Bryn

I don't have the numbers to hand but isn't it 30bn of efficiency savings with 10bn extra going in?

lol

The NHS does need to change, it probably is going to require more individual contributions because the demands are sky rocketing. The debate on the future of the NHS should be a public one and should have been held before doling out punitive contracts.

They haven't even declared what they think a 7 day NHS looks like, nor have the priced it up, which is embarrassing.

Saying it openly is electoral suicide yes.

I'm not even saying all the Tories are evil for this. My personal belief is that Hunt is an NHS abolitionist and that many of his backers are too, but I'm prepared to believe that the majority of politicians simply want a comprehensive 7 day NHS and that if absolutely fine, we would love that too. You think that, even if you consider me a workshy selfish socialist upstart, I don't want access to the full range of services when I'm stick in ED on a Sunday? That makes my life a whole lot easier.

Politicians repeatedly demonstrate that they have no understanding of the situation, right up to David Cameron and Hunt themselves. And despite their patent ignorance, they won't listen to their NHS employees screaming at them that they are at serious risk of breaking the health service and jeopardising patient safety.

So it's about pay after all? I can respect that, not that I believe you're facing a cut, but at least it's honest.

Of course it's PARTLY about pay and conditions, that's the only legal basis for strike action. But fundamentally, if it was pay in isolation, not a chance 99% of doctors vote to strike, no way in hell. There are also factors such as safeguarding our hours and training opportunities, discrimination against women and various others. The impact this will have on recruitment and retention will be devastating at a time when there simply aren't enough staff to meet growing demand. These form the legal basis for industrial action. When have I ever denied this?

But in essence, we cannot sign a contract that commits us to providing a service we cannot do safely, we safely cannot sign a contract committing ourselves to providing 2 more days of elective service at a time when there are gaping holes in the EMERGENCY rota. This is the simplest and most important issue, and if this was not an issue you would not have overwhelming support from the profession and from our consultants and allied health professionals, and majority support from the public and patient groups.

Not that the absence of a weekend effect makes the desire for robust 7 day emergency care wrong. We're just already providing it, making us provide more elective care when there are already gaps of as much as 40% of EMERGENCY rotas is retarded and dangerous, and to then ask us to swallow pay cuts of several thousand of pounds along with it?

I recognise how poor the English is in that post but I think the incoherence enhances the sense of my incredulity.

Again, what?

You're happy with Jeremy Hunt blaming us using a study of which the author and his political ally stated himself that you cannot conclude there is a problem with weekend staffing, which a series of scientists, statisticians and health professionals have criticised, but you're not happy with actually looking at 4.6m emergency admissions and counting how many died and when?

I'm out.

What?

Have you read the article?

The mortality rate is less at the weekend.

The Government rightly say they have a problem with only the sickest patients being admitted at weekends. They want elective services at weekends. That's fine, but there aren't enough of us.

Elective services have nothing to do with mortality.

Junior doctors already provide 24/7 emergency care.

Why is this so hard?

http://www.independent.co.uk/life-style/health-and-families/health-news/seven-day-nhs-jeremy-hunt-staffing-hospitals-weekends-junior-doctors-strike-a7016286.html

Link.

He's a clueless, negligent liar.

Study published that suggests Hunt talking a steaming pile of shite, as we knew.

Hunt will stay. He's the meat shield. The government know he will either achieve what they want or it goes Pete Tong and he takes the fall, and they slide him into some other nice role.

It's not a change of stance, they just don't know what theyre talking about. They're conflating emergency and elective care, as they have from the start. There's no plan, no numbers have been crunched, they don't know what they want to achieve. They just now can't back down on yet another issue, and probably won't.

What happens next is a big question. The DoH are banking on us blinking first, primarily because we don't want to put patients at risk but also because we can't afford to strike indefinitely. I suspect they might be right. Trying to fill rotas in August will be super fun.

Just coincidence I think.

The media have been quiet on it, there's been marches with tens of thousands of people on them in London that didn't register. Part of that is probably lack of media skill on our part.

And then what happens when the consultants all die, and no junior doctor has had any exposure to medicine and has no experience? As it is, we are spending too much time on service provision and missing our educational targets and in the long run this will lead to an erosion of experience and skills.

Why are you so bitter?

Of course they ran quicker, fewer people attended and no patient had to wait for consultant review, they got them instantly because they weren't in clinic.

The polls disagree.

Strike days we can plan and prepare for. There are extra GP slots and a legion of consultants on the wards. Both A&Es in my trust are performing well, which you can check on if you search for Gloucestershire A&E on Google and click the waiting times page.

If the junior doctor workforce is eviscerated, there's nothing we can about that, and no one will thank us.

But that's a side issue, the bottom line is we can't provide any more extensive service than we already do and therefore cannot agree a contract that threatens this further.

Future doctors won't be worse doctors, the service just won't be able to attract and retain top talent as well as it can now, and there are already gaping rota gaps.

I've read that the pay protection lasts for a minimum of three years. In situations like this I'm inclined to think that terms shouldn't be changed after somebody has already committed themselves to a career path. While various factors make that kind of uncertainty a fact of life for most of us, that's not really an excuse a government should use (although they do all the time with everything from pensions to tax to welfare).

I'd have no issue with pay being cut for future doctors, I wouldn't describe that as them being "****ed over" because they'd still have the choice not to become a doctor if they didn't feel the rewards were good enough. But it does seem a raw deal for those who have already committed a lot of time and energy into their training. Then again, raw deals are the order of the day and doctors are still exceptionally well paid, so my sympathy is fairly limited.

Would you like to elaborate on why we deserve pay cuts? Would you like to state how much you think we earn? Do you know our contracted hours? Do you know that proportion of the time we work over for no extra pay? Do you know how much we are given in expenses for mandatory professional fees?

This isn't about money but I don't understand the desire to see us have our pay cut by significant amounts at a time when conditions are appalling for NHS staff.

Probably my lack of knowledge (as usual) but doesn't the government's 'pay protection' offer render all of the complaints about pay cuts effectively moot?

No because it's temporary. It's a way of lying and saying the contract isn't a pay cut. It's a tactic to hope we will cave and **** future generations of doctors over cause it won't quite affect us anymore.

Savage will latch on to whatever is in vogue. He was very critical of us in the Championship.

I don't get the Spurs hate at all, in both directions, at all. Spurs are a really good team with some really impressive and likeable players. Lloris, Alderweireld, Dembele, Eriksen, Kane and Alli are all quality. Pochettino is the best manager in the league, after Ranieri of course. We're both a breath of fresh air. I'll be gutted if we don't win the league but if they pip us they're worthy winners.

"We're staging implementation to ensure it works as intended. Any further delay just means we will take longer to eliminate weekend effect."

Despite the fact that it's been demonstrated to them hundreds of time that there is no causal link between weekend staffing and this "weekend effect", that's still their reasoning. They are negligent liars. I will not sign their imposed contract and nor will a sizeable chunk of my colleagues.

We don't really have a lot of choice, we can't safely deliver the service they're asking so how we can we sign the contract?

 

They needed to have a frank conversation about the future of the NHS and design a contract that was fit for purpose, not just deliver a pre-election soundbite and force us over a barrel before they've ever planned or costed it.

 

I don't trust them not to cherry pick the finest and best staffed trusts in the country, give them funds to hire extra doctors and then pilot it, so **** that. We need to go back to the start. There aren't enough doctors to provide a 7 day emergency NHS, the system will collapse with this contract.