, when you see disgruntled employees calling for ridiculous pay rises, what you're seeing is often more of a cry for help or a collective nervous breakdown rather than a simple wage demand. (Exceptions to this rule are train drivers and firemen.) If you've got pretty crappy working conditions where you're persistently overstretched so you can't offer the level of care to the individual that you think is required, where your patients are having to wait ages before they get to see you, where the rest of the country thinks you're working for an institution whose wheels are falling off ... guess what? You're going to feel like you're undervalued. And that manifests itself in people yelling "pay me more!" and hoping that more cash might make them feel better about their jobs. But cash alone won't do that. If you want people to feel good about their work you need to make them feel valued in a much broader sense than just financial remuneration. They need to feel that their opinion is respected by their employers, that they're given the time and facilities to do their jobs properly, that the general public recognise their expertise. Fail to do all this soft non-financial stuff and throw money at the problem instead and you'll be left with a better-remunerated but still deeply unsatisfied and increasingly cynical workforce.

That chimes with Mister Motivator aka Herzberg, but I'd agree with it either way.

Quote on Herzberg principles from the American Academy of Family Physicians which at this point seems an apt source of a comment said:

Hygiene issues, such as salary and supervision, decrease employees' dissatisfaction with the work environment. Motivators, such as recognition and achievement, make workers more productive, creative and committed.

[turbobloke]

pghstochaj said:

FNG said:

And my point is that junior doctors wanting 35% is excessive given a similar level of erosion in earning power has happened across the board.

So MPs didn't suffer the same erosion. Colour me shocked.

So you expect junior doctors to be passive and ignore that pay has been substantially cut in real terms, just because it has happened to you? Or the doctors should enter into a negotiation process starting out asking for less than they would have been paid if pay had received pay rises in line with inflation? I am assuming you are not in a negotiation role.

Back to facts though, rather than opinion or anecdote.

Using consultant salaries as my indicator as I already have the numbers from above and I know that the terms and conditions have not substantially changed in this time period. Median pay (2008-2023) in the UK for full time employees has gone from £25,165 to £35,145 according to the data below and accounting for the reported 2022-2023 increase:

https://www.statista.com/statistics/1002964/averag...

That is a 40% increase (for info, your salary has grown substantially less than the UK average despite you presumably increasing in experience so the growth should have been much higher to reflect promotion etc., the average increase does not account for this of course). Therefore, using the consultant example above, the salary should have gone from £82,590 to £115,343 to maintain performance with the general population salary inflation. This is less than the £125,000 inflation adjusted figure but far more than the actual current pay of £99,425.

The ONS data paints an even worse picture. Using data from 2008 to 2023 and inflating a salary of £82,590 brings out a salary of £120,581. This is still behind inflation but £20,000 more than the actual pay.

https://www.ons.gov.uk/employmentandlabourmarket/p...

It is completely wrong to say that doctors have only suffered the same erosion as the general public.

This is why consultants will probably vote for action. Being a consultant used to be a very well paid job but now, what is asked of a consultant versus the remuneration makes it less competitive.

I agree with the last point and would like to raise another. How many consultants top up NHS work, as a % say, what's their income today on average, and how does it affect the overall average? To be clear I have no objection to use of state backed training and experience being used for raising income levels in that way by those who choose to do so.

AIUI from BMJ, those on whole time contracts (58% of all consultants) cannot receive more than 10% of their NHS salary from private practice. Those with a maximum part time contract (24%) receive 10/11 of the NHS salary and have no limit on their private earnings. It's not as easy to find any info on what this does to actual income levels, so maybe you can help, or maybe not?

[turbobloke]

pghstochaj said:

turbobloke said:

I agree with the last point and would like to raise another. How many consultants top up NHS work, as a % say, what's their income today on average, and how does it affect the overall average? To be clear I have no objection to use of state backed training and experience being used for raising income levels in that way by those who choose to do so.

AIUI from BMJ, those on whole time contracts (58% of all consultants) cannot receive more than 10% of their NHS salary from private practice. Those with a maximum part time contract (24%) receive 10/11 of the NHS salary and have no limit on their private earnings. It's not as easy to find any info on what this does to actual income levels, so maybe you can help, or maybe not?

I think you are using information there from 2000. The rules around consultants doing private work changed in 2004 to the following:

The key contractual points are:<snip>

Thanks for the info, that BMJ extract may well be outdated, it's what could be found online in a coffee break and there was no date clearly associated with it.

ETA something else dug up in a couple of minutes said "junior doctors in Cambridge may engage in private medical practice for no more than the equivalent of one NHS session (one half day) each working week" which may also be outdated. Odd impression - local differences?

Edited by turbobloke on Friday 14th April 10:36

[turbobloke]

pghstochaj said:

I don't remember a single person in her "cohort" that worked privately whilst a junior doctor (assuming you don't mean taking on extra shifts as a locum). I am not sure it would be practical. Some people do not become consultants but complete their junior doctor training and they are referred to as staff grade. They often pretend to be consultants in private work (check the speciality register to check) and perhaps these people are categorised as junior doctors. Sometimes these are people that are not good enough to become consultants in the NHS, sometimes they are people that just don't want to do it.

Thanks again. This link (to a pdf doc on consultant pay gap) was of interest, but why don't authors put a date on the cover page, my coffee break is already on borrowed time and scrolling past points of interest was too much hassle and I missed it anyway. It's in the url fortunately.

https://www.bma.org.uk/media/3429/bma-consultant-w...

[turbobloke]

skwdenyer said:

julian64 said:

I would have to strongly disagree with you on this. The uk is not a meritocracy when we have a government run NHS which is free at the point of service. Its a system which can set pay knowing that the degree to which it marginalises private medicine means it has a monopoly.

If you did away with the NHS and all medicine became private the the UK would be a meritocracy for medics, and in a situation where the NHS can't fill posts, (and there are a lot) the costs would have to rise.

I doubt it would be a meritocracy for medics or, if it were, the criteria for judging “merit” wouldn’t be the ones we’d like. Yelp reviews, ability to bring in lucrative drug trials, systematic over-billing and needless tests; this lists of things connoting “merit” to a private health provider are legion and mostly unrelated to the needs of society.

Yes to that, i.e. I agree with almost all of the above criticism of what might be termed untrammelled private healthcare practices - not sure what was meant in the detail of drug trials, probably my fault - however, could there not be some trammel applied?

[turbobloke]

Dixy said:

86 said:

Threaten to go abroad well get on with it.

Too many have leaving vast shortages. When the pandemic hit no one was shouting we dont want doctors.

As mentioned earlier, 30% to 40% say they're thinking of it, but available data suggested that annual turnover was closer to 10% which isn't that high.

Just found this (pdf) which looks to have some relevant info but haven't ploughed through it as yet.
https://www.gmc-uk.org/-/media/documents/workforce...

It's not directly comparable but of interest to note that for qualified teachers, a third have left the profession after 5 years.

[turbobloke]

djc206 said:

turbobloke said:

As mentioned earlier, 30% to 40% say they're thinking of it, but available data suggested that annual turnover was closer to 10% which isn't that high.

Just found this (pdf) which looks to have some relevant info but haven't ploughed through it as yet.
https://www.gmc-uk.org/-/media/documents/workforce...

It's not directly comparable but of interest to note that for qualified teachers, a third have left the profession after 5 years.

It’s extremely high given the qualification period. In a highly specialised profession you don’t want turnover anywhere near that.

I don’t understand why anyone would want to become a teacher these days either. Thankless task for mediocre money.

Agreed for the main part, however, the reality of the job after graduating then again after finishing training can conceivably be a significant challenge to some, which only increases over time. Not ideal, but 10% would not be excessive in my view.

More reading on turnover.
https://www.manchester.ac.uk/discover/news/gp-turn...

[turbobloke]

skwdenyer said:

86 said:

pghstochaj said:

86 said:

Tell that to the people who have had their cancer care cancelled and their operations cancelled through the actions of reckless junior doctors. Unforgivable.

If the BMA and RCN go out together they should bring in emergency legislation to make it against the law to strike.

Bizarre. Is this trolling now or do you think everything can be simplified like that? Either you believe the government is the cause of this or you believe the junior doctors are the cause and no understanding between?

No I don’t believe the Government is to blame. We have seen all winter co ordinated action by militant unions trying to bring the Government down. On top of which you can’t negotiate with people who want a 35% pay increase. That’s the trouble with the Doctors and nurses case they have made it political.

Why are people so fixated on the 35% as somehow intrinsically silly just because it is a large number? Surely the question is (a) whether pay should be set so that it has not gone down in real terms, and (b) if so, what number is required to get there.

If pay had really tanked, 50% or even higher could be the fair number.

Fairness to taxpayers' liabilities for other public spending needs to be a consideration, not one element in isolation.

[turbobloke]

Evanivitch said:

86 said:

Evanivitch said:

86 said:

Withdrawing things like cancer care is the final straw.

It's disgusting that the government started doing that 13 years ago, don't you agree?

Post up the evidence. of course there isn’t any. Usual misinformation of the left

"A report by Cancer Research UK (CRUK) in April 2019 showed that the UK had worse survival rates than many western countries due to inadequate early cancer detection and a lack of access to the best treatments. The report also acknowledged a shortage of cancer treatment specialists and that the target for treating 85 per cent of cancer patients within 62 days of an urgent GP referral had been missed every year since 2014."

https://www.independent.co.uk/news/health/cancer-s...

Can't get to the link for some reason, but what you quoted above makes no mention of withdrawing treatment, it mentions survival rates, detection timing, access to treatment, and a 62 day referral to treatment target, but as a comment on actuality not a comment on withdrawing cancer care from a previously superior level. It may be so in the article but if that's the case why not mention the relevant bit as what's there ^ doesn't make the case. Does the article even mention withdrawing or withdrawal?

[turbobloke]

FiF said:

On this question of the brightest and best, medical school selections are not just in that basis, selections are also based on other criteria including personal attitudes.

It's good that this change has occurred, though as you say, it's disheartening to students with 'the grades'who find themselves looking for another course and career, particularly where parental pressure has played a part in an application. Even so, no system will ever be perfect. Each year when I've had sufficient free time to support local students there's been at least one example where the grades were forecast and achieved, and reporting on the student's voluntary work at a hospital or hospice has commented on their ability to form professional and sensitive aka successful working relationships with patients and medical / other staff, but they still don't end up with a med school place. Those involved in the decision making will be doing what they can but interviewing as a part of selection is itself flawed, so this is bound to happen.

[turbobloke]

Evanivitch said:

AstonZagato said:

In any successful negotiation, one needs to be able to see both sides of the argument. There is no way that the government can engage with a 35% headline figure.

If you start at a level that is unlikely to win broad political support, then the government is not forced to the table and you lose public sympathy in the strike process. It's not what I'd have done, for sure. A lesser figure today allied with a long-term plan to regain pay parity and some stuff the government can give you without looking like it's fuelling inflation. Then keep the hard bargaining behind closed doors. Starting at 35% is a useless strategy.

So the entry to negotiations should be that Junior Doctors are overpaid and that they should continue to see a reduction in inflation adjusted earnings?

Is that both unwelcome and inevitable short-term? A long view can be different.

[turbobloke]

s1962a said:

Dixy said:

s1962a said:

We spend £4.6bn on agency doctors (including consulants and junior doctors). Increasing the pay of junior doctors and tying them in to longer contracts should help reduce part of that bill. It might end up being net net, with happier doctors as an outcome.

Edited by s1962a on Tuesday 18th April 15:03

Dont need to ty them in.

Senior reg in ED asked to supervise some foreign doctors brought in as cheaper than a locum but still on £15k a year more than the training number reg. Asked them to demonstrate a relatively basic task, they had never seen it never mind done it.
2 are now moving to another hospital as they will be then paid £45k a year more.

This is not about how much the NHS spends it is who they pay.

Thats the point. Some posters are failing to grasp the issue that we are already paying for agency staff and a lot more than it would cost to give JD's the 35% they are asking for.

I agree that Junior Doctors have a good case for a pay rise, it's just the size of it that's potentially problematic, for example would you say that giving JDs a rise of 35% would be seen by other public sector unions as setting a precedent, and could therefore lead to non-trivial consequences beyond the Junior Doctor situation? Personally I can't see other union bosses wanting to discuss the ins and outs of nuanced JD historical positions, they would surely seize on the headline figure and run with it. Or should that be, strike with it, expecting to receive the same.

[turbobloke]

s1962a said:

If other public sector workers have a massive labour shortage, and the public sector is spending billions on agency staff to replace them, then yes, that is a precedent for them to get massive pay increases too.

I will post this again, as it seems like we are comparing apples with oranges

https://www2.staffingindustry.com/%20eng/Editorial...

If you give the JD's their 35% pay rise and tie them into contracts and an obligation to try and save the NHS money in terms of agency staff, then that increase will pay for itself, increase retention of doctors, and most likely increase their morale.

We want the NHS to be more efficient, run like a business, yet we don't want to do the maths.

It may seem that some don't, I suspect those in gov't do the maths and then look at potential wider consequences. Several PHers have argued cogently that JDs deserve particular consideration, that may be so, but this is a bear pit context with public sector unions who won't care much whether they have as strong a case, they'll see a precedent and expect the same. It's this, not the maths, taken together with current affordability <perceptions> which are constraining the gov't response in my view.

[turbobloke]

Murph7355 said:

julian64 said:

You might want to re-read the sentence you have quoted. You are, in fact, agreeing with me

Apologies - I read your post as suggesting the govt haven't actually done that.

The general public shouldn't need it spelling out that we are already spending more than we take in.

A course of Rishi Maths will sort it