Deal over junior doctors' contracts was torn up, reveals ex-health minister | Society | The Guardian
http://www.theguardian.com/society/2015 ... h-minister

Sounds about right. Why bother when you can kill one of the best ideas ever slowly while simultaneously selling it off bit by bit?

Glad to see some people are taking notice. Maybe it's shifting more into the public conscious.

At the heart of it, there are two separate issues which Hunt is trying to confuse. One is that people admitted at the weekends tend to die more. He hasn't delved any deeper or if he has, he has ignored it. People at the weekend tend to be more poorly/unwell and hence more likely to die. Doesnt seem to be any measure of when they die (that day/week/month). But it's an effect noticed across the world even in more staffed/funded healthcare systems.

Hunt is trying to tie this to lack of consultants and junior docs at weekends. The largest cost in the NHs is staff salaries, and doctors are the most expensive. Both consultant and junior doc cotracts are up for renewal and Hunt basically wants more work for the same money. If he were serious about getting it run properly, he would increase funding to 7/5 =1.4 ie 40% more. He'd have 40% more staff too. But no, he wants everyone to work 40% harder. If every junior doc were suddenly shifted to the new contract overnight, the salary would drop from between 10 and 30%. Big enough that suddenly docs wouldnt be able to afford to live where they are.

More and more docs are seeing the light and emigrating. Why stay in the UK, be treated like [LIFTED] and then get [LIFTED] pay for it. As one eloquent junior doc put it on Question Time: when the banks were in crisis the Govt bailed them out. They paid high salaries to retain highly skilled professionals. Are doctors less important than bankers?

If all you're interested in is money, yes.

I agree with pretty much everything you've said with the exception of the above. Their salary won't drop their hourly rate will.
They'll be on exactly the same money that they can live off at the moment so I don't see why they'll suddenly be unable to live where they are at the moment.
Having said that, nobody in their right mind would accept a 10 - 30% drop in their hourly rate and more hours so I entirely support doctors putting two fingers up at the government.

3 consultants did rounds on Saturday in the ward I was on plenty of Juniors running around as well.

How did you work that out?
The hourly rate drops, so if they work the same hours, the salary will drop. Bearing in mind that junior doctors are normally paid a salary*. They'd have to work more hours to maintain the same salary.


* Currently, a junior doc will have a basic salary with banding to cover the level of anti-social hours. The banding is stratified into 1c (20%), 1b (40%), 1a (50%), 2b (50%), 2a(80%), 3 (100%). Generally speaking, the banding applies to the whole year's rota.

I did say Hunt is making it look like this.

Remember, I've worked as a junior doc. There's plenty of daytime cover at the weekend. It does drop at night but then there tends to be less demand at night. Typically, having started at 8pm, by 1-2am, I'd finished all the outstanding tasks and would have a couple of quiet hours before being called to problems at around 4am. By 6am, the nurses would start their morning rounds and find problems, which is when they'd bleep you.

In addition, Hunt blamed consultants opting out of working weekends. IIRC it was found that only one consultant out of 4000 had opted out.

It's all media spin designed to villify doctors.

Either you are being asked to work more hours for the same money, in which case the hourly rate drops but the overall salary stays the same, or the hourly rate is being reduced but your hours are staying the same so the salary drops.
Having done a bit more reading I see that the proposals appear to be to reduce the times that are considered anti-social (and so attract a higher level of pay) by increasing the 'plain time' from 7am - 7pm Monday to Friday to 7am - 10pm Monday to Saturday. That's a straight pay cut fair enough. My question is - how many hours is a junior doctor normally contracted to work, is that number being forced up along with the change to plain time or are doctors saying they will have to work more hours to cover the shortfall in their wages imposed by the change to what's classified as plain time?

The stuff coming out from the BMA is implying, at least they way I've read it, that the changes amount to a pay cut and increase in hours. Naturally the government is denying this by saying the basic salary is going up.
They can't both be right.

So we're deciding which of two sides is telling the truth, and one side is politicians? Even on a Monday morning...

I think you can probably guess which side I'll be coming down on.

The aim, I gather, is to reduce spending on salaries by imposing cuts.


48 hours as per EWTD. This is an average so the idea is that you could work more one week and less the following week so long as it came out to 48 hours average. eg Mon-Thurs nights (8pm-8am; 12*4 = 48) with the rest of the week off. Remember, because of EWTD, doctors aren't supposed to work more than 48 hours for both patient safety and personal health.


As I stated above, the basic salary is supplemented by the banding. So IIRC my starting salary was something like £20k/yr but the 50% banding meant I got an extra £10k (this was eight years ago so I may be imprecise with figures). The idea is that the basic salary will go up, but the pay for the antisocial hours will go down. So you could have someone who works Tues - Sat and does 2pm - 10pm and will get nothing other than basic pay. That would mean £20k/yr plus whatever increase in basic pay Hunt is alleging.

More than this, there's pay progression. Every year, your pay goes up the pay scale because you are more experienced. So a junior doctor who has been working for twelve months will earn more than someone who has just started. Let's say you've been working as a junior doc in say Paediatrics and you've been there 3 years. You'll have had five years of pay progression (two years Foundation and three years Specialty). If you jump to another specialty eg Orthopaedics, you'll move up to the next level. But under the new contract, your three years are ignored and you start on the bottom rung of specialty training.

Take home pay will also worsen because of increased pension contributions. Almost all junior doctors will be worse off.