Agree with pretty much all of that. In addition, debt/exam costs and relief could be taken from Gross (rather than Net) Salary, so employees could win as well as the NHS.
I have never been employed by the BMA, but 15+ years ago I took part in some joint initiatives with them. I found them to be extremely proficient. I am sure that they still have many talented staff, but the current mouthpieces do not inspire the same level of confidence.
The BMA is both a Professional body and a Trade Union. Both essential roles. But (IMO) not roles that should be carried out by the same organisation.
^^100% this. Many (including lots of talented medical politicians who would greatly benefit the current debate) left the BMA when it became obvious it was using our subs to undertake public health campaigns (smoking in cars, boxing etc etc) rather than to further the interests of its members.
A leading medical student has told how his student loan has now passed £100,000 – even though he has more than a year before qualifying. Rob Tucker is co-chair of the British Medical Association medical students committee and has been student president at Barts Medical School.
Writing about his loan on social media, Tucker said that more generous provision for medical, health and social care students could improve recruitment to these professions.
He has undergone an extended course - as he has included medical education in his undergraduate degree. This has left him with two years with a reduced student finance loan and, he said, an “unliveable” NHS Bursary, of £4,000 a year.
He tweeted: “I don't want to borrow more but it's a solution to the financial stress many have at the end of medical school if able to take more loan, but currently I can't.
“If I hit another milestone of £150k then I really should throw a party! But surely there are better solutions?”
Tucker said he, personally, would not mind the introduction of voluntary service agreements – which would allow students to access funding in return for a commitment to work for the NHS for a minimum period. There should be ways to “get out” of such agreements if necessary, he said.
He said the NHS Workforce Plan had failed to tackle the problem – in spite of proposing a huge expansion of medical school places.
He wrote: “Another solution is tuition fee removal for certain courses that aim towards important health and social care roles. Perhaps this would only happen with a return of service agreements, e.g. five years of tuition fees paid by government, then required to do (5?) years in the NHS.”
The Junior Doctors are using terminology not seen since the 1970s with talk of linking pay to historic inflation. As though their job, or indeed any job, should automatically rise with inflation. Whereas, in reality, Junior Doctors should be paid according to their worth as technology changes. Which, logically, means Junior Doctors in some fields should be earning more. And others, less. As demand changes, and the need for expertise varies with technology. All part of a changing World.
But it is perhaps understandable. Because the NHS us stuck in a 1970s pay system. Which fails to reward those who deserve it.
I spent precisely 1 year working at an organisation which was part of the wider NHS family. I had been made redundant by a different Company, and needed a job. Sharpish. We've all been there. So I took a job paying considerably less than my previous salary.
Within a month or 2, it was apparent that my colleagues were less experienced, and less confident than me. Several did not have formal legal qualifications, and there were frequent occasions when I was tasked with resolving problems due to that inexperience. Both via Management, and my colleagues. Not a problem-spent a lot of my legal career doing that sort of stuff.
What did matter was when I realised that my colleagues were all earning more than me. Because we all had the same job title, and they all had incremental rises via years of service. So I raised that, not as a Grievance, just to ascertain whether I was going to stay. And this is the standard way the NHS reacts. I could have a changed job title, and take on extra responsibilities. Or I would have to wait for the annual increments. I'm well aware of my strengths and weaknesses-for example, I am/was far stronger as a Solicitor than in the Management roles that suit other people. So I left. Simply because I knew my own worth.
This isn't a "woe is me" thing. It shows the fundamental flaw within the NHS. There are thousands of Doctors who are brilliant at their job. Who are better at their job than they would be in more "senior" positions. But the NHS has little or no mechanism to reward people who are good at their job. Just for length of service and/or willingness to take on new jobs.
I have spent my whole career using Building Sites and their staff as the Comparator for these situations. If someone is the best at their role, be it a Bricklayer, a Fitter/Welder, whatever, you pay him according to 3 things. How good he is. How quick he is. And his worth to his employer. And those are the 3 criteria-not whether he could do some joinery, and you don't care how long he has been there.
I don't agree entirely @Essexphil - postgraduate medicine is learned by a combination of apprenticeship/experience and formal postgrad study/exams. Newly qualified doctors are not allowed to prescribe outwith their own hospital and are not allowed to discharge patients, because they lack the experience to do so safely.
It's the age old maxim of 10,000 hours of deliberate practice to become an expert. Doctors 2 years postgrad are worth significantly more than newly qualified docs because their decision-making capability has increased significantly with those hours under their belts. This is why the increments are important and fair. At 4-5 years postgrad further pay progression is stunted without postgrad exams - these are difficult and competitive.
That said, I have worked in teaching hospitals with high flying junior docs who were great at publishing but rarely seen on the wards, so I do nod to your point about the system being unable to reward based upon real world worth.
Meanwhile the dirty tricks are in full swing: hospitals applying for derogations well in advance of the strike (i.e. trying to compel striking doctors to return to work on patient safety grounds) whilst refusing to provide evidence that elective activity has been cancelled and consultants asked to act down.
Meanwhile the dirty tricks are in full swing: hospitals applying for derogations well in advance of the strike (i.e. trying to compel striking doctors to return to work on patient safety grounds) whilst refusing to provide evidence that elective activity has been cancelled and consultants asked to act down.
1 quick point on each of your last 2 posts.
1. Agree with your point about the first 2-3 years and banded pay rises. Although the Strikers seem to ignore this in relation to the "£14/15 per hour" stuff. Been annoying me when the BMA start comparing themselves to Baristas. Baristas do not get a 10% rise on top of pay rises just for being still employed. Nor out-of-hours uplifts, or Final Salary Pensions. I'm not saying the most Junior Junior Doctors are paid well enough-just that the BMA are giving out misleading statistics
2. Dirty tricks? 2-way street. Firstly, the people who are trying to provide these forecasts are the wrong people-simply because the right people aren't there. I'm sure some of the derogations are as you describe-and others through lack of knowledge, and (a few) genuine. The other thing to say is that the BMA are adopting similar tactics to that eejit Health Secretary (although Edwina Currie makes even her look rational). Your Union will not agree to talks unless and until the Govt makes a new offer. So. Preconditions before agreeing to talks. Holding the Public to ransom. I get why the Govt does that. They are unprofessional. Whereas...
The government has for well over a year refused to discuss the pay envelope. That is why we are where we are. Now they say they won't talk unless strike is abandoned.
The government has for well over a year refused to discuss the pay envelope. That is why we are where we are. Now they say they won't talk unless strike is abandoned.
I'm very much as outsider looking on. With all the advantages-and disadvantages-that brings.
Much as I dislike both this Govt and its stance in this dispute, in some senses it has not "refused to discuss the pay envelope". It has made what is considers to be a fair offer. And stuck to it. Your Union insists it must change. While for various reasons, many of which are political as well as economic, they have no intention of doing so-at least in public. Which the majority of Doctors do not consider sufficient. For reasons I can fully appreciate-it is just the extent of the strike action that I do not like.
Then for the next year 1 side has claimed "that's all your going to get" while the other demands 35%. And both blame the other for refusing to budge from their positions. Disregarding the fact that neither position is realistic. 2 sets of negotiators firm in the belief that failure to compromise is entirely the fault of the other.
"Won't talk until strike abandoned"-ridiculous. "Won't talk until a new offer put on the table"-equally ridiculous.
This Govt is on its last legs. The battle for more money will not be "won" under the next Govt, but progress will be easier. Within a year. Why take the sort of strike action that will be counterproductive in relation to pay? I can see lots of advantages to the BMA for actions taken right now. And for the Labour Party. Just not for the Junior Doctors.
@Essexphil one of the most annoying things about working in the NHS is that everyone who doesn't has an opinion, LOL. I've literally been interrupted on dates by mortgage advisors to tell me their opinion on the NHS news du jour.
The simple fact is that we had 10 years of austerity. Sub inflationary 1% pay rises for TEN YEARS. So that bankers who couldn't run banks properly could still collect bonuses whilst their organisation had to be taken over by HMG. I've never seen a **** bonus, and I'm fine with that. I'm not fine with less able people in failed organisations getting a massively better deal out of my pay.
Then we had Covid. I did 63 days of consecutive 24 hour on call during that. Was I paid for it? Was I flip. I'm sure that all the people like you who know so much better about the NHS can really identify with this type of hard work. Are we bitter about it? You betcha.
Working briefly for a company who once did some work alongside the NHS is not a substitute for 20 years at the sharp end, I can tell you.
Completely agree. That is why I said there are both advantages and disadvantages to being outside looking in. There is always a depth of knowledge that comes from being actually in the dispute. Conversely, there is always a risk that being in it causes the people in it to lose perspective in some instances. By which I mean the BMA-not you.
It wasn't a company that did some work alongside the NHS. It is a constituent part of the NHS, involving a different set of Professionals within it. That is both a professional body and a Union. I just didn't want to identify them. Plus I have spent more than 20 years at the sharp end of industrial disputes, for Unions, Management and Employees (and me). Which is your "sharp end" right now in relation to this dispute.
The point I was making remains. People are routinely paid in the NHS according to job title and length of service. Ability in the job you do seems to be a minor factor. To use something you mentioned, people who worked their buns off during Covid are not rewarded going forward any more than the ones who were less helpful, whether due to ability or design. The majority-like you-put in a massive extra effort. But the NHS pay structure currently has little or no mechanism to reward that.
The only people who appear to pay little part in the pay of individual Doctors are Doctors. As though no-one in your position has any input or knowledge as to who of your colleagues are the best at what they do. We are the only major country that has a National Health Service and a National pay scale. Everywhere else, the best are rewarded or swiftly move to a rival without having to totally change job or Country.
Comments
Agree with pretty much all of that. In addition, debt/exam costs and relief could be taken from Gross (rather than Net) Salary, so employees could win as well as the NHS.
I have never been employed by the BMA, but 15+ years ago I took part in some joint initiatives with them. I found them to be extremely proficient. I am sure that they still have many talented staff, but the current mouthpieces do not inspire the same level of confidence.
The BMA is both a Professional body and a Trade Union. Both essential roles. But (IMO) not roles that should be carried out by the same organisation.
^^100% this. Many (including lots of talented medical politicians who would greatly benefit the current debate) left the BMA when it became obvious it was using our subs to undertake public health campaigns (smoking in cars, boxing etc etc) rather than to further the interests of its members.
Rob Tucker is co-chair of the British Medical Association medical students committee and has been student president at Barts Medical School.
Writing about his loan on social media, Tucker said that more generous provision for medical, health and social care students could improve recruitment to these professions.
He has undergone an extended course - as he has included medical education in his undergraduate degree. This has left him with two years with a reduced student finance loan and, he said, an “unliveable” NHS Bursary, of £4,000 a year.
He tweeted: “I don't want to borrow more but it's a solution to the financial stress many have at the end of medical school if able to take more loan, but currently I can't.
“If I hit another milestone of £150k then I really should throw a party! But surely there are better solutions?”
Tucker said he, personally, would not mind the introduction of voluntary service agreements – which would allow students to access funding in return for a commitment to work for the NHS for a minimum period. There should be ways to “get out” of such agreements if necessary, he said.
He said the NHS Workforce Plan had failed to tackle the problem – in spite of proposing a huge expansion of medical school places.
He wrote: “Another solution is tuition fee removal for certain courses that aim towards important health and social care roles. Perhaps this would only happen with a return of service agreements, e.g. five years of tuition fees paid by government, then required to do (5?) years in the NHS.”
https://uk.yahoo.com/news/steve-barclay-squirms-susanna-reid-094604920.html
But it is perhaps understandable. Because the NHS us stuck in a 1970s pay system. Which fails to reward those who deserve it.
I spent precisely 1 year working at an organisation which was part of the wider NHS family. I had been made redundant by a different Company, and needed a job. Sharpish. We've all been there. So I took a job paying considerably less than my previous salary.
Within a month or 2, it was apparent that my colleagues were less experienced, and less confident than me. Several did not have formal legal qualifications, and there were frequent occasions when I was tasked with resolving problems due to that inexperience. Both via Management, and my colleagues. Not a problem-spent a lot of my legal career doing that sort of stuff.
What did matter was when I realised that my colleagues were all earning more than me. Because we all had the same job title, and they all had incremental rises via years of service. So I raised that, not as a Grievance, just to ascertain whether I was going to stay. And this is the standard way the NHS reacts. I could have a changed job title, and take on extra responsibilities. Or I would have to wait for the annual increments. I'm well aware of my strengths and weaknesses-for example, I am/was far stronger as a Solicitor than in the Management roles that suit other people. So I left. Simply because I knew my own worth.
This isn't a "woe is me" thing. It shows the fundamental flaw within the NHS. There are thousands of Doctors who are brilliant at their job. Who are better at their job than they would be in more "senior" positions. But the NHS has little or no mechanism to reward people who are good at their job. Just for length of service and/or willingness to take on new jobs.
I have spent my whole career using Building Sites and their staff as the Comparator for these situations. If someone is the best at their role, be it a Bricklayer, a Fitter/Welder, whatever, you pay him according to 3 things. How good he is. How quick he is. And his worth to his employer. And those are the 3 criteria-not whether he could do some joinery, and you don't care how long he has been there.
It's the age old maxim of 10,000 hours of deliberate practice to become an expert. Doctors 2 years postgrad are worth significantly more than newly qualified docs because their decision-making capability has increased significantly with those hours under their belts. This is why the increments are important and fair. At 4-5 years postgrad further pay progression is stunted without postgrad exams - these are difficult and competitive.
That said, I have worked in teaching hospitals with high flying junior docs who were great at publishing but rarely seen on the wards, so I do nod to your point about the system being unable to reward based upon real world worth.
1. Agree with your point about the first 2-3 years and banded pay rises. Although the Strikers seem to ignore this in relation to the "£14/15 per hour" stuff. Been annoying me when the BMA start comparing themselves to Baristas. Baristas do not get a 10% rise on top of pay rises just for being still employed. Nor out-of-hours uplifts, or Final Salary Pensions. I'm not saying the most Junior Junior Doctors are paid well enough-just that the BMA are giving out misleading statistics
2. Dirty tricks? 2-way street. Firstly, the people who are trying to provide these forecasts are the wrong people-simply because the right people aren't there. I'm sure some of the derogations are as you describe-and others through lack of knowledge, and (a few) genuine.
The other thing to say is that the BMA are adopting similar tactics to that eejit Health Secretary (although Edwina Currie makes even her look rational). Your Union will not agree to talks unless and until the Govt makes a new offer. So. Preconditions before agreeing to talks. Holding the Public to ransom.
I get why the Govt does that. They are unprofessional. Whereas...
Much as I dislike both this Govt and its stance in this dispute, in some senses it has not "refused to discuss the pay envelope". It has made what is considers to be a fair offer. And stuck to it. Your Union insists it must change. While for various reasons, many of which are political as well as economic, they have no intention of doing so-at least in public. Which the majority of Doctors do not consider sufficient. For reasons I can fully appreciate-it is just the extent of the strike action that I do not like.
Then for the next year 1 side has claimed "that's all your going to get" while the other demands 35%. And both blame the other for refusing to budge from their positions. Disregarding the fact that neither position is realistic. 2 sets of negotiators firm in the belief that failure to compromise is entirely the fault of the other.
"Won't talk until strike abandoned"-ridiculous.
"Won't talk until a new offer put on the table"-equally ridiculous.
This Govt is on its last legs. The battle for more money will not be "won" under the next Govt, but progress will be easier. Within a year. Why take the sort of strike action that will be counterproductive in relation to pay? I can see lots of advantages to the BMA for actions taken right now. And for the Labour Party. Just not for the Junior Doctors.
The simple fact is that we had 10 years of austerity. Sub inflationary 1% pay rises for TEN YEARS. So that bankers who couldn't run banks properly could still collect bonuses whilst their organisation had to be taken over by HMG. I've never seen a **** bonus, and I'm fine with that. I'm not fine with less able people in failed organisations getting a massively better deal out of my pay.
Then we had Covid. I did 63 days of consecutive 24 hour on call during that. Was I paid for it? Was I flip. I'm sure that all the people like you who know so much better about the NHS can really identify with this type of hard work. Are we bitter about it? You betcha.
It wasn't a company that did some work alongside the NHS. It is a constituent part of the NHS, involving a different set of Professionals within it. That is both a professional body and a Union. I just didn't want to identify them. Plus I have spent more than 20 years at the sharp end of industrial disputes, for Unions, Management and Employees (and me). Which is your "sharp end" right now in relation to this dispute.
The point I was making remains. People are routinely paid in the NHS according to job title and length of service. Ability in the job you do seems to be a minor factor. To use something you mentioned, people who worked their buns off during Covid are not rewarded going forward any more than the ones who were less helpful, whether due to ability or design. The majority-like you-put in a massive extra effort. But the NHS pay structure currently has little or no mechanism to reward that.
The only people who appear to pay little part in the pay of individual Doctors are Doctors. As though no-one in your position has any input or knowledge as to who of your colleagues are the best at what they do. We are the only major country that has a National Health Service and a National pay scale. Everywhere else, the best are rewarded or swiftly move to a rival without having to totally change job or Country.