Greedy Doctors Discussed On Question Time?

[spyguy]

No i believe there will be less risks to patient safety.

The new contracts are designed to reduce that risk from the current level,

think of it like a factory employer who has tired staff working 60-70hrs a week on lots of overtime.

What does any smart business do?

They move to "continental shift working" where they rosta staff on a 4 on 4 off rolling week basis

& increase the basic hourly rate as a sweetner / compensator for the loss of overtime premiums.

Less tired more productive workers, 7 day cover & smaller wage bill.

Like i said the games up.

Nurse mentioned in another thread.

She always works Sat + Sun, then a day + half day during the week.

Thats it - she's done her 37h.

Partner looks after kids on weekend.

She has 3.5 days free in the week to do stuff.

Works for them.

[Bloo Loo]

Nurse mentioned in another thread.

She always works Sat + Sun, then a day + half day during the week.

Thats it - she's done her 37h.

Partner looks after kids on weekend.

She has 3.5 days free in the week to do stuff.

Works for them.

lucky she can choose to work the best paid hours and no nights...

[workingpoor]

The other big risk with overtime for the employer needing weekend cover is it is voluntary and you have to rely on people wanting to work or chosing when they work overtime, and can also be refused during any further union disputes on a work to rule basis.

Can't really run a business like that (although alot have been in the past)

I think the NHS needs to move on from this "mass blanket overtime" that it seems to rely on to function and i think this has been noted at higher levels and is a fundamental principle of the new reforms.

[Riedquat]

Embrace change is the key... They have got to get the contracts right prior to privatisation..... Innit, else no one will buy it?

"Embrace change" is a big red warning flag phrase, beware of anyone who says it. I'll embrace improvement, change for the sake of change can go **** itself along with anyone who wants it, it's already done untold damage.

[richc]

You can do that here if you pay for it which you would be in the US.

If you think the health service is optimized in the US then you clearly have never lived there, the only thing optimized is the price you pay. Is the level of care good yes absolutely but it's certainly no better than anywhere else in the world if you go private.

I lived in the US for more than 30 years, thanks.

If you're an illegal immigrant in the US or an long-term unemployed 45 year-old alcoholic, then, yes, healthcare in the US will be much worse than what you find in the UK, but for almost everyone else, it's far better.

The NHS is a cult. They make decisions based on political point scoring rather than what is best for patient care and outcomes. It makes no sense to make everything free at the point of care, but then impose all sorts of bureaucratic hurdles to make sure that people don't actually make it to the point of care. Having a small fee would limit time wasters and increase resources for actual patient care, while those in financial need (and the right to use the NHS) could easily be provided with funds to pay the fees and address any question about equality of access.

[Guest eight]

"Embrace change" is a big red warning flag phrase

You need to get with the times.

[whitevanman]

In the G20 economies health spending is associated with life expectancy. The only problem is it's a negative association. The more we spent, the shorter our lives become.

We know from the AGW and OMGarteryblockingsaturatedfatsandcholesterol debate: correlation equals causation. Reduce spending for better health!

I'm actually somewhat serious, the NHS does quite a bit of damage to the health of patients by removing people's agency to control their own destiny and also by being pushers for big pharma. It obviously does a great deal of good too, especially when it comes to acute illness, it's just not the unalloyed force for good the PC fascists try to make out.

Oh, NHS doctors are whinging gits who need to understand that their position rests on a foundation of force and coercion. If you're treated so badly in the public sector then leave!

[spyguy]

I lived in the US for more than 30 years, thanks.

If you're an illegal immigrant in the US or an long-term unemployed 45 year-old alcoholic, then, yes, healthcare in the US will be much worse than what you find in the UK, but for almost everyone else, it's far better.

The NHS is a cult. They make decisions based on political point scoring rather than what is best for patient care and outcomes. It makes no sense to make everything free at the point of care, but then impose all sorts of bureaucratic hurdles to make sure that people don't actually make it to the point of care. Having a small fee would limit time wasters and increase resources for actual patient care, while those in financial need (and the right to use the NHS) could easily be provided with funds to pay the fees and address any question about equality of access.

Sister in law is a German Dr.

She ranks UK NHS as 3rd world, mainly due to length of time it takes to see someone and the random level of competence you get when you do.

[Doesn't Commute Anymore]

I've posted about this before. I used to be an NHS scientist but now have specialised in training/education, only working a little now in hospital environments. Here is my insight:

Modern medicine is very multidisciplinary and necessarily managerial:

1. Multiple healthcare professionals now contribute to the healthcare team effort, some with academic backgrounds far more demanding and harder to achievein life than a medical degree - think PhD ++ (thinking cancer radiation treatment units, robotic surgery etc).

2. Complex treatment scheduling and co-ordination (combined chemo/radio/immuno therapy) with pressurised patient throughput targets requiring experienced, competent healthcare professional expertise to keep it all running in a system with faults in the infrastructure

I am not sure the junior doctor skillset is the most valued in the healthcare team in 2016. A young medic's skills are not really more worthy than the scientific or professional/managerial expertise elsewhere in the modern healthcare team. But the clinical scientists and superintendent sonographers aren't striking and complaining for more money (which is what the strike is, along with 7 day working changes the other professions accept will have to come in, and within a climate of budgetary austerity.)

Scientists all know that its not going to be a wealthy lifestyle, but do their job for the chance to contribute to the scientific progress or essential work in development of drugs/medical equipment through industry etc. Healthcare assistants, paramedics etc. are paid far worse and worked/stressed harder than all groups I have mentioned sofar.

Doctors are supposed to be motivated by helping the sick and vulnerable. They come across as having pretty much forgotten this and lost their calling. The deal with being a doctor is as follows: that you work long hours in your 20s/30s, but do so as its a vocation and your mission in life. Work hard and progress, and you will get to consultant grade in the end or switch to being a GP. Note that the GPs and medical consultants are not joining the strike picket lines (they got a stupidly generous deal a few years back and want to keep quiet about it, the hours and conditions being very acceptable)

In a way, junior doctors are not the rooster in the multidisciplinary healthcare henhouse anymore but still act very rooster-like. They have not coped well with the rise in expertise of other healthcare professionals, meaning a junior doctor's status isn't superior in the multidisciplinary healthcare world. Hence the #savetheNHS and #itseveryonesfight placards is a bit tiresome when a special status is assumed by doctors but doesnt exist anymore. Why is the overtime supplement of a registrar or junior doctor my fight?. Because doctors are special? They are not anymore. Pay the paramedics and healthcare assistants more rather than the junior doctors. Its also tiresome when we all know this is really about junior doctors pay and the loss of lucrative junior doctor locuming opportunities they until now get.

The NHS is simply as expensive already as the UK can afford - it needs to stop the higher death rates at weekends statistics (by becoming 24/7) and stop the extravagant expenditures (locums, staff bank, silly procurement with exclusive supply contracts).

My suggestion:

+ De-regulate the medical school monopoly and get another 5 or 10 in the UK, all monitored closely for teaching quality. Make it a buyers market for the NHS with a large pool of junior doctors to choose from for each vacancy- so only those with skills and dedication can only get the posts. That's how it works with PhD studentships/postdoctoral research assistants in universities - applicants all know they will be worked very hard and lucky to hold a post, and treat it as a salary while being developed/trained.

+ Also, the Open University medical school concept needs re-starting (with summer schools for practical skills) as the demographic of protesting medics outside hospitals seems a little too middle class in my opinion. Encourage entry for 22-30 year olds with a first degree in a STEM subject and a bit of life experience to know the pros and cons of being a medic. The UCAS application form system is too beneficial to 18 year olds from posh schools with help completing the forms. The picket lines look full of such well-brought up darlings complaining of harsh treatment which isnt that bad all in all.

[PopGun]

No i believe there will be less risks to patient safety.

The new contracts are designed to reduce that risk from the current level,

think of it like a factory employer who has tired staff working 60-70hrs a week on lots of overtime.

What does any smart business do?

They move to "continental shift working" where they rosta staff on a 4 on 4 off rolling week basis

& increase the basic hourly rate as a sweetner / compensator for the loss of overtime premiums.

Less tired more productive workers, 7 day cover & smaller wage bill.

Like i said the games up.

That's completely unworkable. A hospital isn't a factory, there's no clocking in or off.

[PopGun]

"Embrace change" is a big red warning flag phrase, beware of anyone who says it. I'll embrace improvement, change for the sake of change can go **** itself along with anyone who wants it, it's already done untold damage.

+100

[Riedquat]

You need to get with the times.

What, as in today? No thanks. I'll look to the future though.

(because I'm at work today but not tomorrow)

[richc]

I've posted about this before. I used to be an NHS scientist but now have specialised in training/education, only working a little now in hospital environments. Here is my insight:

Modern medicine is very multidisciplinary and necessarily managerial:

1. Multiple healthcare professionals now contribute to the healthcare team effort, some with academic backgrounds far more demanding and harder to achievein life than a medical degree - think PhD ++ (thinking cancer radiation treatment units, robotic surgery etc).

2. Complex treatment scheduling and co-ordination (combined chemo/radio/immuno therapy) with pressurised patient throughput targets requiring experienced, competent healthcare professional expertise to keep it all running in a system with faults in the infrastructure

I am not sure the junior doctor skillset is the most valued in the healthcare team in 2016. A young medic's skills are not really more worthy than the scientific or professional/managerial expertise elsewhere in the modern healthcare team. But the clinical scientists and superintendent sonographers aren't striking and complaining for more money (which is what the strike is, along with 7 day working changes the other professions accept will have to come in, and within a climate of budgetary austerity.)

Scientists all know that its not going to be a wealthy lifestyle, but do their job for the chance to contribute to the scientific progress or essential work in development of drugs/medical equipment through industry etc. Healthcare assistants, paramedics etc. are paid far worse and worked/stressed harder than all groups I have mentioned sofar.

Doctors are supposed to be motivated by helping the sick and vulnerable. They come across as having pretty much forgotten this and lost their calling. The deal with being a doctor is as follows: that you work long hours in your 20s/30s, but do so as its a vocation and your mission in life. Work hard and progress, and you will get to consultant grade in the end or switch to being a GP. Note that the GPs and medical consultants are not joining the strike picket lines (they got a stupidly generous deal a few years back and want to keep quiet about it, the hours and conditions being very acceptable)

In a way, junior doctors are not the rooster in the multidisciplinary healthcare henhouse anymore but still act very rooster-like. They have not coped well with the rise in expertise of other healthcare professionals, meaning a junior doctor's status isn't superior in the multidisciplinary healthcare world. Hence the #savetheNHS and #itseveryonesfight placards is a bit tiresome when a special status is assumed by doctors but doesnt exist anymore. Why is the overtime supplement of a registrar or junior doctor my fight?. Because doctors are special? They are not anymore. Pay the paramedics and healthcare assistants more rather than the junior doctors. Its also tiresome when we all know this is really about junior doctors pay and the loss of lucrative junior doctor locuming opportunities they until now get.

The NHS is simply as expensive already as the UK can afford - it needs to stop the higher death rates at weekends statistics (by becoming 24/7) and stop the extravagant expenditures (locums, staff bank, silly procurement with exclusive supply contracts).

My suggestion:

+ De-regulate the medical school monopoly and get another 5 or 10 in the UK, all monitored closely for teaching quality. Make it a buyers market for the NHS with a large pool of junior doctors to choose from for each vacancy- so only those with skills and dedication can only get the posts. That's how it works with PhD studentships/postdoctoral research assistants in universities - applicants all know they will be worked very hard and lucky to hold a post, and treat it as a salary while being developed/trained.

+ Also, the Open University medical school concept needs re-starting (with summer schools for practical skills) as the demographic of protesting medics outside hospitals seems a little too middle class in my opinion. Encourage entry for 22-30 year olds with a first degree in a STEM subject and a bit of life experience to know the pros and cons of being a medic. The UCAS application form system is too beneficial to 18 year olds from posh schools with help completing the forms. The picket lines look full of such well-brought up darlings complaining of harsh treatment which isnt that bad all in all.

Completely agree with this.

[Will!]

Nurse just now on QT said some home truths about doctors but the audience did not want to hear it. Has the BBC filled the audience with junior doctors and their families?

Sorry I missed it. I was at work.

Are doctors now, like celebrities and islam, sacred cows that we must not criticise?

No.

We've talked about this before by the way.

[Will!]

I am now in a twitter row with a junior doctor who seems to think that he and, according to him, hundreds of doctors he knows, are somehow hard done by.

I pointed out the fabulous salaries and pensions... and that vast numbers of Brits work the same hours for a fraction of the pay without any pensions... but he just thinks that he and his colleagues are hard done by.

Since medical pay and conditions are a matter of public record that should have been quite a short argument. They don't take into account unpaid overtime though. The old NHS pension scheme was unsustainably generous and it closed a few years ago. We've talked about that too.

[Saver]

NHS is a cult. Anyone who dares criticize it is confronted with the obligatory 'oh so you want the american system where people are left to die on streets if they dont have insurance'

as if 1) there are only 2 choices of healthcare in the universe, the NHS or the yank insurers.

and 2) as if they actually leave people in the streets dieing in the US (or ever did outside of hollywood movies)

NHS will never improve as we arent allowed to discuss it, unless the discussion is throwing more money at it.

I'm not confident an american style system is not what the Tories would want. I think if people had confidence we could have a european model they would not be so anti-private.

[The Masked Tulip]

The threads should probably be merged.

I just felt so annoyed last night at how biased towards doctors the whole QT discussion was... and how one voice talking from experience - the nurse - was shouted down for telling some home truths.

[Frank Hovis]

I'm not confident an american style system is not what the Tories would want. I think if people had confidence we could have a european model they would not be so anti-private.

When people praise the idea of the NHS what they actually mean, and I have asked them, is that they like a "free" health service.

There is general agreement that it is wildly bureacratic and inefficient, anecdotes are rife of friends who are nurses who are finding places to skive and smoke a fag, people who have had to walk out because despite everything having been fixed no doctor could be found to formally discharge them.

All the Conservatives need to do is come out and say that the support the principles of the NHS but would sort out the whole sorry mess that it actually is and they would be onto a vote winner; by not saying this they let people think a US style private semi-monopoly is their goal. Labour is in the pockets of the NHS unions who paint themsleves as defenders of the NHS when they are in reality purely trying to keep the employees on their over-generous pay and pensions.

[Saver]

I lived in the US for more than 30 years, thanks.

If you're an illegal immigrant in the US or an long-term unemployed 45 year-old alcoholic, then, yes, healthcare in the US will be much worse than what you find in the UK, but for almost everyone else, it's far better.

The NHS is a cult. They make decisions based on political point scoring rather than what is best for patient care and outcomes. It makes no sense to make everything free at the point of care, but then impose all sorts of bureaucratic hurdles to make sure that people don't actually make it to the point of care. Having a small fee would limit time wasters and increase resources for actual patient care, while those in financial need (and the right to use the NHS) could easily be provided with funds to pay the fees and address any question about equality of access.

I lived in the US for 2 years, and also had very close family friends who lived there for a long time. In the former case I came across people I worked with who could not afford health insurance due to increasing premiums. In the latter case I came across some of their friends who could not afford health insurance at all and avoided going to hospital for problems because they could not afford it. They were not unemployed.

[The Masked Tulip]

It made the Daily Mail:

http://www.dailymail.co.uk/news/article-3553362/Question-Time-audience-boos-woman-launches-furious-rant-against-junior-doctors.html?login#readerCommentsCommand-message-field

[Guest eight]

It made the Daily Mail:

http://www.dailymail.co.uk/news/article-3553362/Question-Time-audience-boos-woman-launches-furious-rant-against-junior-doctors.html?login#readerCommentsCommand-message-field

It's the HPC / Daily Mail continuum. IRRO sends links one way and you send stories back the other way.

[spyguy]

I've posted about this before. I used to be an NHS scientist but now have specialised in training/education, only working a little now in hospital environments. Here is my insight:

Modern medicine is very multidisciplinary and necessarily managerial:

1. Multiple healthcare professionals now contribute to the healthcare team effort, some with academic backgrounds far more demanding and harder to achievein life than a medical degree - think PhD ++ (thinking cancer radiation treatment units, robotic surgery etc).

2. Complex treatment scheduling and co-ordination (combined chemo/radio/immuno therapy) with pressurised patient throughput targets requiring experienced, competent healthcare professional expertise to keep it all running in a system with faults in the infrastructure

I am not sure the junior doctor skillset is the most valued in the healthcare team in 2016. A young medic's skills are not really more worthy than the scientific or professional/managerial expertise elsewhere in the modern healthcare team. But the clinical scientists and superintendent sonographers aren't striking and complaining for more money (which is what the strike is, along with 7 day working changes the other professions accept will have to come in, and within a climate of budgetary austerity.)

Scientists all know that its not going to be a wealthy lifestyle, but do their job for the chance to contribute to the scientific progress or essential work in development of drugs/medical equipment through industry etc. Healthcare assistants, paramedics etc. are paid far worse and worked/stressed harder than all groups I have mentioned sofar.

Doctors are supposed to be motivated by helping the sick and vulnerable. They come across as having pretty much forgotten this and lost their calling. The deal with being a doctor is as follows: that you work long hours in your 20s/30s, but do so as its a vocation and your mission in life. Work hard and progress, and you will get to consultant grade in the end or switch to being a GP. Note that the GPs and medical consultants are not joining the strike picket lines (they got a stupidly generous deal a few years back and want to keep quiet about it, the hours and conditions being very acceptable)

In a way, junior doctors are not the rooster in the multidisciplinary healthcare henhouse anymore but still act very rooster-like. They have not coped well with the rise in expertise of other healthcare professionals, meaning a junior doctor's status isn't superior in the multidisciplinary healthcare world. Hence the #savetheNHS and #itseveryonesfight placards is a bit tiresome when a special status is assumed by doctors but doesnt exist anymore. Why is the overtime supplement of a registrar or junior doctor my fight?. Because doctors are special? They are not anymore. Pay the paramedics and healthcare assistants more rather than the junior doctors. Its also tiresome when we all know this is really about junior doctors pay and the loss of lucrative junior doctor locuming opportunities they until now get.

The NHS is simply as expensive already as the UK can afford - it needs to stop the higher death rates at weekends statistics (by becoming 24/7) and stop the extravagant expenditures (locums, staff bank, silly procurement with exclusive supply contracts).

My suggestion:

+ De-regulate the medical school monopoly and get another 5 or 10 in the UK, all monitored closely for teaching quality. Make it a buyers market for the NHS with a large pool of junior doctors to choose from for each vacancy- so only those with skills and dedication can only get the posts. That's how it works with PhD studentships/postdoctoral research assistants in universities - applicants all know they will be worked very hard and lucky to hold a post, and treat it as a salary while being developed/trained.

+ Also, the Open University medical school concept needs re-starting (with summer schools for practical skills) as the demographic of protesting medics outside hospitals seems a little too middle class in my opinion. Encourage entry for 22-30 year olds with a first degree in a STEM subject and a bit of life experience to know the pros and cons of being a medic. The UCAS application form system is too beneficial to 18 year olds from posh schools with help completing the forms. The picket lines look full of such well-brought up darlings complaining of harsh treatment which isnt that bad all in all.

I think this post should be read and understood by posters and the wdier public.

The contribution of Drs (and Nurses!) to the nation health is pretty limited.

The big imprivements to he Uks health have come from fresh water + waste pipes, followed by Antibiotics and availability of food.

Then vaccines.

These far outweight any value add by the hopsitals, GPs, DRs and the like.

Even when health involves going to hospital, the technical staff -blood + stool, microbiolists, MRI, meds are more important.

[Will!]

The threads should probably be merged.

Can you point out the "fabulous salaries and pensions" first?

[Executive Sadman]

I'm not confident an american style system is not what the Tories would want. I think if people had confidence we could have a european model they would not be so anti-private.

Im not sure comparisons by country are particularly useful, regardless of the country. Healthcare is broken throughout the west. I dont actually think the NHS is that bad compared to our economic comparison countries, but rather the problems in the NHS are endemic throughout the industry.

If salvation comes it will be through people opting out and going to cash-in-hand, genuine indvidual free market providers, not through trying to emulate an entire system somewhere else.

That is to say, I dont think the NHS can (or perhaps even should be) reformed, rather it just needs to die. Which will happen, through its own obsolescence, whether the champagne socialists who make millions from it like it or not.

[Executive Sadman]

I think this post should be read and understood by posters and the wdier public.

The contribution of Drs (and Nurses!) to the nation health is pretty limited.

The big imprivements to he Uks health have come from fresh water + waste pipes, followed by Antibiotics and availability of food.

Then vaccines.

These far outweight any value add by the hopsitals, GPs, DRs and the like.

Even when health involves going to hospital, the technical staff -blood + stool, microbiolists, MRI, meds are more important.

Quite. Its like the police saying the roads are safer because of their good traffic work educating drivers and so forth, (not because of safer car technology).

Of course, the lies that come from the police in this regard can be easily disproven as the amount of accidents are actually roughly the same. People are no better drivers than they were 30 years ago...rather the cars protect them more successfully. Accident rates have stayed the same, but survival and injury rates improved.

Scientists and engineers ALWAYS make things better.

Lawyers, bureaucrats, civil servants...those now in charge, not so much.