# NHS doctors’ strike is ‘inevitable,’ says new BMA chair



## Northerner (Jul 15, 2022)

A doctor’s strike is “inevitable” and will expose how dangerously threadbare the Conservatives have left the health service, the profession’s new leader has said.

In his first interview since taking over as the British Medical Association’s chair of council, Prof Philip Banfield warned ministers that doctors will take the fight to them by using a pay dispute to tell the public patients are dying as a direct result of government neglect of the NHS.

Members of the doctors’ union voted last month to seek a 30% increase in their salaries over the next five years. This would amount to a “full pay restoration” for the real-terms cut in income they have suffered since 2008, through years of pay freezes and 1% or 2% annual uplifts. Ministers criticised the claim as unrealistic and unaffordable.









						NHS doctors’ strike is ‘inevitable,’ says new BMA chair
					

Exclusive: doctors will use pay row to expose ‘desperate state’ of NHS after years of government neglect, Prof Philip Banfield warned




					www.theguardian.com


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## mikeyB (Jul 16, 2022)

Doctors are just one of the many public sector workers such as teachers who have had pay rises not keeping up with inflation since the Tories came into power in 2010.  All are looking for corrective pay rises and threatening industrial action. 

The pay rises in the private sector are averaging around 8% in many areas, despite the right wing press moaning about public sector workers bleeding the country dry.


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## Abi (Jul 16, 2022)

But more pay will mean the chalice is still just as poisonous.
The whole system needs huge reform- ensuring that work is delegated appropriately to staff according to their skill  and there is sufficient time / equipment / support to complete it.
Some patients are being shockingly under served ( and others are still making inappropriate demands )


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## travellor (Jul 16, 2022)

Abi said:


> But more pay will mean the chalice is still just as poisonous.
> The whole system needs huge reform- ensuring that work is delegated appropriately to staff according to their skill  and there is sufficient time / equipment / support to complete it.
> Some patients are being shockingly under served ( and others are still making inappropriate demands )



£120,000 a year isn't too shabby.
And do many students start training on £30,000 basic rising to £40,000 with 8 hours overtime week?


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## Windy (Jul 17, 2022)

Amity Island said:


> Why are some of the wealthiest employees in the country planning on striking? Are they struggling to make ends meet? What is their motivation?



I imagine that their motivation is to see their pay stop being effectively eroded each year due to inflation (which is 9%, according to the ONS). They've had one and two percent pay rises per year in the past, which is in effect a 7 or 8% pay cut, if that's what the government offer them now. They have skills that the country needs, it takes 10 years to train a GP, and they're seeing shortages of GPs which is putting pressure on the ones in post. 

I don't disagree that they're paid well, but do you expect intelligent, highly qualified health professionals like doctors to work for a crappy wage? If I'd spent 10 years studying for something, I'd want a decent wage for it. It's not unreasonable to expect them to leave medicine and just get a better paying job somewhere else if they're not paid the going rate, or leave the country and work somewhere else where their skills, knowledge and experience are valued.

I don't work in health care, but I do appreciate the job that they're doing. I had a phone appointment with my GP, and it was at 7.30 in the evening. If I had to work as late as that after starting at 8am, I think I'd be earning every penny of the £120k. Merchant bankers earn about £150k a year, are they worth more to society than a GP?


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## travellor (Jul 17, 2022)

Windy said:


> I imagine that their motivation is to see their pay stop being effectively eroded each year due to inflation (which is 9%, according to the ONS). They've had one and two percent pay rises per year in the past, which is in effect a 7 or 8% pay cut, if that's what the government offer them now. They have skills that the country needs, it takes 10 years to train a GP, and they're seeing shortages of GPs which is putting pressure on the ones in post.
> 
> I don't disagree that they're paid well, but do you expect intelligent, highly qualified health professionals like doctors to work for a crappy wage? If I'd spent 10 years studying for something, I'd want a decent wage for it. It's not unreasonable to expect them to leave medicine and just get a better paying job somewhere else if they're not paid the going rate, or leave the country and work somewhere else where their skills, knowledge and experience are valued.
> 
> I don't work in health care, but I do appreciate the job that they're doing. I had a phone appointment with my GP, and it was at 7.30 in the evening. If I had to work as late as that after starting at 8am, I think I'd be earning every penny of the £120k. Merchant bankers earn about £150k a year, are they worth more to society than a GP



Well doctors use merchant bankers to look after their pensions, so I guess they think so.
And this ten years studying?
Every job has ongoing training, just not with such high starting salaries and guaranteed pay rises throughout.
As to shift work, yes, some may work a longer day on day true, but they certainly don't work everyday. (The old "Doctors in today" on the surgery notice board, when you go get into the surgery?)
Trying to actually get an appointment with your own doctor nowadays is nearly impossible, not knowing if they are in or not anymore.
Maybe telling people on the breadline now holding down two or three jobs that £120k for the odd long day isn't enough and justifies a £40,000 pay rise isn't going to get them brownie points off most people?


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## Windy (Jul 17, 2022)

travellor said:


> Trying to actually get an appointment with your own doctor nowadays is nearly impossible, not knowing if they are in or not anymore.


It's a signifier of how much pressure the NHS is under. I'm not sure paying GPs less in real terms (as a 9% inflation rate and a 2% pay rise would mean a 7% pay cut for them) would help with recruitment of more GPs to help with the workload.


travellor said:


> Maybe telling people on the breadline now holding down two or three jobs that £120k for the odd long day isn't enough and justifies a £40,000 pay rise isn't going to get them brownie points off most people?


Long days seem to be standard for a GP - even part time ones are 40 hours a week, according to the BMA, so I've no idea how many hours full time would be.
I don't think anyone's telling anyone that £120k isn't enough, it's just the going rate for GPs. It's supply and demand, just like it is with housing and everything else, if there's scarcity of houses, or doctors or whatever, it costs more. It's not a popularity contest or a race to the bottom. If you hold a skillset which is rare and useful, then perhaps you should be paid commensurate with that, or you'll take your skills elsewhere. If you don't have a rare skillset, and have to work two or three jobs, then your employers should value you more, and pay you enough that you can afford to live without recourse to food banks or benefits. Perhaps I'm an idealist, but I don't think anyone deserves to live in poverty, irrespective of the job that they do. I've worked in a factory and packed shelves, and even less glamorous jobs like these shouldn't mean poverty wages. Even as a factory worker, I would have recognised that GPs should earn more than me for their skillset and experience.
The government had plenty of money to waste on some things, like useless PPE (£4 billion wasted during the pandemic that had to be burned as it wasn't up to scratch), so I suspect it's entirely politically motivated that the coffers are apparently bare for pay rises, but full for other things.


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## Windy (Jul 17, 2022)

Amity Island said:


> The problem then appears to be not the actual amount they get paid, but by the comparison to this or that (inflation, what others are being paid),  only then is it seen as a problem.
> 
> E.g I've got a great mobile phone.....until I see my mates phone which is better, my phone isn't as good now.


No, I don't think it's the politics of envy or the lure of new shiny things, it's just supply and demand. If you want something rare, you have to pay more for it. If it takes ten years to train someone to do something, then it makes sense to keep them doing that job after, and to do that it helps not to keep effectively cutting their pay by allowing it to fall behind the inflation rate.


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## travellor (Jul 17, 2022)

Windy said:


> It's a signifier of how much pressure the NHS is under. I'm not sure paying GPs less in real terms (as a 9% inflation rate and a 2% pay rise would mean a 7% pay cut for them) would help with recruitment of more GPs to help with the workload.
> 
> Long days seem to be standard for a GP - even part time ones are 40 hours a week, according to the BMA, so I've no idea how many hours full time would be.
> I don't think anyone's telling anyone that £120k isn't enough, it's just the going rate for GPs. It's supply and demand, just like it is with housing and everything else, if there's scarcity of houses, or doctors or whatever, it costs more. It's not a popularity contest or a race to the bottom. If you hold a skillset which is rare and useful, then perhaps you should be paid commensurate with that, or you'll take your skills elsewhere. If you don't have a rare skillset, and have to work two or three jobs, then your employers should value you more, and pay you enough that you can afford to live without recourse to food banks or benefits. Perhaps I'm an idealist, but I don't think anyone deserves to live in poverty, irrespective of the job that they do. I've worked in a factory and packed shelves, and even less glamorous jobs like these shouldn't mean poverty wages. Even as a factory worker, I would have recognised that GPs should earn more than me for their skillset and experience.
> The government had plenty of money to waste on some things, like useless PPE (£4 billion wasted during the pandemic that had to be burned as it wasn't up to scratch), so I suspect it's entirely politically motivated that the coffers are apparently bare for pay rises, but full for other things.



It's a scarcity generated by the Medical old boys network.
The UK has been notorious for setting the university entry requirements at an artificially high level for UK candidates.
Or giving a nod to those whose parents can "support" the university.
And before the "well, we need the brainiest", we are more than happy to accept that doctors trained abroad, in university education that is totally different to ours, and indeed of which we actually normally have no knowledge, are just as intelligent, and obviously worth the same pay level.


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## Windy (Jul 17, 2022)

travellor said:


> It's a scarcity generated by the Medical old boys network.
> The UK has been notorious for setting the university entry requirements at an artificially high level for UK candidates.
> Or giving a nod to those whose parents can "support" the university.
> And before the "well, we need the brainiest", we are more than happy to accept that doctors trained abroad, in university education that is totally different to ours, and indeed of which we actually normally have no knowledge, are just as intelligent, and obviously worth the same pay level.


I wouldn't disagree with you there. There's a research paper which says that only 4% of doctors are from a working class background. How we should address this, I don't have an answer. I would like for able, talented children who happen to be poor to have the same opportunities as able, talented children who happen to be rich, but I acknowledge it's not the case.
As for recruiting (poaching?) doctors who have trained abroad, they're probably needed in their home countries too, but I can understand why people would move to another country for a better wage and better opportunites than they can get at home.
If I had any answers to the whole thing, I would be PM, rather than an office worker!
Hope you stay cool in this horrible heat @travellor, Sarah


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## travellor (Jul 17, 2022)

Windy said:


> I wouldn't disagree with you there. There's a research paper which says that only 4% of doctors are from a working class background. How we should address this, I don't have an answer. I would like for able, talented children who happen to be poor to have the same opportunities as able, talented children who happen to be rich, but I acknowledge it's not the case.
> As for recruiting (poaching?) doctors who have trained abroad, they're probably needed in their home countries too, but I can understand why people would move to another country for a better wage and better opportunites than they can get at home.
> If I had any answers to the whole thing, I would be PM, rather than an office worker!
> Hope you stay cool in this horrible heat @travellor, Sarah



We should address it by accepting they are just a very small part of the NHS as a whole.
Without the machinery, the nurses, the receptionist who answers the phone, they couldn't work.
It's a group that propogates their own myth, and we should actively force change to entry requirements and class background.


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## Hardy (Jul 17, 2022)

Where has this £120000 figure come from?
 It is not reflective of pay of  junior doctors and GPs


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## travellor (Jul 17, 2022)

Hardy said:


> Where has this £120000 figure come from?
> It is not reflective of pay of  junior doctors and GPs



You're right..Junior doctors pay tops out on £80,000 a year.
Then again, that's not a shabby junior salary.
But we are talking about doctors, it seems a bit of a distraction to mention "junior".
Unless other non junior doctors want to chip a bit of their £120,000 in to cover them? Or step back from their demands for the same 30% rise?

A salaried GP is £62,000 to £94,000.
GP partners are self-employed and would only be doing that if they beat that salary.


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## Hardy (Jul 17, 2022)

My understanding is that a junior doctor is any doctor that is  not a consultant. 

This is on my surgery website 
The average pay for GPs working in xx Surgery in the last financial year was £73,989 before tax and National Insurance.

I have absolutely no issue with this


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## mikeyB (Jul 17, 2022)

travellor said:


> Well doctors use merchant bankers to look after their pensions, so I guess they think so.
> And this ten years studying?
> Every job has ongoing training, just not with such high starting salaries and guaranteed pay rises throughout.
> As to shift work, yes, some may work a longer day on day true, but they certainly don't work everyday. (The old "Doctors in today" on the surgery notice board, when you go get into the surgery?)
> ...


I don't know of any doctors who used merchant bankers to manage their pensions. Not when the NHS pension is one of the best you can pay for. I know, because that's what my accountant said. The Civil Service is even better, it's not contributory to make up for the lower pay they get in comparison to the private sector similar jobs. That's why my accumulated pension in the NHS was transferred into the Civil Service when i changed my job. My pension now increases each year in line with RPI. And it's more money than any junior doctor can make.


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## Windy (Jul 17, 2022)

Amity Island said:


> Hi @Windy
> 
> I don't think I explained what i meant very well.
> 
> ...


It's not just humans who see inequitable treatment and don't like it. There's a fascinating experiment shown here with two monkeys who are paid with cucumber or grapes (2 mins 43s long). 
No one wants to be cucumber monkey.


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## Abi (Jul 17, 2022)

I think the real disatisfaction is about far more  than pay. It's about working in a system which is often barely or non functioning in which people become mired down having to do the jobs of others and hence cannot do their own effectively...
 (Competent )Receptionists and nurses are vital I agree - and a whole host of others not only in  health care but other services -we need other staff in sufficient numbers- often do not end up with them


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## Benny G (Jul 17, 2022)

So, 12% of GPs working full time, perhaps the money is not so important to the part timers, or else they would work more hours and put in a full week.

Yes, the figures are from before the government's lock downs.



			https://www.pulsetoday.co.uk/news/workload/nhs-england-says-almost-90-of-gps-work-part-time-in-response-to-pulse-survey/


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## travellor (Jul 18, 2022)

Benny G said:


> View attachment 21525
> 
> So, 12% of GPs working full time, perhaps the money is not so important to the part timers, or else they would work more hours and put in a full week.
> 
> ...



They'd better advertise the strike well then.
We might not realise otherwise!


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## nonethewiser (Jul 18, 2022)

Fundamental problem with recruitment & retention with GPS far as can gather, fair few in our surgery have opted for early retirement

. Money they make is good & very generous but couldn't do job for no amount of money, must be very stressful.


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## Abi (Jul 18, 2022)

It could be made less stressful with better less unwieldy IT support, more admin support, better signposting of patients and other sectors including social care and secondary care able to also  function more effectively. Ultimately better patient education as to which problems need a GP and when this is urgent and when other services ranging from 999 to social services to informal/ voluntary sector and support from family and friends is more approprate. Hell I just remembered 999 needs to be able to function which means ambulances need to be able to offload which needs social services need to be able to function. Utimately more appointments are needed and quite probably more hours worked by GPs doing clinically relevent work and not being bogged down by nonsense. Which means  more other staff so that it is safe for them to see patients and an end to the " 5 o'clock " - for some services( or even 5:30 or 6:30) -6:30 for all other staff to leave-phenomenon which means that if it is still appropriate for you to offer an appointment that day rather than direct to A and E  there will be someone in the building with you in case they do become agitated/ agressive or an emergency develops for which you need assistance,  or contacting ambulance service, sending urgent fax ( if not in England) etc  Plus pharmacies to still be open and mental health services to be contactable in the event of the patient having a mental health crisis
And lots and lots of coffee


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## Benny G (Jul 18, 2022)

Unfortunately the NHS is in an unstoppable downward spiral. If it was an animal, I'm not sure at what point it should be allowed to pass over the rainbow bridge. That day is coming.


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## travellor (Jul 22, 2022)

Benny G said:


> View attachment 21525
> 
> So, 12% of GPs working full time, perhaps the money is not so important to the part timers, or else they would work more hours and put in a full week.
> 
> ...



This isn't actually true for all NHS doctors.
(Including GP's I know that do private surgeries)
This is the number of hours they are working on contract to the NHS.

Not the number of hours the NHS pay them for.
Most of the senior doctors and consultants at our local NHS hospitals work part time.
But only because they work at a local private hospital on other days.
So, you can jump the queue, see the consultants privately, then they will put you in the NHS system, - jumping the queue.
Or, the local NHS will refer patients to the private clinic, paying the consultants the fees for them, (subcontracted NHS work), and then the consultant will mix continued care at the private clinic, and in NHS hospitals, in a mix of NHS and private work, but all paid by the NHS.
Obviously if they worked full time NHS, they couldn't do this.
So, a very nice little scheme, to get paid private rates by the NHS.
Possibly considering exclusive NHS contracts would focus them more?


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## Benny G (Jul 22, 2022)

travellor said:


> This isn't actually true for all NHS doctors.
> (Including GP's I know that do private surgeries)
> This is the number of hours they are working on contract to the NHS.
> 
> ...


Or they could follow the money, and do even less 'NHS GP' hours and more private hours. 

Zero hours contracts for NHS opens a whole other tin of worms.


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## travellor (Jul 23, 2022)

Benny G said:


> Or they could follow the money, and do even less 'NHS GP' hours and more private hours.
> 
> Zero hours contracts for NHS opens a whole other tin of worms.



Easy answer.
Contract them in at the start of training.
We pay for their training for several years after they start in the NHS until they are actually "qualified," contract them for a substantial exclusive period after they qualify.
If they leave before the contract is up, they pay it back. 
Most other jobs do it.


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## Leadinglights (Jul 23, 2022)

Students go to medical school at 18 years old when they have no life experience and no idea of the reality of the work and dedication required when studying medicine most of them have no experience of dealing with people who are severely unwell and it is a shock. They don't get the long holidays like other students who can get summer jobs. Many think that once they get their qualification, that is the end of the learning which cannot be further from the truth, it is a continuous process for the rest of their career.
My daughter is a glutton for punishment but doing a nursing degree and a chiropractic degree before going to med school better prepared her for the reality of the situation. But even then she needed further study to get her membership of the Royal College of Obs and Gynae. 
To fit family life into the schedule of a hospital doctor is difficult and her husband became a GP as both of them trying to work hospital schedules was impossible as shifts were allocated but even as a GP the workload is huge but the hours more regular.
They both work on admin nearly every evening when the kids have gone to bed.
The so called Agenda for Change in the NHS seems to have had little impact on the job satisfaction of staff or monetary reward. For years it had relied on the good will and commitment that most NHS staff have.


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## mikeyB (Jul 25, 2022)

While I agree about your comments about two doctors married, it's nothing new. I made a sensible decision not to associate with other female medical students to avoid that situation arising (I married a historian). But i don't recognise the lack of summer holidays while i was a student. The first couple of years are entirely non clinical learning anatomy, physiology, and pathology, plus pharmacy. Normal University terms. And long holidays, giving me the time to learn how to work in a factory, mix with normal people, learned how to chrome plate and nickel plate bits and pieces, learned wood machining and and how to make dry dog food. And in one Easter break how to build deer fences in Dumfries and Newton Stewart region.

All those jobs has helped me become the person I am, and none of them are medical in nature. I can talk to anybody as an equal.

But in my day, as a junior doctor, I was on call every third day,and third weekend. That is staying at the hospital, which in those days had bedrooms for the doctors. Nonetheless, that could involve driving to the hospital on a Friday morning, dong a days work then starting a weekend on call, then a normal day working on the Monday before driving home. Without a single night of unbroken sleep. That no longer applies. GPs don't do their own home visits during the night, that's all handed over to the on call system, so patients don't see their own doctor at night, who has no access to their history.

And no GP should be dong admin work at night. The trick is to get a competent  practice manager, who governs the admin work and staffing, but that costs money, meaning a reduction in their take home pay. It's the whole practice that gets the money, how it is distributed is the choice of the GPs.


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## travellor (Sep 2, 2022)

"GPs saw their earnings rise to £142,000 during the pandemic in a Covid pay boom, new data show.

The official NHS figures reveal that as surgeries closed their doors to patients, routinely restricting face-to-face appointments, doctors’ incomes rose to unprecedented heights.

GP partners – who make up the majority of family doctors – saw average incomes rise by £20,000 to £142,000 in the 12 months after the first lockdown."

Not a bad salary really.
For a 3 day week.
Puts a merchant banker to shame.
(Maybe they'll retrain?)

But at least GP's won't have to worry over energy bills.










						GPs given record pay rises in Covid pandemic
					

Wages hit a ‘difficult to justify’ level of £142,000 as patients were turned away from surgeries




					www.telegraph.co.uk


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## mikeyB (Sep 6, 2022)

Benny G said:


> View attachment 21525
> 
> So, 12% of GPs working full time, perhaps the money is not so important to the part timers, or else they would work more hours and put in a full week.
> 
> ...


I've just noticed this post. Most GPs are not salaried, they are *self employed*, They pay *salaried GPs *out of the money received by the practice - in other words, out of their own potential income. They are often female GPs who are starting families. But nothing in that report can tell you how may hours a normal GP works. It only tells you how may hours salaried GPs work.

You certainly can't make the comment that only 12% of GPs are working full time, that only refers to salaried GPs. The vast majority of GPs work full time.


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## travellor (Sep 6, 2022)

mikeyB said:


> I've just noticed this post. Most GPs are not salaried, they are *self employed*, They pay *salaried GPs *out of the money received by the practice - in other words, out of their own potential income. They are often female GPs who are starting families. But nothing in that report can tell you how may hours a normal GP works. It only tells you how may hours salaried GPs work.
> 
> You certainly can't make the comment that only 12% of GPs are working full time, that only refers to salaried GPs. The vast majority of GPs work full time.



No, the report is the number of hours they are on contract to the NHS for.
They certainly do not contract to the NHS even vaguely approaching full time.


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