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Thread: Opinions on junior doctors striking

  1. #151
    Quote Originally Posted by ryanb741 View Post
    Honest question. Do you think that's a lot of money for the amount of study they have to do, the responsibility they have and the entrance criteria in the first place? Especially compared to what people of a similar ilk earn in the corporate sector?
    The UK health service recruits from a global talent pool of medical practitioners in competition with other health services around the world. The recruitment market seems to imply that it is adequate.

  2. #152
    Quote Originally Posted by helidoc View Post
    Ok, slightly against my better judgement, this is what I think.


    Iím an NHS Consultant in Emergency Med, and have been for 22 yrs. It has been sometime since I was a junior!

    Before the issue of pay / strike, it might be helpful to think about the state of the NHS, what might fix it, and where junior doctors pay and conditions have come from.

    From my perspective, which is solely Emergency Dept based, the NHS has never been so pressurised, or so dysfunctional. Up to 4-5 years ago, it was a winter phenomenon, but itís now all the time.

    It isnít a simple matter of resource. When I was appointed in 2003 (second cons job), I was number 5, which was 4.5 whole time equivalents. We now have 16 consultants and this expansion has been mirrored across all grades of doctor and nurse clinician. Our main issue is a hospital that has over 100% bed occupancy, with an explosion of demand from frail elderly that almost always need an in-patient bed, as they are sick. Our walk in stream of the less sick has also increased massively, and part of this is driven by difficulties in primary care access. There is nowhere to see patients, they queue on corridors and up to 18 have to be looked after by paramedics. Doctors and nurse clinicians canít be effective or productive in that environment. It isnít safe, it isnít dignified. Ambulance response times are now hours, as the paramedics are stuck in hospitals.

    I donít deal with elective work, but pressure from emergency patients constantly pressurises this, and this includes vital cancer work.

    Junior doctors pay and conditions
    Obviously Iím out of this. In some ways they are much better than when I was a junior. I used to work 1:3 weekends, which meant Friday 8am to Monday 6pm without a break, the bulk of my hours being paid at 1/3 of time, I donít mean time and a third.

    Todays doctors do have a lot of antisocial hours and weekends as itís a 168h a week service. There are enforced rest days, 4h education a week and personal development time. I think the hardest thing for my colleagues is having to consult in cubby holes and corridors. They are amazing young people, but the structural impediments to them working the way they feel they should must be hard. They are relatively protected now from high risk decisions, as much of the clinical risk is transferred to consultants. My juniors canít discharge a feverish infant, an adult with chest pain, someone who reattends with the same issue, or admit anyone lest we ok it.

    What about juniors pay?
    I donít really know these days, so Iíve had a look.
    Take the example of a Specialty Trainee in year 3, ST3, so 5 years after graduation with another 3-5 years until completing training.

    What do they get paid, assuming a 48h working week with a weekend frequency of 1:4 or greater?
    Basic £51107
    1A banding is another 50%, so £25553
    Total £76600

    There is also a fairly decent pension scheme which relates to final salary. At this level a 13.5% contribution from pensionable pay is £4140 net, yet that is worth 1/54 of final consultant pensionable pay CPI linked.

    Is the grass greener elsewhere?

    When I was responsible for Foundation training, half of our doctors used to go to Australia or New Zealand , and a chunk never returned. This ceased close to 10 years ago, as Auz / NZ had enough locally trained doctors. Since then we have seen them do a bit of travel, a couple of years of locums before returning to training in the UK. If not sure the antipodes have the capacity to soak up a lot of UK graduates.

    What about the commercial sector?

    Iíve never worked in industry, but to get an equivalent salary in the long term, I suspect itís going to need long hours and productivity or you are out. The NHS doesnít get rid of people easily. There are significant numbers of trainees needing extra support who are looked after by the NHS in a way that contrasts sharply with what I think a commercial organisation would do.

    The NHS is failing, but it isnít as simple as just funding.

    I donít have the answers, but I think it needs a total structural rethink, not pouring cash into the current structure.

    Separating elective and emergency hospitals, so the most complex work could be done in an elective unit, not just the usual low-acuity activity might be a start. It needs protecting from a unscheduled emergencies

    There needs to be a massive expansion in social care beds, and medical support to avoid hospital. When the elderly fall, or become unwell, a care assistant on a low wage is going to call an ambulance and then you are in hospital. You canít blame them for that decision.

    A lot more clinicians, not just doctors but also nurses, and paramedics,in ENP and ACP roles. Nurse clinicians are amazing, and Iím sure there is a role for Physicians Associates too.

    We have recruited lot of doctors from Nigeria, they are amazing, and the best that the country produces. Iím conflicted, as Nigeria needs their skills.

    Should doctors go on strike? I donít know, but if they do I would be honest about the issue being pay. I would be clear about banded pay, job security, career progression, guaranteed pension. Conflating pay with other issues such as patient safety, crowding, delays to be seen, cancelled activity isnít correct.


    Dave


    Sent from my iPhone using Tapatalk
    Thank you

  3. #153
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    Dave ‘Helidoc’

    Thanks for the time taken to write such an informative view from the sharp end and in a very American way “Thank you for your service” I was recently in A&E and can’t speak highly enough of the team under what seemed considerable pressure and ‘volume’.


    It does seem sheer number of people needing to use Hospitals is clearly a massive factor and clearly a population growth of 25% over last 25 years and an ageing population would require matched investment in infrastructure and people that is seemingly lacking or misdirected as bed count has dropped from 240’000 in 2000 down to 160’000 today which is perplexing.

    Expensive PFI deals seem to drain the NHS funds and the use of costly agencies to provide extra staff likewise ?

    It’s also apparent from your writing that hospitals seem to have become first defence as local services become harder or less available to access which must be frustrating for you.

    I know from experience of time spent in Spain pharmacies are superb at advising and dispensing good advice and resolving many ailments or just giving peace of mind and hence avoiding un necessary hospital visits.

    It does not sound like throwing more and more money will resolve the issue long term and as you say it needs a rethink..

    I guess the question is as someone with intimate knowledge what do you think will fix it long term ?

  4. #154
    Are junior doctors junior for ever or do most eventually become consultants and if so how long does this take?

  5. #155
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    Opinions on junior doctors striking

    You donít need to thank me TKH, itís been fun, interesting, worthwhile, I get to train some fantastic people, and the money is good.

    There arenít enough acute beds, thatís obvious, and the acute side compromises the elective side.

    It isnít a failure of General Practice either, although it sometimes feels like that. Our bed pressures come from patients on trolleys that are brought by ambulance. They are predominantly elderly and frail. 20-25 years ago, our patients were much younger, the demographic time-bomb has already arrived.

    We do get significant primary care, maybe 25 patients and hour will book in from about 11am today, and these ambulant patients are quite GP like. That seems a lot, but if you consider the denominator of local GP activity, it probably isnít.

    Why do they come, why wouldnít they! Easy access, easy parking, no appointment, we have a nice Costa to keep you hydrated. My team over do tests, we can get any blood test in an hour, and CT scans on demand. These are psychologically powerful. We donít deliberately over investigate, but bloods are often taken at triage to avoid delays down the line waiting for results, and juniors investigate more than GPs and Consultants. Patients love seeing a specialist and having tests.

    Walk in centres do redirect to us as they are risk averse, so the following is very common:
    Hot child, chest discomfort, palpitations
    Try and get Gp appointment, fail
    Redirected to NHS 111 phone line
    They redirect to walk in centre
    Wait at WIC
    Risk averse clinician says you better go to A&E


    There was another question about how long they are junior doctors for, although that isnít the right term.
    After graduation itís 2 years of Foundation training, then specialty training (ST) which is 3 years for GP (ST1-3), or 6-8 for hospital specialties. Some doctors like secondary care but donít wish to be consultants, they have career grade options such as Staff Grade

    Dave


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    Last edited by helidoc; 28th November 2022 at 10:20.

  6. #156
    Grand Master oldoakknives's Avatar
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    Quote Originally Posted by ryanb741 View Post
    Honest question. Do you think that's a lot of money for the amount of study they have to do, the responsibility they have and the entrance criteria in the first place? Especially compared to what people of a similar ilk earn in the corporate sector?
    I think those in the corporate sector have entirely different work demands and job security as well as other differences.
    Started out with nothing. Still have most of it left.

  7. #157
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    Quote Originally Posted by benny.c View Post
    Whatís poor about it? Iíve said NHS staff should get paid more but life is tough for everyone at the moment and unfortunately in life you have to make compromises sometimes. Struggling to get by does not mean having to skip a service on your Swiss watch.
    I think that going through someoneís sc history to see what they have sold & other forum posts to look for evidence to challenge if they are ďreallyĒ struggling is poor form.

  8. #158
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    It appears that if you're an MP, CEO or banker you're entitled to regular increases in pay and or bonuses, - just saying,
    "Once is happenstance. Twice is coincidence. The third time it's enemy action."

    'Populism, the last refuge of a Tory scoundrel'.

  9. #159
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    V interesting input from Helidoc.

    The healthcare situation in the U K seem to be reaching crisis point and part from Covid all this was predictable. I donít know the answers but Iím sure they involve putting more money in. However, from what Iím seeing the whole structure of healthcare, from the GP model to care homes for the elderly needs a critical review, pouring more money into our current system may not be the right answer.

    An ageing and increasing population are factors that lead to increased healthcare demands and it isnít hard to quantify, the data either exists or could be generated. On a statistical basis the level of demand can be estimated, basically we can predict how much of any specific care/ resource is likely to be required. A simple analogy; if you had a party of 16 of different age groups to cater for you could work out how many party balloons, beer, sandwiches and cakes youíd need to keep everyone happy or at least satisfy basic needs to ensure the event was a success. Why canít we do the same for healthcare? Statistically we can estimate how many people will develop a specific illness, how many broken legs need fixing etc, so its possible to calculate ( estimate) demand. Once thatís been established the number of doctors/ hospitals for any given area can be determined. Thatís what we need, next question is how to provide it in the most cost- effective and efficient manner. Iím probably over simplifying it but in principle this seems correct, work out whatís needed, work out the best structure to provide it and give the final bill to the govt........simples!

    I donít known how healthcare is provided in countries such as France , Germany, Holland etc but I see these nations as our peer group (there are others) and maybe itís time to learn from them. First we have to accept that our cherished NHS model is no longer working and then come up with answers. Healthcare shouldn't be kicked around like a political football, Iíd like to see it given priority as a national crisis which could be addressed by a cross- party coalition focusing purely on fixing it.......but first we have to acknowledge that its well and truly broken!

    Off the top of my head I think we need more resource at a local level ( GPs or something similar) and more care home resource. Cutting down A&E demand and getting the old folks into the right places woukd ve a good starting point!

  10. #160
    Quote Originally Posted by oldoakknives View Post
    Probably not if the pension was £88,364 to £119,133 per year.
    sorry i may have been grumpy having worked 12 hours yesterday on sundays which are always bad when i wrote that

    but you could give the entire NHS a 20% pay rise for less then it costs to give the pensioners 10.1%, that's before the extra help for fuel etc

    you'd also probably get 30% of that back in tax

    like how if you think you're under taxed you can send money to hrmc, if you think your wait for a gp appointment or a&e is too short because we're over paid, feel free to let someone else in the queue go ahead of you

    as a patient once said after coming to A&E with a probklem he'd had for 6 months and never seen someone "sonny, if there anything wrong with me, it's an emergency"

    We all want to very best insurance when paying out, but we want to cheapest insurance when we're buying.

    We all want to have access to things 24/7 but want to work ourselves 9-5 monday to friday

    now back to work :)

  11. #161
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    Quote Originally Posted by number2 View Post
    It appears that if you're an MP, CEO or banker you're entitled to regular increases in pay and or bonuses, - just saying,
    Just so, pensioners too. teehehe.

  12. #162
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    Quote Originally Posted by Passenger View Post
    Just so, pensioners too. teehehe.
    You shit on pensioners, you lose the election. We are the most import pressure group going and we know how to flex our muscles. We make the unions look like babies.

  13. #163
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    Quote Originally Posted by Mick P View Post
    You shit on pensioners, you lose the election. We are the most import pressure group going and we know how to flex our muscles. We make the unions look like babies.
    This is almost certainly the funniest s**t ever posted on TZUK.

  14. #164
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    Quote Originally Posted by Papa Hotel View Post
    This is almost certainly the funniest s**t ever posted on TZUK.
    Also the truest s**t.

  15. #165
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    Quote Originally Posted by Mick P View Post
    You shit on pensioners, you lose the election. We are the most import pressure group going and we know how to flex our muscles. We make the unions look like babies.
    Yup demographics is destiny...poor old GB perpetually in thrall to folk smelling slightly of wee, one foot in the grave, always harking back to idealised good old days, preferring to try and relive past glories than face reality and seize the day ...explains why we are where we are.

    But I digress.

  16. #166
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    Quote Originally Posted by Passenger View Post
    Yup demographics is destiny...poor old GB perpetually in thrall to folk smelling slightly of wee, one foot in the grave, always harking back to idealised good old days, preferring to try and relive past glories than face reality and seize the day ...explains why we are where we are.

    But I digress.
    Last one from me on this as your comments on older peoples medical conditions are bloody offensive and totally uncalled for. I had you down as a decent human being, big mistake on my part.

    The present bunch of retirees are the baby boomers who changed society in the sixties, brought in decent music, stopped the war in Vietnam and have been the most influenceable generation ever.

    We know how to look after ourselves and most of us are healthier than ever before.

    We also cherish democracy and that's why most of us vote time and time again come wind or shine and that is what makes us powerful.

  17. #167
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    Quote Originally Posted by Mick P View Post
    Last one from me on this as your comments on older peoples medical conditions are bloody offensive and totally uncalled for. I had you down as a decent human being, big mistake on my part.

    The present bunch of retirees are the baby boomers who changed society in the sixties, brought in decent music, stopped the war in Vietnam and have been the most influenceable generation ever.

    We know how to look after ourselves and most of us are healthier than ever before.

    We also cherish democracy and that's why most of us vote time and time again come wind or shine and that is what makes us powerful.
    "Once is happenstance. Twice is coincidence. The third time it's enemy action."

    'Populism, the last refuge of a Tory scoundrel'.

  18. #168
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    Quote Originally Posted by Mick P View Post
    Last one from me on this as your comments on older peoples medical conditions are bloody offensive and totally uncalled for. I had you down as a decent human being, big mistake on my part.

    The present bunch of retirees are the baby boomers who changed society in the sixties, brought in decent music, stopped the war in Vietnam and have been the most influenceable generation ever.

    We know how to look after ourselves and most of us are healthier than ever before.

    We also cherish democracy and that's why most of us vote time and time again come wind or shine and that is what makes us powerful.
    And so as a Nation we slip humourlessly backwards and downwards, see most everything, oh and exceptionalism and entitlement.
    Last edited by Passenger; 28th November 2022 at 12:28.

  19. #169
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    Quote Originally Posted by Mick P View Post
    The present bunch of retirees are the baby boomers who changed society in the sixties, brought in decent music, stopped the war in Vietnam and have been the most influenceable generation ever.
    If war is a preoccupation perhaps consider the silent generation before the boomers who were involved in not one but two world wars and founded the NHS.
    Vietnam, honestly.

  20. #170
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    Quote Originally Posted by mrpgkennedy View Post
    sorry i may have been grumpy having worked 12 hours yesterday on sundays which are always bad when i wrote that

    but you could give the entire NHS a 20% pay rise for less then it costs to give the pensioners 10.1%, that's before the extra help for fuel etc

    you'd also probably get 30% of that back in tax

    like how if you think you're under taxed you can send money to hrmc, if you think your wait for a gp appointment or a&e is too short because we're over paid, feel free to let someone else in the queue go ahead of you

    as a patient once said after coming to A&E with a probklem he'd had for 6 months and never seen someone "sonny, if there anything wrong with me, it's an emergency"

    We all want to very best insurance when paying out, but we want to cheapest insurance when we're buying.

    We all want to have access to things 24/7 but want to work ourselves 9-5 monday to friday

    now back to work :)
    The chances of the wait for an appointment to see my GP being too short are somewhere between slim and none tbh. And slim left town. And I don't think my GP is paid less than he was before covid, when I could get a same day appointment if I wanted to.

    I'm sure everyone in the NHS is more deserving of a 20% pay rise, than any of the pensioners getting 10%. That extra 20k for many would probably come in handy.

    And having 24/7 services doesn't necessarily mean someone is working 7 days a week. Staggered working would cover that.

    Anyway no worries about it sounding grumpy, I didn't think that.
    Started out with nothing. Still have most of it left.

  21. #171
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    Quote Originally Posted by oldoakknives View Post
    The chances of the wait for an appointment to see my GP being too short are somewhere between slim and none tbh. And slim left town. And I don't think my GP is paid less than he was before covid, when I could get a same day appointment if I wanted to.

    I'm sure everyone in the NHS is more deserving of a 20% pay rise, than any of the pensioners getting 10%. That extra 20k for many would probably come in handy.

    And having 24/7 services doesn't necessarily mean someone is working 7 days a week. Staggered working would cover that.

    Anyway no worries about it sounding grumpy, I didn't think that.
    Some doctors, nurses, carers, fruit and veg pickers, lorry drivers etc were made to feel just a bit unwelcome.
    "Once is happenstance. Twice is coincidence. The third time it's enemy action."

    'Populism, the last refuge of a Tory scoundrel'.

  22. #172
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    Personally I think the "free at the point of service" NHS has had it. It is the largest employer in Europe and we are still in a mess with even more money demanded.

    Back when it was formed the population was a lot fewer and people died a lot earlier thanks to smoking, unhealthy diets etc.

    Now people live a lot longer, the population is a lot larger so far more patients than ever.

    I honestly think some form of additional private insurance may be the answer.

    Although similar to the NHS in Australia my SIL has had to pay for ambulances and certain procedures out of her own pocket.

    I have had the misfortune to go to hospital in the USA and the difference in A&E between there and here is night and day. Ten minute wait and a CT scan and drugs supplied in around two hours.

    All the time it is "free" people are still going to pile into A&E with minimum 4 hour waits because, why not?
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  23. #173
    Quote Originally Posted by Neil.C View Post
    Personally I think the "free at the point of service" NHS has had it. It is the largest employer in Europe and we are still in a mess with even more money demanded.

    Back when it was formed the population was a lot fewer and people died a lot earlier thanks to smoking, unhealthy diets etc.

    Now people live a lot longer, the population is a lot larger so far more patients than ever.

    I honestly think some form of additional private insurance may be the answer.

    Although similar to the NHS in Australia my SIL has had to pay for ambulances and certain procedures out of her own pocket.

    I have had the misfortune to go to hospital in the USA and the difference in A&E between there and here is night and day. Ten minute wait and a CT scan and drugs supplied in around two hours.

    All the time it is "free" people are still going to pile into A&E with minimum 4 hour waits because, why not?
    I'm in agreement with this.

    Society has changed out of all recognition since the NHS was created and the demands upon it now are far, far greater than ever before. I really cannot see any other alternative than a format of 'self-funding' for those who can afford to pay.

    R
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  24. #174
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    Quote Originally Posted by Passenger View Post
    And so as a Nation YOU slip humourlessly backwards and downwards, see most everything, oh and exceptionalism and entitlement.
    Fixed that for you, in case you need reminding you jumped ship overseas. Can`t expect to play the smug bastard at every juncture and still be considered as one of us.

    I think most of us on here are tired of your anti-British jibes, it really shouldn't concern you unless you feel guilty about deserting your folks.

  25. #175
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    Maybe it's time to accept that the original ideals and aims of the NHS, which were achievable in 1948, are no longer feasible. The NHS is considered sacrosanct but it simply doesn`t work, I`m no expert so I`m in no position to postulate a viable alternative, but something definitely needs to change.

    I get frustrated when I hear about A & E Depts being clogged up with non-urgent cases, that's got to change.

  26. #176
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    Quote Originally Posted by walkerwek1958 View Post
    Fixed that for you, in case you need reminding you jumped ship overseas. Can`t expect to play the smug bastard at every juncture and still be considered as one of us.

    I think most of us on here are tired of your anti-British jibes, it really shouldn't concern you unless you feel guilty about deserting your folks.
    Ah but we're still putting into the UK community chest, take nothing out... So a little thanks should really be in order... though I expect none, good deeds being their own reward, happy to help the less well off and those who can't help themselves.

    Dark and self deprecatory humour particularly in the face of adversity used to be one of our defining national characteristics along with a penchant for gently mocking the continental neighbours. I'm mildly surprised that a Brit's perspective from outside looking in, admittedly with a touch of banter, should irk you quite so much. Funny though!

    If you're tired, might I suggest a lie down. A little nap can be very restorative.

  27. #177
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    I think that NI contributions should be used to fund a pot of cash that builds over the years to pay for medical treatment. Those diagnosed with lifelong conditions from childhood/accidents etc would be exempt. That pot is dipped into every time you use medical facilities. Should you exceed the pot (e.g. in latter life as a pensioner) then a charge is taken out on your property/estate etc to pay for it. If you have no property/estate then that's that I guess, the state would pay.

    This way people would only use healthcare when they need to and it would be (largely) funded and reimbursable after the death of the user.

    At the same time legalise assisted suicide - for those with terminal conditions living in pain. That would save a lot of costs as well

  28. #178
    Quote Originally Posted by ryanb741 View Post
    I think that NI contributions should be used to fund a pot of cash that builds over the years to pay for medical treatment. Those diagnosed with lifelong conditions from childhood/accidents etc would be exempt. That pot is dipped into every time you use medical facilities. Should you exceed the pot (e.g. in latter life as a pensioner) then a charge is taken out on your property/estate etc to pay for it. If you have no property/estate then that's that I guess, the state would pay.

    This way people would only use healthcare when they need to and it would be (largely) funded and reimbursable after the death of the user.
    No doubt a new raft of financial advisors will spring up to 'hide' peoples assets in old age.

  29. #179
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    Quote Originally Posted by number2 View Post
    Some doctors, nurses, carers, fruit and veg pickers, lorry drivers etc were made to feel just a bit unwelcome.
    None of the GPs at my surgery are from the EU. So none returned there. So not sure what the relevance is to my post tbh.
    Started out with nothing. Still have most of it left.

  30. #180
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    Quote Originally Posted by oldoakknives View Post
    None of the GPs at my surgery are from the EU. So none returned there. So not sure what the relevance is to my post tbh.
    Oh sorry I hadn't realised that the thread was only about your surgery / circumstances.
    Last edited by number2; 28th November 2022 at 18:41.
    "Once is happenstance. Twice is coincidence. The third time it's enemy action."

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  31. #181
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    Quote Originally Posted by ryanb741 View Post
    I think that NI contributions should be used to fund a pot of cash that builds over the years to pay for medical treatment.
    NI contributions are already accounted for, unfortunately. One of the first Ponzi schemes.

    Nye Bevan, the founder of the NHS, admitted: "The great secret about the National Insurance Fund is that there ain't no fund."

  32. #182
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    Quote Originally Posted by number2 View Post
    Oh sorry I hadn't realised that the thread was only about your surgery / circumstances.
    It's not only about that. But given you replied to my post I assumed your reply would have some relevance to it. If you just want to be seen to say something '..but Brexit..' fine, but no need to quote my post unless it's relevant.

    Started out with nothing. Still have most of it left.

  33. #183
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    Quote Originally Posted by number2 View Post
    Some doctors, nurses, carers, fruit and veg pickers, lorry drivers etc were made to feel just a bit unwelcome.
    That's interesting. I have to wonder then why so very many other people from abroad feel welcome here at the moment.

    https://www.independent.co.uk/news/u...-b2232091.html

  34. #184
    Quote Originally Posted by ryanb741 View Post
    I think that NI contributions should be used to fund a pot of cash that builds over the years to pay for medical treatment. Those diagnosed with lifelong conditions from childhood/accidents etc would be exempt. That pot is dipped into every time you use medical facilities. Should you exceed the pot (e.g. in latter life as a pensioner) then a charge is taken out on your property/estate etc to pay for it. If you have no property/estate then that's that I guess, the state would pay.

    This way people would only use healthcare when they need to and it would be (largely) funded and reimbursable after the death of the user.

    At the same time legalise assisted suicide - for those with terminal conditions living in pain. That would save a lot of costs as well
    You really don't like the elderly do you? Have you forgotten the bit where people now are already forced to sell their homes to fund care in later life? Ive got a good idea….why don't we just kill everyone over 70 thats unlikely to live the next 5 years…that would work wouldn't it? Harvest the organs for those likely to live over 70 and also get their house….double whammy.

    Alternatively we could just use the resources better and turn away people who rock up with a splinter in their toe, anyone brought in over the weekend pissed out of their tree ( you only need watch any 999 emergency programme on the telly to see this ) gets charged for the treatment including the ambulance. Minimum charge £1000….there you go, enforceable by law. Theres so much more we can do than A chucking money at people and B taxing people who can ill afford it.
    Last edited by Franky Four Fingers; 28th November 2022 at 20:14.

  35. #185
    Grand Master ryanb741's Avatar
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    Quote Originally Posted by Franky Four Fingers View Post
    You really don't like the elderly do you? Have you forgotten the bit where people now are already forced to sell their homes to fund care in later life? Ive got a good idea….why don't we just kill everyone over 70 thats unlikely to live the next 5 years…that would work wouldn't it? Harvest the organs for those likely to live over 70 and also get their house….double whammy.

    Alternatively we could just use the resources better and turn away people who rock up with a splinter in their toe, anyone brought in over the weekend pissed out of their tree ( you only need watch any 999 emergency programme on the telly to see this ) gets charged for the treatment including the ambulance. Minimum charge £1000‚Ķ.there you go, enforceable by law. Theres so much more we can do than A chucking money at people and B taxing people who can ill afford it.
    Sure. So basically we'll end up with privatisation then.

    Re using the resources better means attracting a better calibre of staff to create an organisational management framework across the entire NHS (virtually impossible as it is massive), lay off the poor quality staff, instill cultural change etc etc etc. All of which will cost more money in the short term if you do it internally, or you outsource it and it becomes private.

    Some very difficult decisions to take. 1 would be to cut overseas aid, cut military budget, don't support Ukraine etc. All unpalatable and a non starter.

    Another would be to fund and instil a culture of healthy eating and living. Alcohol sales restricted to Friday and Saturdays only. Huge levys on fast food, subsidised veg etc. Subsidised gyms. Ban smoking entirely. All of which will lower the burden on the NHS.

    Final option is you start paying for your healthcare. And this final option will be what happens. Even the 'free healthcare' countries do have to pay something so that will happen here I'm sure.

  36. #186
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    Quote Originally Posted by ryanb741 View Post
    Sure. So basically we'll end up with privatisation then.

    Re using the resources better means attracting a better calibre of staff to create an organisational management framework across the entire NHS (virtually impossible as it is massive), lay off the poor quality staff, instill cultural change etc etc etc. All of which will cost more money in the short term if you do it internally, or you outsource it and it becomes private.

    Some very difficult decisions to take. 1 would be to cut overseas aid, cut military budget, don't support Ukraine etc. All unpalatable and a non starter.

    Another would be to fund and instil a culture of healthy eating and living. Alcohol sales restricted to Friday and Saturdays only. Huge levys on fast food, subsidised veg etc. Subsidised gyms. Ban smoking entirely. All of which will lower the burden on the NHS.

    Final option is you start paying for your healthcare. And this final option will be what happens. Even the 'free healthcare' countries do have to pay something so that will happen here I'm sure.
    I think you will find that the younger generation of 20ish year olds are pretty healthy and seem to enjoy a healthier lifestyle than previous generations. Less of them smoke than previous generations, they drink less, and they like going to the gym etc even if it is for the look at me photos. They wonít be looking like Pilsbury Dough Boys and Girls when they reach 50 , unlike many 50 year olds now from my and your generation.


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  37. #187
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    Quote Originally Posted by monogroover View Post
    That's interesting. I have to wonder then why so very many other people from abroad feel welcome here at the moment.

    https://www.independent.co.uk/news/u...-b2232091.html
    Hahaha good whataboutism...
    "Once is happenstance. Twice is coincidence. The third time it's enemy action."

    'Populism, the last refuge of a Tory scoundrel'.

  38. #188
    Quote Originally Posted by monogroover View Post
    That's interesting. I have to wonder then why so very many other people from abroad feel welcome here at the moment.

    https://www.independent.co.uk/news/u...-b2232091.html
    There's no need to 'wonder', simply read the article.

    R
    Ignorance breeds Fear. Fear breeds Hatred. Hatred breeds Ignorance. Break the chain.

  39. #189
    The thread has drifted a bit from the original topicÖ

    OP - strike if you want to. As a consultant you would have my support. The pay has actually been eroded over what is more like 20-25 years in real terms.

    The end of the old firm structure was before my time, but in those days you received free accommodation and you had the benefit of a tightly knit unit of colleagues. The flip side of course was the hours culture was prehistoric.

    When I was an F1 back in 2014, one of our consultants showed us a payslip from the very early noughties that was only a couple of grand shy of the £21k we were on then.

    Beware the BMA though. As has been previously pointed out, they marched us to the top of the hill in 2016 only to take us back down again with significantly worse terms and a pay progression structure that peaked and then flattened at the CT/ST 2/3 nodal point. Itís not much fun in a on-call light specialty like psychiatry when you realise how little extra you will earn between starting life as a reg, and ending training a few days before consultant life beckons. The craft specialties have the bonus of the golden nugget to keep traineesí minds on the bigger prize. However, as we know, the job itself is the most rewarding profession out there, so not all benefits can be measured at the end of the month.

    Good luck to you all in whatever you vote for.

  40. #190
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    Quote Originally Posted by ralphy View Post
    There's no need to 'wonder', simply read the article.

    R
    QUALITY:applouse

  41. #191
    Just a comment on the A&E reg on 76k

    They will be working round the clock. Try maintaining any relationship or family life with those hours. Try doing it for six to eight years of training. It's unsustainable for even months, let alone years

    I did an A&E rotation that lasted four months and it was easily the worst rotation of my junior doctor years. The registrars were doing nights at least twice a month, if not more. Night shifts mess up your life like very few other things

    I'm now in my final months of GP training and will do a max of one day NHS GP on qualifying. Just to help those that really need it. Rest of the time I'll do other things to earn my bread because the NHS will break me. Demand is unsustainable

  42. #192
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    This does belong in G&D as it is a civilised discussion on key social issues.

    My mini manifesto:

    1. No MP, Peer, donor, spin doctor etc is allowed to use private hospitals, or skip any queue, irrespective of their position of wealth. Many on here have had jobs with far more social purpose or value but been left to rot. Let them experience the pain, and feel the panic normal people do.
    2. Portcullis House and HOC heating temperatures reduced to levels which will not damage the buildings but will reflect the crisis. Let them freeze.
    3. Meals in PH of HoC to cost 30p to make, hot or cold. Lunches elsewhere eg clubs strictly forbidden.
    4. Private schools: to lose charitable status - that money goes direct to the LEA to help fund things like photocopying paper, locks on toilet door, books. Yes, things really are that bad, and we are not going to subsidies children of oligarchs and CCP members to get a UK privileged education while ours suffer. My local private schools do almost zero for the local community, apart from clog up with roads with badly driven and parked spotless 4x4s. An ex-public school person spouting here.
    5. Transport: no 1st class travel, and nearly all ministerial vehicles temporarily withdrawn - climate commitments and sheer cost. NL Queen Wilhelmina used to cycle everywhere after all.
    6. Pay: no more increases. They may occasionally think they're worth - PMQ shows they're not - so share the pain, not economically medicate it away.

    They must experience what things are like, not go on what their overly-arrogant inexperienced aides tell them.

    Failing that, a military coup. We have enough suitable TZ'ers to form a better HQ, and enough military watches to look the part.

    All for one...

  43. #193
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    Quote Originally Posted by Snowdon View Post
    Just a comment on the A&E reg on 76k

    They will be working round the clock. Try maintaining any relationship or family life with those hours. Try doing it for six to eight years of training. It's unsustainable for even months, let alone years

    I did an A&E rotation that lasted four months and it was easily the worst rotation of my junior doctor years. The registrars were doing nights at least twice a month, if not more. Night shifts mess up your life like very few other things

    I'm now in my final months of GP training and will do a max of one day NHS GP on qualifying. Just to help those that really need it. Rest of the time I'll do other things to earn my bread because the NHS will break me. Demand is unsustainable
    I think you make a very valid point. The work life balance is totally absent in the situation you describe.

  44. #194
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    Quote Originally Posted by OldHooky View Post
    This does belong in G&D as it is a civilised discussion on key social issues.

    My mini manifesto:

    1. No MP, Peer, donor, spin doctor etc is allowed to use private hospitals, or skip any queue, irrespective of their position of wealth. Many on here have had jobs with far more social purpose or value but been left to rot. Let them experience the pain, and feel the panic normal people do.
    2. Portcullis House and HOC heating temperatures reduced to levels which will not damage the buildings but will reflect the crisis. Let them freeze.
    3. Meals in PH of HoC to cost 30p to make, hot or cold. Lunches elsewhere eg clubs strictly forbidden.
    4. Private schools: to lose charitable status - that money goes direct to the LEA to help fund things like photocopying paper, locks on toilet door, books. Yes, things really are that bad, and we are not going to subsidies children of oligarchs and CCP members to get a UK privileged education while ours suffer. My local private schools do almost zero for the local community, apart from clog up with roads with badly driven and parked spotless 4x4s. An ex-public school person spouting here.
    5. Transport: no 1st class travel, and nearly all ministerial vehicles temporarily withdrawn - climate commitments and sheer cost. NL Queen Wilhelmina used to cycle everywhere after all.
    6. Pay: no more increases. They may occasionally think they're worth - PMQ shows they're not - so share the pain, not economically medicate it away.

    They must experience what things are like, not go on what their overly-arrogant inexperienced aides tell them.

    Failing that, a military coup. We have enough suitable TZ'ers to form a better HQ, and enough military watches to look the part.

    All for one...
    I like the cut of your jib sir.

    Also. Brexit broke the NHS. Most foreign doctors and nurses who plugged the gaps and kept things going by completing their training here, no longer can. Instant shortage of staff. Add in poor pay for docs and nurses and that gap shows no sign of being filled.

    Having lived in the states and seeing many friends and acquaintances heart breaking Ďgo fund meí begging requests on Facebook for life saving medical procedures due to no insurance or insurance weaselling out of covering their illness I really donít want my kids or I to be faced with that despicable horror show.

    Only 3 words ever came out of that floppy haired mug Borisí mouth that I agreed with and they were ďprotect the NHSĒ

  45. #195
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    It is difficult perhaps impossible to point to anything positive from a socio economic perspective that this Government has achieved in the last 12 years, if we rule out the hypothetical and intangibles like 'taking back control'... though current evidence rather suggests a loss of control across several key areas including but not restricted to the economy, borders and the health service, that is if we're being honest.
    For balance though... hashtag winning.



    Yup also seen the tragic go fund me requests.
    Last edited by Passenger; 5th December 2022 at 08:44.

  46. #196
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    Quote Originally Posted by OldHooky View Post
    This does belong in G&D as it is a civilised discussion on key social issues.

    My mini manifesto:

    1. No MP, Peer, donor, spin doctor etc is allowed to use private hospitals, or skip any queue, irrespective of their position of wealth. Many on here have had jobs with far more social purpose or value but been left to rot. Let them experience the pain, and feel the panic normal people do.
    ÖÖÖ.

    All for one...

    Perhaps more people who can afford to go private should do so, and take some of the pressure off the NHS.


    Quote Originally Posted by OldHooky View Post
    This does belong in G&D as it is a civilised discussion on key social issues.

    My mini manifesto:

    ÖÖÖÖ.
    4. Private schools: to lose charitable status - that money goes direct to the LEA to help fund things like photocopying paper, locks on toilet door, books. Yes, things really are that bad, and we are not going to subsidies children of oligarchs and CCP members to get a UK privileged education while ours suffer. My local private schools do almost zero for the local community, apart from clog up with roads with badly driven and parked spotless 4x4s. An ex-public school person spouting here.
    ÖÖ..

    All for one...

    As someone who lives a few hundred yards from a state funded school, I can confirm the roads are just as badly clogged up twice a day with badly driven and parked spotless 4x4s.
    They certainly arenít all hobbling to school like underprivileged Dickensian waifs. Perhaps things are different in London?
    Started out with nothing. Still have most of it left.

  47. #197
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    Quote Originally Posted by oldoakknives View Post
    Perhaps more people who can afford to go private should do so, and take some of the pressure off the NHS.





    As someone who lives a few hundred yards from a state funded school, I can confirm the roads are just as badly clogged up twice a day with badly driven and parked spotless 4x4s.
    They certainly arenít all hobbling to school like underprivileged Dickensian waifs. Perhaps things are different in London?
    It must be nice for you to see all the clean cars OOK...donīt you also drive a 4 x 4, is it spotless? Do you go private thereby taking pressure off the Nhs? GOOD ON YOU if So.

  48. #198
    Grand Master oldoakknives's Avatar
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    Quote Originally Posted by Passenger View Post
    It must be nice for you to see all the clean cars OOK...donīt you also drive a 4 x 4, is it spotless? Do you go private thereby taking pressure off the Nhs? GOOD ON YOU if So.
    Yes. Yes. Yes. Thank you.

  49. #199
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    Quote Originally Posted by oldoakknives View Post
    Yes. Yes. Yes. Thank you.
    #Winning. Congrats.

  50. #200
    Grand Master oldoakknives's Avatar
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    Quote Originally Posted by Passenger View Post
    #Winning. Congrats.
    Hardly compared to the more well heeled here, but thanks anyway.

    And I wasn't actually complaining about the school traffic, it doesn't affect me at all. Merely observing that most schools these days are very busy with cars dropping children off and collecting them. You can't blame them with all the headlines about children being harassed these days.
    Started out with nothing. Still have most of it left.

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