I start this blog with three statements. 1) I believe in and support our National Health Service. 2) I support the Government drive to deal with the deficit. 3) I have no connection with the NHS or the Conservative Party other than I am a citizen.
The Government have and continue to make changes to how health care is delivered. This is necessary in principle to drive out inefficiency and waste and to provide better health, treatment and care outcomes in an ever more challenging and complex environment.
One of these challenges is to try and deal with the disparity between outcomes on those treated on weekdays and weekends. It would be hard to argue with that!
So what is Jeremy Hunt and the Conservative government proposing? Answer - unfair and shockingly provocative changes to the junior doctor contract. Junior Doctors and the BMA are outraged by the proposals and are quite right to be so. Why?
To qualify as a Junior Doctor you have to attend Medical School for 5 years minimum, study incredibly hard and pass challenging exams. Of course this is necessary because being a doctor requires an exceptionally high degree of complex knowledge - quite literally a future patients life will rest in their hands - an there is nothing much more complex than the human body.
To ensure Medical Students are likely to be capable of completing the 5 year medical school assault course and pass the necessary exams they only take the brightest most gifted academic students. It is hard to get into medical universities for this reason - their standards are exacting. Unlike most university courses (which are 3 years) Medical Students have to go through a searching interview process to ensure they also have the essential personal qualities as well as the academic excellence to succeed as a doctor.
The ability of students that choose medicine is evidently so high that they could in reality succeed in pretty much any career - banking, the law, engineering, business/corporate management etc etc. Most are attracted to medicine because they see a vocational element - an opportunity to do good and important work - but they are far from mugs. If the Government treat them as such their will be a massive recruitment and retention problem. Jeremy Hunt is trying to treat them as mugs! How?
Currently Junior Doctors have a base starting salary of under £23000. Lets put that in context. Some of our brightest, hard working and most decent young people - study extremely hard for 5 years - incur a massive financial debt for paying for the privilege of qualifying as a doctor - now doing a job carrying huge responsibility and consequences will earn just £8000 gross per year more than someone on minimum wage working in McDonald's with no qualifications or responsibility. This is the current situation and bad enough. Junior Doctors do typically earn more by working anti social hours and much longer hours (a contractual requirement demanded by the NHS) than a typical working week - and this has to some extent offset the ridiculously low basic salary - and only just. The Government are now proposing to dramatically curtail the ability to top up the basic salary by modifying or removing overtime payments for anti social hours and weekend work.
As a lay person I wish to make these observations.
The Government have and continue to make changes to how health care is delivered. This is necessary in principle to drive out inefficiency and waste and to provide better health, treatment and care outcomes in an ever more challenging and complex environment.
One of these challenges is to try and deal with the disparity between outcomes on those treated on weekdays and weekends. It would be hard to argue with that!
So what is Jeremy Hunt and the Conservative government proposing? Answer - unfair and shockingly provocative changes to the junior doctor contract. Junior Doctors and the BMA are outraged by the proposals and are quite right to be so. Why?
To qualify as a Junior Doctor you have to attend Medical School for 5 years minimum, study incredibly hard and pass challenging exams. Of course this is necessary because being a doctor requires an exceptionally high degree of complex knowledge - quite literally a future patients life will rest in their hands - an there is nothing much more complex than the human body.
To ensure Medical Students are likely to be capable of completing the 5 year medical school assault course and pass the necessary exams they only take the brightest most gifted academic students. It is hard to get into medical universities for this reason - their standards are exacting. Unlike most university courses (which are 3 years) Medical Students have to go through a searching interview process to ensure they also have the essential personal qualities as well as the academic excellence to succeed as a doctor.
The ability of students that choose medicine is evidently so high that they could in reality succeed in pretty much any career - banking, the law, engineering, business/corporate management etc etc. Most are attracted to medicine because they see a vocational element - an opportunity to do good and important work - but they are far from mugs. If the Government treat them as such their will be a massive recruitment and retention problem. Jeremy Hunt is trying to treat them as mugs! How?
Currently Junior Doctors have a base starting salary of under £23000. Lets put that in context. Some of our brightest, hard working and most decent young people - study extremely hard for 5 years - incur a massive financial debt for paying for the privilege of qualifying as a doctor - now doing a job carrying huge responsibility and consequences will earn just £8000 gross per year more than someone on minimum wage working in McDonald's with no qualifications or responsibility. This is the current situation and bad enough. Junior Doctors do typically earn more by working anti social hours and much longer hours (a contractual requirement demanded by the NHS) than a typical working week - and this has to some extent offset the ridiculously low basic salary - and only just. The Government are now proposing to dramatically curtail the ability to top up the basic salary by modifying or removing overtime payments for anti social hours and weekend work.
As a lay person I wish to make these observations.
- We need to attract and retain excellent Junior Doctors. The Government is blithely saying they are going to recruit large numbers of new doctors because we need them. It takes a minimum of 5 years to train them! There is a world shortage of properly trained doctors. British trained doctors can find jobs anywhere. Australia, USA etc etc. They will leave if not treated reasonably. The brightest students will not choose medicine unless it is seen as a career with prospects (vocation in its self will not be enough for most - and rightly so). We are already recruiting doctors from countries where English is not the first language and training might not be so good. We will have to recruit many more to compensate for the loss or our own unless the Government change their thinking. This is crazy and totally short sighted.
- The NHS is a hugely wasteful organisation. Management "suits" in on going "meetings". Scandalous PFI and purchasing. Profligate maintenance contracts. These should be the target areas for Jeremy Hunt - not Junior Doctor's pay.
- Doctors and nurses are the ones at the coal face. They are the ones who have to deal with an increasingly obnoxious public - a public brim-full of their rights - empty on responsibility (largely government's fault). It is doctors and nurses that have to patiently deal with the ignorant consequences of obesity, smoking and alcohol related violence. Doctors and nurses are actually heroes and should be treated as such.
- Just to show how skewed public thinking is there was an outcry in some quarters when the government wanted to introduce a benefits cap of £26000 (net). The Labour Party want to remove the benefits cap as unfair. Junior Doctors earn £23000 (gross). How crazy and unfair is that.
- Junior Doctors already work anti social hours and weekends. Hunt's objective to improve treatment outcomes at weekends does not lie in making Junior Doctor's have to work these hours for even less pay how ever bad the overall deficit. He is targeting the wrong people. He will demotivate them and damage their public spirited co operation.
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