The reality though is without thousands more specialty training jobs there has been a 15 year trend towards people doing F3 and now F4 and F5 years typically as locums. So if labour tries to restrict the free market for doctors labour there’s a sizeable group of doctors who have little choice (barring emigration which is a pretty radical option for many) but to swallow it.
At the end of the day those consultants will still need juniors to do the bulk of the leg work of actually effecting their plans. Consultant Surgeons are still going to need assistants and more elective work will ultimately mean more inpatient capacity is needed - which is only going to come from more labour at every level and every profession including obviously the nurses.
The headline says Consultants' pay. Extra contractual work for 1.5 times pay? - people won't cover those shifts for reasons people have said elsewhere in this thread.
Hospitals will shift more NHS patients to be seen by the private sector where staff pay is better... Perhaps that's the idea.
They're always trying. Difficulty is, overtime being flexible, it's a free market.
You can do this strategy at a national level for a little bit, but then one slightly shittier place (that's not getting any locums) breaks rank and puts their rate up a little, forcing the others to follow and get into a bidding war, until you're back where you started.
Though increasing base pay and training places would help to reduce it.
True, but in order to be a monopoly, NHS Professionals would have to at least have the slightest tinge of competence, which I think we're a way off from.
>The reality though is without thousands more specialty training jobs there has been a 15 year trend towards people doing F3 and now F4 and F5 years typically as locums
Whilst specialty competition is higher over the last two or three years, for most of that trend, competition **fell** compared to 2000s/2010s. In the mid 2010s, it wasn't uncommon to underfill CMT places, for instance.
The drift to F3ing was driven by worsening standard T&Cs and more lucrative locum work (driven by a vicious circle of underfilling training posts).
Whilst there are a lot of reasons for heightened competition to specialty numbers today, the cumulative net exiting doctors from training pathway now seeking to re-enter is contributing.
The biggest factor though is the equal footing between local graduates and foreign graduates - an unprecedented experiment in doctor wage suppression not seen anywhere else in the world.
I did say it wasn't the only factor. But the fact that analysis of people appointed to specialist training in this country (posted previously in this subreddit) still have same proportion pf domestic graduates as before recent changes show that this is by no means the only factor (or even largest one).
(Other important factors include expansion of medical schools without commiserate expansion of specialist places, as seen by the lack of foundation places over the last couple of years)
No consultant is going to do WLI work for £75/hr.
Post tax that really wouldn’t be worth my time. Or paying for childcare for.
It will just lead to the trusts making up the difference between the paid rate and what they’re offering to pay if they want them covered.
That's appalling. ED Consultant in London and I see £150 / hour for locums. Below BMA rates and should be higher but I think it's the bare minimum I would accept.
I suspect this is quite speciality and location specific.
We struggle to fill weekend anaesthetist shifts at £150/hr.
Anaesthetic WLI shifts will always have to compete with the private sector which our group has negotiated fairly reasonable rates for.
I'm in a place where there's quite a sense of "this needs to be done and we need to muck in", which is kind of how we all want to work- but it's difficult to contrast a sense of duty with a realistic impression of how that contributes to the spiral. We're in a very low cost of living area with not enough private work to go around, which I think drives some of the willingness.
London shifts were the same or just slightly less compared to the rest of the country until they introduced the cap on locum shifts which the Labour are planning for the whole country. Private work is flourishing because of the waiting lists. Don't underestimate the damage Labour can do by slashing waiting lists and capping your locums.
I know I'll get downvoted to shit, but this sub has so many Labour-loving voters that they are blind to the fact that Labour will screw us over.
A pro-doctor agenda isn't something that any big party will commit to. They will prioritise the masses rather than us, the minority. An expensive minority. And without any major net increase on spendings/tax cuts/major reform, we, as doctors are doomed. Our only leverage is keep on applying pressure on whoever comes into power. We need a strong union that is pro-Doctors. No pro-patients or left-leaning. A fucking hard-core, non-compromising pro-doctor union that will not hesitate to stand up to whoever is in power for doctors. Fuck the NHS, fuck being a martyr to the system, it's about time we stood up for ourselves properly.
I get attacked for pointing this stuff out. But my position is not "anti-Labour", but anti-politician. I don't care what party they are from, my view is that the NHS system is made by politicians for politicians. Doctors and nurses are doing the actual work, but those with power influence, and who have most access to money (from the private sector and the rest of the associated healthcare industries like pharma) are actually politicians.
I am happy for doctors to strike against Tory and against Labour and against Lib Dems - and against Abraham Lincoln too if required - until doctors get the respect and money they deserve.
>the NHS system is made by politicians for politicians. Doctors and nurses are doing the actual work, but those with power influence, and who have most access to money (from the private sector and the rest of the associated healthcare industries like pharma) are actually politicians.
I couldn't agree more. Ever since I got into healthcare (before medical school) it was apparent that the NHS is a political football game between parties and the only way for the NHS to truely proper is for health and social care to be de-politicised. Get it run by actual qualified, politically neutral, and experienced health leaders and experts. Not the likes of Hunt/Hancock/Javed/Barclay/Coffey. They're all fucking idiots. And the Labour equivalents aren't much better either.
Absolutely though. I will happily strike against whoever is in power. We and the BMA need to unapologictically stand up for ourselves first and foremost, then our colleagues, then our patients.
I agree with you about “political football”. It doesn’t suit any political party to have a well run NHS - then they have nothing to improve on and things can only get worse. So a well run NHS isn’t happening.
I totally disagree about a QANGO running the NHS. Isn’t that NHS England? What a fuck up they have been.
Politicians have to be responsible because they are accountable to the public (at the ballot box). QANGOs have no accountability.
It needs radical change. That’s clear.
I believe it also needs some decentralisation with local mayors taking a lot of responsibility. Those responsible HAVE to be accountable to the electorate. It’s the only way.
Personally I’d prefer the Westminster politicians to set the basic rules (funding etc) and I’d prefer that to be cross party agreement.
Then I’d expect mayors to be responsible for the detail and tailoring the local services to local needs. Their job should depend on improving services.
Thanks for raising awareness disqussion. Your efforts don’t go unnoticed but the mental gymnastics of the Red faction are bizarre. Some people have claimed that Labour have to lie to win the election but that what they are saying is not actually what they will do?!?
I’m on the side of doctors…and I don’t care who is in power. I believe that our institutions particularly the royal colleges have to work for us rather than the State
>Some people have claimed that Labour have to lie to win the election but that what they are saying is not actually what they will do?!?
Exactly this is copium all the way up to 11.
The old saying about the only time a politician isn't lying is when his mouth isn't moving...
Streeting may not be as egregious or incompetent as Barclay, Atkins or *unt but all of them are politicians.
They will do whatever to get elected and re-elected.
The strategy for the BMA should not change and be even more skeptical of any pay offers/cancellation of strikes.
>Streeting may not be as egregious or incompetent as Barclay, Atkins or *unt but all of them are politicians.
The guy is renowned for being anti-doctor because of personal issues. He despises us.
>The strategy for the BMA should not change and be even more skeptical of any pay offers/cancellation of strikes.
Absolutely, I couldn't agree more.
This is the truth. The national jobs service will be sustained whatever happens and our basic might go up but overall more people will be fighting for a dwindling slice of the pie.
I keep being downvoted for saying there were no locums when Labour was in power and if people paid us properly we’d not lead to locum but what the politicians deem proper and what we are two very different things
A long waiting list is actually in our interest and this is the most socialist of policies. Cap our locum rates so that we are forced to work more…stealth paycut
Yeah the NHS is an employment service. It lets people who aren't the brightest have the hope of "promotion", a work email, a desk, a swivel chair etc. Uptil now doctors were at least paid similar to other professionals, but now they are also being degraded and pushed down into working class.
It made my blood boil when Streeting said that it would be capped at 1.5x in line with nurses pay.
They need to stop comparing us to nurses because we provide different services. If I'm an F1 and my base is £15/hr, I really wouldn't want to come into work on a weekend for £22.50. This is a lower hourly locum pay than the worst caps out there. It's a paycut to locum work. Equally, as a reg on £26.52/hr, good luck getting me to even respond to a £40/hr weekend clinic/theatre list.
You'll see these clinics/lists covered by AfC MAPs on a lower rate yet same 1.5x Saturday enhancement.
Bottom line, we're not nurses, don't compare us to them. Pay us properly.
I don't entirely disagree, labour are potentially going to fuck us sideways, but, the Tories have fucked me from both ends. So when my wife started getting symptoms of MS, not only was the wait for an urgent referral 38 weeks, but I also don't have the money for private treatment.
At least under labour there's a chance of decent public services to fall back on....
I am sorry to hear about your wife and frankly, a 38 week wait is abysmal. Embaressing and not fair on you. People shouldn't feel like they need to rely on private healthcare to get prompt treatment for life debilitating conditions.
>At least under labour there's a chance of decent public services to fall back on
However, this needs money. New money. New money for doctors, nurses, MRIs, labs, clinic space. Not restructuring or diverting or cost cutting. A net increase in spending either through increased taxation or borrowing. Yet nobody wants to talk about that.
You really this the percentage spent on "shit and wastage" is all that's needed? That's such a tory misnomer. "Efficiency and optimisation savings". I don't disagree that things can be run better but Even if it's 10-20% that's wasted, that's not enough to build new hospitals or train more doctors.
We need new money and a radical change to the system that includes expansion rather than minimisation.
>I know I'll get downvoted to shit, but this sub has so many Labour-loving voters that they are blind to the fact that Labour will screw us over.
This sub isn't unanimously pro-Labour, far from it.
I think Wes Streeting is an absolute toad of a politician who should have never been let near a portfolio like health, and I doubt I am the only one here.
The "doctors= Momentum activists" thing is right out of the Daily Mail
What even is time and a half?
Seriously..... have these people even got a clue? We're not on an hourly rate, we're salaried.
The best I can work out I get paid about £192 per PA in normal time, which works out as £48/hr. £72/hr for overtime?.... Nah, think I'll pass thanks.
I think its pretty clear that's what he means.
And yeah, \~£37 per hour post-tax (or about £21 per hour if you're into the 100k tax trap, as many will be) for an evening or weekend shift. Haha. No.
Less than childcare would cost.
Literally no-one will do WLI at that rate. And given that WLI is propping up the NHS and, realistically, the ONLY way of meeting Labour's pledge to cut waiting times down... what exactly is Streeting playing at?
The closest to logic I can figure is that he wants to financially pressurize trusts to get more in-timetable/on-call consultant PAs... but the whole problem here is the complete inability to recruit and retain anyone!
They’re going to try and job plan this, that’s where time and a half comes from. Overtime = Additional PAs. Non-pensionable. So instead of a 240 minute PA (standard) it will be a 160 minute PA (2 hours 40 mins).
The hourly rate is on the pay slip. We're salaried based on a multiplication between an hourly rate and the number of hours in the job plan. Like it or not, we're salaried and not shift workers but we absolutely have an hourly rate.
It might not be worth it to you or I, but the NHS has spent the last decade bussing in tens of thousands of doctors from places like Pakistan, Egypt, India etc. who may well be prepared to work for claps as they don’t know any better.
There's no but. You said the NHS salary makes us rich at home country and that's not true. What £100 can do in Egypt is irrelevant because I live in the UK, can't work remotely and only have a maximum of 6 weeks to spend away from work.
I don't understand what your sorrow is about though. Do you feel bitter that people can save a few hundreds and can spend some of that on a cheap holiday? You can do that if you wish
You’re right, there is no but. The money you earn here makes you rich in your country, even after tax and bills. Maybe rich isn’t the right word but at least well-off.
The overwhelming presence of your people (don’t care if you’re from an arab country or european country or african country) is a detriment to doctors. The evidence is in the competition ratios for both training and non-training positions.
I have to disagree partly here, not an IMG but honestly when you look at costs of living in this country, how is anyone saving? Also, Costs of living, esp in EU countries, are soaring. The UK isn’t what it used to be in the 90s, I genuinely don’t know how one can save a substantial amount here
Now your sorrow and bitterness is even more clear 😂 It's pathetic though.
The British doctors and professionals are working allover the world but no one makes much fuss about them. Because maybe they work in successfull and growing countries where there's a culture of growth and abundance. Unfortunately the UK is failing in the last 30 years and that's complicating things. The UK doctors were complaining when the hospitals had no enough doctors and now complaining of the enough doctors. Now they introduced PAs and ANPs to limit recruiting overseas doctors but still not happy.They aren't happy either way because the problem is in the whole system.
That's not "his lot's" fault though is it? You're trying to tell me that if the US suddenly said it's open season for UK doctors to move to California you wouldn't be on the first plane? I would, and I wouldn't give a fuck what the local doctors thought about it. Direct your ire at the government's open season policy, not at individuals just trying to make the best of their life, because you would 100% do the same in their position.
People who speak like you do rarely have any sense of personal accountability or responsibility.
Why didn't YOU pick a career that gave you what you want? Why haven't YOU worked hard enough to get into the training programme? Why don't you get out there, work like a dog, save like mad and invest until you are doing well?
Don't blame other people because your life hasn't worked out the way you wanted it to. That's on each of us to deliver for ourselves.
Not an IMG but I know a lot of IMGs. I presume what you are saying likely doesn’t matter tho because the majority of that disposable income is likely spent in the UK or if it is entirely saved then the IMGs are living miserable lives nonetheless. It’s also likely that the average IMGs have a far lower support network and friendship groups. Speaking to a lot of IMGs the UK is not one of the preeminent destination for medical graduates it once was and a lot of IMGs unfortunately get that rude awakening once they arrive here. Additionally, when I asked a bunch of IMGs(mostly from India and Pakistan) they all said that the biggest pro of UK medicine is significantly better work life balance. In India it’s not uncommon for their trainee doctors to be working 80 hour work weeks and generally they said the environment was more ‘toxic’. The pay is better in the UK but when accounting for how expensive things are the quality of life is more or less similar.
A three bedroom flat in nice area in Egypt now cost around £100,000. Yes half the price of the UK but not cheap and the NHS salary sadly can’t make me rich in Egypt
For someone to make the move from a developing country where their annual salary is less than your wage for a month, I don't see how you can state that they have low self worth. It's precisely because of the opposite, that they leave in the first place.
It’s an easy calculation for me.
You’re paying for my time.
I consider it worth more than you’re offering.
It’s a “no” from me.
I’ll be busy fishing looking after my H&WB. 👍
What's to stop them then going even further: making extra work mandatory as part of the existing responsibilities, for the purposes of "national service" or whatever?
[https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/](https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/)
Looks like the skeptics here were correct about Labour.
In other news I have decided that I will not be paying more than 1.5x the normal rate for out-of-hours plumbing when I next get a broken pipe. Take that plumbers!
My biggest annoyance is the Expenses.
They claim "expenses" because they are serving the public (like doctors/nurses don't serve the public??!)
And at the same time, they have so much free time to be "advisers" to banks, to give "speeches" at companies, etc. and to do all kinds of lobbying work. John Redwood made £700k on his side-gigs in just one year (I believe). But they also continue to claim 100s of thousands for their "expenses".
Meanwhile doctors who do extra shifts at hospital get hit by pension taxes. Seriously this country is so corrupt.
And then people go around saying "I don't mind paying extra tax to improve services". People fgs stop worshiping taxation and just campaign to clean up our politics! That will save billions from waste (recently the Home Office ordered 1 million pounds worth of office chairs), corruption, and cronyism.
My sentiments exactly. Why can't this apply to doctors as well? Why can't things like exams, courses be "expenses"? Also, we pay taxes and the taxes are basically used to pay NHS (us?) So every month we are actually paying in, to pay ourselves next month? I have a great idea, instead of us asking for a a " 30% pay rise" (FPR), why not say we will be happy with current pay, but zero tax. like literally zero tax. I'll be happy with that. On my NHS payslip I'm actually happy with the pre-tax amount. not post-tax.
They can honestly fuck off. As I get older I’ve realised my free time and peace is way more valuable than piddly NHS pennies. Nothing they are capable of offering would make me give that up.
Our standard full time rota is 48 hours per week. For anyone else 48 hours would already be well into overtime territory.
As a consultant I can say good luck with the waiting lists. Not a single of my colleagues will work for less. Time is the most important currency there is and my time is worth a lot more.
A night or weekend / extra list working for peanuts whilst the politicians enjoy time on the beach or at home. Best of luck like I said.
This genuinely can’t be serious… it must just be for pre election .
They know that no consultant is going to give up their weekend time for 65 pounds an hour , of which they will keep between 20 to 30 pounds ….
I don't know about that. Everyone seems to love giving Labour the benefit of the doubt!
Why mention this at all? They can just say "overtime" and leave it at that. Instead they are specifying things. This is so they can say after the election "we said before the election that this is the max we are giving, we made a solemn promise to the public". Same reason why they specifically say "no to 35%".
But this sub keeps going all wobbly for them.
It feels so backwards to repeatedly point fingers at the salaries of frontline staff.
The NHS is bloated with middlemen/idiotic IT contracts/idiotic maintenance contracts/idiotic rental agreements: these are the places to cut costs.
I've long been concerned that all the doctors who made the pay debate an anti-tory campaign are perhaps too young to remember a time labour were in charge of the health service. This will get worse, not better. Not in any way suggesting it's been well managed- only that labour's track record is equally abysmal and their ideology is firmly against doctors on the sole basis of their earnings category.
Agree completely. Milburn is the typical champagne socialist getting rich while demonizing doctors. Streeting too, very cosy with private groups (allegedly).
I disagree. I was a junior doctor under Milburn and pay increased significantly. As did resources, over a number of years. Emergency Departments actually functioned under New Labour.
Of course, the current crop are not the same people any more. But I would welcome Milburn coming in as NHS chief exec. He was there last time and would provide some continuity.
The problem is that this time... we never, thanks to austerity, recovered from the global crash, let alone Covid. New Labour had fiscal wiggle room. This time they really do not. Add to that an ever-aging population and we are basically screwed.
As a moddle-aged man, my strategy is this: get as close to BMA rates for overtime as possible; meanwhile, have taken put private health insurance for myself and my family.
The NHS is finished. No politician will admit it. Bit they all know it.
These guys don’t understand basic economics and are trying to dictate government policy… if you want to clear more appts need more surgical/procedural specialty consultants …. Need more radiologists to manage those extra images … Need some surgeons to remove those extra tumours we’re finding … Need more oncologists to manage these patients chemo and follow up …. Need more pathologists and labs to process and report these specimens…. And so on the knock on effect goes
Healthcare cannot be run by traditional business profit and loss methods especially not a government funded one.
I’m so confused, weren’t labour saying a couple of months ago that they wanted to make incentives such as increased overtime pay in order to reduce reliance on locums. Can someone explain?
Good luck with that. We struggle to fill extra sessions at £133ph or £177ph unsociable. Most of my colleague will only do it for lieu.
When you have a marginal tax rate of 62% I'd rather not risk burn out thanks.
Exactly this …… lots of departments are propped up by some level of good will to actually do extra shifts currently. Lots of consultants prefer their free time rather than the shift money .
Labour haven’t realised yet that in this country you cannot force people to work OT.
Where are all the people who were getting wet about a Labour government? I’m not saying the Tories are any good (lol) but I will continue to say this: Labour are not your friends. They’d have you working for free in shackles if they could
Another example of why it’s stupid to think voting Labour will be better . NEITHER party want to pay doctors appropriately for their skill set on their day off.
I always find it hilarious how so many doctors think Labour will be our friends.
The problem is with the NHS model of healthcare, rather than any particular political party. All politicians will want to pay us as little as they can get away with. That is the fundamental problem with us having a nationalised monopoly employer.
I think this stems from the fact that a lot of people in UK medicine are socialists and really believe in the concept of the state providing free healthcare to all. They take it as a form of moral superiority over other nations, especially vs the USA. The fact that people sit on "free" waiting lists and die, or receive subpar "free" treatment in the NHS compared to the US or even some middle income and developing nations, just does not register for them.
It's in a comment I made but here
[https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/](https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/)
Well, if ever I've seen a plan doomed to fucking fail, this is it. Wes is a dangerous and frankly stupid man of he thinks this is the answer.
Once more for those in the back:
OUR GOODWILL HAS GONE
OUR FAITH IN GOVT IN GONE
THIS IS NOT A VOCATION
WE WILL NO LONGER SACRIFICE OUR FAMILIES FOR YOURS
IF YOU WANT A WORKING SOCIALIST HEALTH SYSTEM, YOU NEED TO PROPERLY PAY THE PEOPLE WHO DELIVER IT
Fin
Choice quote from the article:
Streeting says:
>“What we’re not prepared to do is throw good money after bad. People will get the money in order to deliver the appointments. If they say they can’t deliver those appointments, then they won’t have the money.”
You can't force someone to work overtime for less pay... you just stop doing overtime lol
The reality though is without thousands more specialty training jobs there has been a 15 year trend towards people doing F3 and now F4 and F5 years typically as locums. So if labour tries to restrict the free market for doctors labour there’s a sizeable group of doctors who have little choice (barring emigration which is a pretty radical option for many) but to swallow it.
True - but clearing the backlog of elective surgery/outpatient appts can only really be done by consultants, not the army of F3+
At the end of the day those consultants will still need juniors to do the bulk of the leg work of actually effecting their plans. Consultant Surgeons are still going to need assistants and more elective work will ultimately mean more inpatient capacity is needed - which is only going to come from more labour at every level and every profession including obviously the nurses.
Hopefully they won’t just use PAs for this
3000 PAs with a backlog of 8 million patients? Yeah... no.
The headline says Consultants' pay. Extra contractual work for 1.5 times pay? - people won't cover those shifts for reasons people have said elsewhere in this thread. Hospitals will shift more NHS patients to be seen by the private sector where staff pay is better... Perhaps that's the idea.
At 40%+ tax, it literally isn't worth it.
That won’t help with waiting list initiative work. That’s all consultant or senior SAS work.
But this is consultants extra work, nothing to do with the excess SHOs available for locum
They're always trying. Difficulty is, overtime being flexible, it's a free market. You can do this strategy at a national level for a little bit, but then one slightly shittier place (that's not getting any locums) breaks rank and puts their rate up a little, forcing the others to follow and get into a bidding war, until you're back where you started. Though increasing base pay and training places would help to reduce it.
Not if you use the power of monopoly. Government mandated price caps, the power of capitalism eh.
True, but in order to be a monopoly, NHS Professionals would have to at least have the slightest tinge of competence, which I think we're a way off from.
Not when it comes to overtime, though. We can literally walk away from it.
>The reality though is without thousands more specialty training jobs there has been a 15 year trend towards people doing F3 and now F4 and F5 years typically as locums Whilst specialty competition is higher over the last two or three years, for most of that trend, competition **fell** compared to 2000s/2010s. In the mid 2010s, it wasn't uncommon to underfill CMT places, for instance. The drift to F3ing was driven by worsening standard T&Cs and more lucrative locum work (driven by a vicious circle of underfilling training posts). Whilst there are a lot of reasons for heightened competition to specialty numbers today, the cumulative net exiting doctors from training pathway now seeking to re-enter is contributing.
The biggest factor though is the equal footing between local graduates and foreign graduates - an unprecedented experiment in doctor wage suppression not seen anywhere else in the world.
I did say it wasn't the only factor. But the fact that analysis of people appointed to specialist training in this country (posted previously in this subreddit) still have same proportion pf domestic graduates as before recent changes show that this is by no means the only factor (or even largest one). (Other important factors include expansion of medical schools without commiserate expansion of specialist places, as seen by the lack of foundation places over the last couple of years)
No consultant is going to do WLI work for £75/hr. Post tax that really wouldn’t be worth my time. Or paying for childcare for. It will just lead to the trusts making up the difference between the paid rate and what they’re offering to pay if they want them covered.
£85 ph consultant shifts in London are being snapped instantly. Impoverish people and destroy their self respect and they would accept anything.
Seriously ? By who?! I’m the only consultant in my dept who does frequent WLIs , and we get 500-750 depending on weekday or weekend .
Are you asking who fill the consultant locum shifts?
What department and where ?
General medicine in London. I can see £78 ph for a 9-5 shift on patchwork now for Endocrinology consultant
For ward cover essentially. Not surprised. Try getting any sort of waiting list reduced with these rates
That's appalling. ED Consultant in London and I see £150 / hour for locums. Below BMA rates and should be higher but I think it's the bare minimum I would accept.
https://preview.redd.it/6mquu8jc2y9d1.jpeg?width=1284&format=pjpg&auto=webp&s=42e207a3e25cbed47c0f89c961ef51838406444b
Hehehe have a friend do an F2 shift for £625 last week (Wales)💀💀💀💀 this is ridiculous
Patchwork has terrible locum rates especially in West London
£500? For how many hours? If it's premium time, that seems low.
It’s a flat payment , regardless of hours for half day . Trusts up north have been known to offer only 250 per session to consultants
I suspect this is quite speciality and location specific. We struggle to fill weekend anaesthetist shifts at £150/hr. Anaesthetic WLI shifts will always have to compete with the private sector which our group has negotiated fairly reasonable rates for.
Is that rate for WLI or for standard overtime? That's double what consultants get where I am!
We get paid the same for WLI and standard overtime. That's the weekend rate the weekday rate is around £100/hr.
Wild. Where I am it's 1.8x base, no negotiation. People take almost all the shifts. Weekends would be around £90/hr.
I find that bizarre, almost every consultant will be in 60%+ tax bracket. There's no way I'm giving up my Saturday for £40/hr.
I'm in a place where there's quite a sense of "this needs to be done and we need to muck in", which is kind of how we all want to work- but it's difficult to contrast a sense of duty with a realistic impression of how that contributes to the spiral. We're in a very low cost of living area with not enough private work to go around, which I think drives some of the willingness.
London shifts were the same or just slightly less compared to the rest of the country until they introduced the cap on locum shifts which the Labour are planning for the whole country. Private work is flourishing because of the waiting lists. Don't underestimate the damage Labour can do by slashing waiting lists and capping your locums.
I know I'll get downvoted to shit, but this sub has so many Labour-loving voters that they are blind to the fact that Labour will screw us over. A pro-doctor agenda isn't something that any big party will commit to. They will prioritise the masses rather than us, the minority. An expensive minority. And without any major net increase on spendings/tax cuts/major reform, we, as doctors are doomed. Our only leverage is keep on applying pressure on whoever comes into power. We need a strong union that is pro-Doctors. No pro-patients or left-leaning. A fucking hard-core, non-compromising pro-doctor union that will not hesitate to stand up to whoever is in power for doctors. Fuck the NHS, fuck being a martyr to the system, it's about time we stood up for ourselves properly.
I get attacked for pointing this stuff out. But my position is not "anti-Labour", but anti-politician. I don't care what party they are from, my view is that the NHS system is made by politicians for politicians. Doctors and nurses are doing the actual work, but those with power influence, and who have most access to money (from the private sector and the rest of the associated healthcare industries like pharma) are actually politicians. I am happy for doctors to strike against Tory and against Labour and against Lib Dems - and against Abraham Lincoln too if required - until doctors get the respect and money they deserve.
>the NHS system is made by politicians for politicians. Doctors and nurses are doing the actual work, but those with power influence, and who have most access to money (from the private sector and the rest of the associated healthcare industries like pharma) are actually politicians. I couldn't agree more. Ever since I got into healthcare (before medical school) it was apparent that the NHS is a political football game between parties and the only way for the NHS to truely proper is for health and social care to be de-politicised. Get it run by actual qualified, politically neutral, and experienced health leaders and experts. Not the likes of Hunt/Hancock/Javed/Barclay/Coffey. They're all fucking idiots. And the Labour equivalents aren't much better either. Absolutely though. I will happily strike against whoever is in power. We and the BMA need to unapologictically stand up for ourselves first and foremost, then our colleagues, then our patients.
I agree with you about “political football”. It doesn’t suit any political party to have a well run NHS - then they have nothing to improve on and things can only get worse. So a well run NHS isn’t happening. I totally disagree about a QANGO running the NHS. Isn’t that NHS England? What a fuck up they have been. Politicians have to be responsible because they are accountable to the public (at the ballot box). QANGOs have no accountability. It needs radical change. That’s clear. I believe it also needs some decentralisation with local mayors taking a lot of responsibility. Those responsible HAVE to be accountable to the electorate. It’s the only way. Personally I’d prefer the Westminster politicians to set the basic rules (funding etc) and I’d prefer that to be cross party agreement. Then I’d expect mayors to be responsible for the detail and tailoring the local services to local needs. Their job should depend on improving services.
Thanks for raising awareness disqussion. Your efforts don’t go unnoticed but the mental gymnastics of the Red faction are bizarre. Some people have claimed that Labour have to lie to win the election but that what they are saying is not actually what they will do?!? I’m on the side of doctors…and I don’t care who is in power. I believe that our institutions particularly the royal colleges have to work for us rather than the State
>Some people have claimed that Labour have to lie to win the election but that what they are saying is not actually what they will do?!? Exactly this is copium all the way up to 11.
The old saying about the only time a politician isn't lying is when his mouth isn't moving... Streeting may not be as egregious or incompetent as Barclay, Atkins or *unt but all of them are politicians. They will do whatever to get elected and re-elected. The strategy for the BMA should not change and be even more skeptical of any pay offers/cancellation of strikes.
>Streeting may not be as egregious or incompetent as Barclay, Atkins or *unt but all of them are politicians. The guy is renowned for being anti-doctor because of personal issues. He despises us. >The strategy for the BMA should not change and be even more skeptical of any pay offers/cancellation of strikes. Absolutely, I couldn't agree more.
This is the truth. The national jobs service will be sustained whatever happens and our basic might go up but overall more people will be fighting for a dwindling slice of the pie. I keep being downvoted for saying there were no locums when Labour was in power and if people paid us properly we’d not lead to locum but what the politicians deem proper and what we are two very different things A long waiting list is actually in our interest and this is the most socialist of policies. Cap our locum rates so that we are forced to work more…stealth paycut
Yeah the NHS is an employment service. It lets people who aren't the brightest have the hope of "promotion", a work email, a desk, a swivel chair etc. Uptil now doctors were at least paid similar to other professionals, but now they are also being degraded and pushed down into working class.
Yeah but it’s because these guys are used to managing supermarkets and they bring the same level of detail to this
It made my blood boil when Streeting said that it would be capped at 1.5x in line with nurses pay. They need to stop comparing us to nurses because we provide different services. If I'm an F1 and my base is £15/hr, I really wouldn't want to come into work on a weekend for £22.50. This is a lower hourly locum pay than the worst caps out there. It's a paycut to locum work. Equally, as a reg on £26.52/hr, good luck getting me to even respond to a £40/hr weekend clinic/theatre list. You'll see these clinics/lists covered by AfC MAPs on a lower rate yet same 1.5x Saturday enhancement. Bottom line, we're not nurses, don't compare us to them. Pay us properly.
I don't entirely disagree, labour are potentially going to fuck us sideways, but, the Tories have fucked me from both ends. So when my wife started getting symptoms of MS, not only was the wait for an urgent referral 38 weeks, but I also don't have the money for private treatment. At least under labour there's a chance of decent public services to fall back on....
I am sorry to hear about your wife and frankly, a 38 week wait is abysmal. Embaressing and not fair on you. People shouldn't feel like they need to rely on private healthcare to get prompt treatment for life debilitating conditions. >At least under labour there's a chance of decent public services to fall back on However, this needs money. New money. New money for doctors, nurses, MRIs, labs, clinic space. Not restructuring or diverting or cost cutting. A net increase in spending either through increased taxation or borrowing. Yet nobody wants to talk about that.
Or actually evaluating budgets and cutting the shit and wastage
You really this the percentage spent on "shit and wastage" is all that's needed? That's such a tory misnomer. "Efficiency and optimisation savings". I don't disagree that things can be run better but Even if it's 10-20% that's wasted, that's not enough to build new hospitals or train more doctors. We need new money and a radical change to the system that includes expansion rather than minimisation.
Yes there's absolutely no question that the Tories have destroyed the healthcare service.
>I know I'll get downvoted to shit, but this sub has so many Labour-loving voters that they are blind to the fact that Labour will screw us over. This sub isn't unanimously pro-Labour, far from it. I think Wes Streeting is an absolute toad of a politician who should have never been let near a portfolio like health, and I doubt I am the only one here. The "doctors= Momentum activists" thing is right out of the Daily Mail
just hide your wealth offshore like the tory bois with a eu pp just in case
What wealth? To build PP wealth, you need a competitive salary from a thriving PP economy. Thankfully, this is slowly happening.
What even is time and a half? Seriously..... have these people even got a clue? We're not on an hourly rate, we're salaried. The best I can work out I get paid about £192 per PA in normal time, which works out as £48/hr. £72/hr for overtime?.... Nah, think I'll pass thanks.
I think its pretty clear that's what he means. And yeah, \~£37 per hour post-tax (or about £21 per hour if you're into the 100k tax trap, as many will be) for an evening or weekend shift. Haha. No. Less than childcare would cost.
Literally no-one will do WLI at that rate. And given that WLI is propping up the NHS and, realistically, the ONLY way of meeting Labour's pledge to cut waiting times down... what exactly is Streeting playing at? The closest to logic I can figure is that he wants to financially pressurize trusts to get more in-timetable/on-call consultant PAs... but the whole problem here is the complete inability to recruit and retain anyone!
They’re going to try and job plan this, that’s where time and a half comes from. Overtime = Additional PAs. Non-pensionable. So instead of a 240 minute PA (standard) it will be a 160 minute PA (2 hours 40 mins).
Good luck with that. Job Plans can be changed... by mutual consent...
They can. And they can be imposed with 3 months notice
The hourly rate is on the pay slip. We're salaried based on a multiplication between an hourly rate and the number of hours in the job plan. Like it or not, we're salaried and not shift workers but we absolutely have an hourly rate.
So… overtime won’t happen then? Muppets.
Exactly. No one is doing their 11th PA for time and a half.
Doctors should do no overtime if he tries to pull that shit, suggests me.
Given the tax rates already , they would find the shifts just wouldn’t be covered. It wouldn’t be worth it.
It might not be worth it to you or I, but the NHS has spent the last decade bussing in tens of thousands of doctors from places like Pakistan, Egypt, India etc. who may well be prepared to work for claps as they don’t know any better.
The money they earn here makes them RICH in their country.
The money we earn here is spent here because we can barely live here. My rent, utility bills and transport alone is £1700 a month on SHO job
Yes but the money you save here (your dispoable income) is still more than your monthly salary in your home country
There's no but. You said the NHS salary makes us rich at home country and that's not true. What £100 can do in Egypt is irrelevant because I live in the UK, can't work remotely and only have a maximum of 6 weeks to spend away from work. I don't understand what your sorrow is about though. Do you feel bitter that people can save a few hundreds and can spend some of that on a cheap holiday? You can do that if you wish
You’re right, there is no but. The money you earn here makes you rich in your country, even after tax and bills. Maybe rich isn’t the right word but at least well-off. The overwhelming presence of your people (don’t care if you’re from an arab country or european country or african country) is a detriment to doctors. The evidence is in the competition ratios for both training and non-training positions.
I have to disagree partly here, not an IMG but honestly when you look at costs of living in this country, how is anyone saving? Also, Costs of living, esp in EU countries, are soaring. The UK isn’t what it used to be in the 90s, I genuinely don’t know how one can save a substantial amount here
Now your sorrow and bitterness is even more clear 😂 It's pathetic though. The British doctors and professionals are working allover the world but no one makes much fuss about them. Because maybe they work in successfull and growing countries where there's a culture of growth and abundance. Unfortunately the UK is failing in the last 30 years and that's complicating things. The UK doctors were complaining when the hospitals had no enough doctors and now complaining of the enough doctors. Now they introduced PAs and ANPs to limit recruiting overseas doctors but still not happy.They aren't happy either way because the problem is in the whole system.
Yes I am very bitter at how my friends are struggling to get jobs because of your lot. And I’m not going to reply to all of your strawmans
That's not "his lot's" fault though is it? You're trying to tell me that if the US suddenly said it's open season for UK doctors to move to California you wouldn't be on the first plane? I would, and I wouldn't give a fuck what the local doctors thought about it. Direct your ire at the government's open season policy, not at individuals just trying to make the best of their life, because you would 100% do the same in their position.
People who speak like you do rarely have any sense of personal accountability or responsibility. Why didn't YOU pick a career that gave you what you want? Why haven't YOU worked hard enough to get into the training programme? Why don't you get out there, work like a dog, save like mad and invest until you are doing well? Don't blame other people because your life hasn't worked out the way you wanted it to. That's on each of us to deliver for ourselves.
Not an IMG but I know a lot of IMGs. I presume what you are saying likely doesn’t matter tho because the majority of that disposable income is likely spent in the UK or if it is entirely saved then the IMGs are living miserable lives nonetheless. It’s also likely that the average IMGs have a far lower support network and friendship groups. Speaking to a lot of IMGs the UK is not one of the preeminent destination for medical graduates it once was and a lot of IMGs unfortunately get that rude awakening once they arrive here. Additionally, when I asked a bunch of IMGs(mostly from India and Pakistan) they all said that the biggest pro of UK medicine is significantly better work life balance. In India it’s not uncommon for their trainee doctors to be working 80 hour work weeks and generally they said the environment was more ‘toxic’. The pay is better in the UK but when accounting for how expensive things are the quality of life is more or less similar.
A three bedroom flat in nice area in Egypt now cost around £100,000. Yes half the price of the UK but not cheap and the NHS salary sadly can’t make me rich in Egypt
They do know better but they have low self worth
For someone to make the move from a developing country where their annual salary is less than your wage for a month, I don't see how you can state that they have low self worth. It's precisely because of the opposite, that they leave in the first place.
Pump the PAs in…
National Gulag Service
By order of Keir Stalin: Doctor Pay will be reduced until the BaCkLoG is cleared!
It’s an easy calculation for me. You’re paying for my time. I consider it worth more than you’re offering. It’s a “no” from me. I’ll be busy fishing looking after my H&WB. 👍
Got downvoted previously for saying there’s no difference between Tories and Keir Starmer’s Labour. Told you so.
I got eviscerated quite a few times for saying the same thing.
What's to stop them then going even further: making extra work mandatory as part of the existing responsibilities, for the purposes of "national service" or whatever? [https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/](https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/) Looks like the skeptics here were correct about Labour.
In other news I have decided that I will not be paying more than 1.5x the normal rate for out-of-hours plumbing when I next get a broken pipe. Take that plumbers!
Cons strikes round 2
Because tgat would entail a change of job plan which, for a consultant, can only happen with mutual consent...
Westminster is genuinely full of clowns.
who are good at making money
Can there also be a "cap" on the amount of money MPs earn on their seconds jobs then? Say cap to 1k per month, pre-tax.
My biggest annoyance is the Expenses. They claim "expenses" because they are serving the public (like doctors/nurses don't serve the public??!) And at the same time, they have so much free time to be "advisers" to banks, to give "speeches" at companies, etc. and to do all kinds of lobbying work. John Redwood made £700k on his side-gigs in just one year (I believe). But they also continue to claim 100s of thousands for their "expenses". Meanwhile doctors who do extra shifts at hospital get hit by pension taxes. Seriously this country is so corrupt. And then people go around saying "I don't mind paying extra tax to improve services". People fgs stop worshiping taxation and just campaign to clean up our politics! That will save billions from waste (recently the Home Office ordered 1 million pounds worth of office chairs), corruption, and cronyism.
My sentiments exactly. Why can't this apply to doctors as well? Why can't things like exams, courses be "expenses"? Also, we pay taxes and the taxes are basically used to pay NHS (us?) So every month we are actually paying in, to pay ourselves next month? I have a great idea, instead of us asking for a a " 30% pay rise" (FPR), why not say we will be happy with current pay, but zero tax. like literally zero tax. I'll be happy with that. On my NHS payslip I'm actually happy with the pre-tax amount. not post-tax.
haha that would be amazing
Classic Labour, not understanding how the economy and even work works.
They can honestly fuck off. As I get older I’ve realised my free time and peace is way more valuable than piddly NHS pennies. Nothing they are capable of offering would make me give that up. Our standard full time rota is 48 hours per week. For anyone else 48 hours would already be well into overtime territory.
As a consultant I can say good luck with the waiting lists. Not a single of my colleagues will work for less. Time is the most important currency there is and my time is worth a lot more. A night or weekend / extra list working for peanuts whilst the politicians enjoy time on the beach or at home. Best of luck like I said.
This genuinely can’t be serious… it must just be for pre election . They know that no consultant is going to give up their weekend time for 65 pounds an hour , of which they will keep between 20 to 30 pounds ….
I don't know about that. Everyone seems to love giving Labour the benefit of the doubt! Why mention this at all? They can just say "overtime" and leave it at that. Instead they are specifying things. This is so they can say after the election "we said before the election that this is the max we are giving, we made a solemn promise to the public". Same reason why they specifically say "no to 35%". But this sub keeps going all wobbly for them.
WLI clinics were paid at around £500 each in the 00s - need that adjusted for inflation or forget it.
Anything eroding pay should prompt further strike action.
It feels so backwards to repeatedly point fingers at the salaries of frontline staff. The NHS is bloated with middlemen/idiotic IT contracts/idiotic maintenance contracts/idiotic rental agreements: these are the places to cut costs.
I've long been concerned that all the doctors who made the pay debate an anti-tory campaign are perhaps too young to remember a time labour were in charge of the health service. This will get worse, not better. Not in any way suggesting it's been well managed- only that labour's track record is equally abysmal and their ideology is firmly against doctors on the sole basis of their earnings category.
Agree completely. Milburn is the typical champagne socialist getting rich while demonizing doctors. Streeting too, very cosy with private groups (allegedly).
I disagree. I was a junior doctor under Milburn and pay increased significantly. As did resources, over a number of years. Emergency Departments actually functioned under New Labour. Of course, the current crop are not the same people any more. But I would welcome Milburn coming in as NHS chief exec. He was there last time and would provide some continuity. The problem is that this time... we never, thanks to austerity, recovered from the global crash, let alone Covid. New Labour had fiscal wiggle room. This time they really do not. Add to that an ever-aging population and we are basically screwed. As a moddle-aged man, my strategy is this: get as close to BMA rates for overtime as possible; meanwhile, have taken put private health insurance for myself and my family. The NHS is finished. No politician will admit it. Bit they all know it.
These guys don’t understand basic economics and are trying to dictate government policy… if you want to clear more appts need more surgical/procedural specialty consultants …. Need more radiologists to manage those extra images … Need some surgeons to remove those extra tumours we’re finding … Need more oncologists to manage these patients chemo and follow up …. Need more pathologists and labs to process and report these specimens…. And so on the knock on effect goes Healthcare cannot be run by traditional business profit and loss methods especially not a government funded one.
I’m so confused, weren’t labour saying a couple of months ago that they wanted to make incentives such as increased overtime pay in order to reduce reliance on locums. Can someone explain?
Answer: Labour have just as big a track record for lying as the tories. Those of us who were here last time round will well remember.
Anything above the standard rate is "overtime", even if it's just 1pence.
I suggest a solution. Stop paying for international wars and use that money to pay doctors who actually help the people in the country.
Nah, actualizing fanatical obsessions about global empire and hegemony is priceless to these goons in politics and in the media too.
Good luck with that. We struggle to fill extra sessions at £133ph or £177ph unsociable. Most of my colleague will only do it for lieu. When you have a marginal tax rate of 62% I'd rather not risk burn out thanks.
Exactly this …… lots of departments are propped up by some level of good will to actually do extra shifts currently. Lots of consultants prefer their free time rather than the shift money . Labour haven’t realised yet that in this country you cannot force people to work OT.
Where are all the people who were getting wet about a Labour government? I’m not saying the Tories are any good (lol) but I will continue to say this: Labour are not your friends. They’d have you working for free in shackles if they could
Exactly. It's Doctors vs politicians+NHS.
35% pay rise first, with 50% extra for OT, and you might stand a chance lol
This is so dumb I’m wondering if it’s made up
Another example of why it’s stupid to think voting Labour will be better . NEITHER party want to pay doctors appropriately for their skill set on their day off.
No fucking thank you Wes
The reality is, you have to just vote with your feet. Go to the places that value you.
Ha! Like that will work 🙄
So £75/hour for consultants and £25-30 for FY1? Good fucking luck with that.
I won't be doing that for a 67% tax (Scotland) you out of touch with the reality-wankers
I always find it hilarious how so many doctors think Labour will be our friends. The problem is with the NHS model of healthcare, rather than any particular political party. All politicians will want to pay us as little as they can get away with. That is the fundamental problem with us having a nationalised monopoly employer.
I think this stems from the fact that a lot of people in UK medicine are socialists and really believe in the concept of the state providing free healthcare to all. They take it as a form of moral superiority over other nations, especially vs the USA. The fact that people sit on "free" waiting lists and die, or receive subpar "free" treatment in the NHS compared to the US or even some middle income and developing nations, just does not register for them.
Could we have a link to the sauce please?
It's in a comment I made but here [https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/](https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/)
But their plan was to increase overtime to clear the backlog? Streeting you massive wally.
I wonder if the insourcers will have the same limitations
[https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/](https://www.telegraph.co.uk/politics/2024/07/01/doctors-less-overtime-help-clear-nhs-backlog-streeting/)
I’ve got 2 hairy gifts for Wes streeting to suck on.
This is just electioneering.
I'm already saying no to wlis because I want a life outside work. This isn't making them any more enticing.
F. U.
And to think I thought this would be the last strike😂😂😂 see you guys after change over day
Well, if ever I've seen a plan doomed to fucking fail, this is it. Wes is a dangerous and frankly stupid man of he thinks this is the answer. Once more for those in the back: OUR GOODWILL HAS GONE OUR FAITH IN GOVT IN GONE THIS IS NOT A VOCATION WE WILL NO LONGER SACRIFICE OUR FAMILIES FOR YOURS IF YOU WANT A WORKING SOCIALIST HEALTH SYSTEM, YOU NEED TO PROPERLY PAY THE PEOPLE WHO DELIVER IT Fin
Feel the NHS will be a completely IMG led service as they are the only ones who will work in such a system
Wasn’t the Labour behind the criminal wars in Iraq and Afghanistan and in charge when the financial crisis happened? 🤔
Correct. Us older folk remember exactly this
That's brutal 😭 I didn't realise I must be old to remember these stuff 😂
You're probably not 🙃 but I just feel 102 after 30 years in the NHS!!
I can relate 😂
Choice quote from the article: Streeting says: >“What we’re not prepared to do is throw good money after bad. People will get the money in order to deliver the appointments. If they say they can’t deliver those appointments, then they won’t have the money.”
…… and the appointments won’t be delivered then.