NHS Staff Sickness

[161BMW]

ZedLeg said:

Ok, you said the nhs mostly helps people with self inflicted conditions with no evidence to back it up then said it was obvious because

some

people are fat.
overweight according to the BMI.

• most

I didn’t mention BMI once that something you mentioned.
I said body fat percentage.

Obesity annual costs the nhs 6 billion. If population were healthier than this could be good annual cost saving. https://www.gov.uk/government/news/new-obesity-tre...

Edited by 161BMW on Friday 30th June 17:12

Edited by 161BMW on Friday 30th June 17:16

[ZedLeg]

My point is that the medical definition of overweight isn't the same as looking at someone and saying they're fat.

[E63eeeeee...]

161BMW said:

ZedLeg said:

Ok, you said the nhs mostly helps people with self inflicted conditions with no evidence to back it up then said it was obvious because

some

people are fat.
overweight according to the BMI.

• most

I didn’t mention BMI once that something you mentioned.
I said body fat percentage.

Obesity annual costs the nhs 6 billion. If population were healthier than this could be good annual cost saving. https://www.gov.uk/government/news/new-obesity-tre...

Edited by 161BMW on Friday 30th June 17:12

Edited by 161BMW on Friday 30th June 17:16

6bn out of a 160bn budget? Most of what the NHS does is look after old people. Arguably getting old is self inflicted, so you're not completely wrong, I guess. It's just that the ways of avoiding it aren't very palatable.

[Brainpox]

You can’t lump all NHS staff in the same boat here.

There are definitely those who take the piss with sickness. In my department we had one woman who went sick with a sore neck for 6 months. Then COVID hit and her husband went to an at the time illegal party. He got COVID, passed it onto this person I work with, who then spent almost two years sick with long COVID. She was on full pay as it was COVID related and the policy at the same was it was cheaper to keep paying someone than risk being sued for failing to protect staff - except that she caught it at home!

Anyone like the above is a pain in the arse because everyone else has to work harder to cover them - either because they aren’t present in the day, or everyone else has to do more unsocial hours shifts.

There’s also general apathy to the whole ongoing pay situation. A few years ago one of the reasons for being paid less than private sector and getting below inflation pay rises was because the pension, annual leave, and sickness policies were so good. I accept the first two but the implication with the third is that if you aren’t using a decent chunk of your sickness allowance you are not using full use of the benefits and effectively being underpaid. So some people use this as a reason to go off sick.

Then there’s genuine sickness. The problems if a clinical person goes into work with sickness are quite obvious really:
- they spread it to other staff
- they spread it to patients
- they are more likely to make poor decisions that compromise patient care or service provision

When your job is dealing with sick people rather than trying to make someone else more money i think it’s reasonable for expectations of sickness to change. If someone run down with a fever forces themselves into work they won’t perform to a high level, forcing others to pick up the slack, and they will then get sick too. Before you know it you don’t have enough staff to run a key service.

Ultimately there’s very little managers are allowed to do by HR to deal with people who abuse the sickness policy. It is all about ‘supporting’ staff and you only see people getting sacked if they are dangerously incompetent at their job.

[Logistix]

You certainly can’t.

By the way has anyone noticed the tiny flaw in the ‘historic’ NHS 15 year staffing plan?

To address the crisis in understaffing and recruitment (people leaving because they are burnt out and can get paid better elsewhere or just want to retire) the plan is to double the number of medical students and shorten the medical degree from 5-6 years to 4.

This will require at least a doubling of training opportunities. More actually as lowering the entry bar will attract less able student who will require more training than at present.

As the current medical staff are running to stand still who is going to do all this extra training and mentoring?

Will you be happy to be treated by a doctor with approx 40% of the clinical experience of the current graduates?

It’s pie in the sky, but at least Sunak can say ‘Hold your nerve, I’ve got a plan…’

(Before you ask, the priority should be dealing with retention of experienced staff first. If you’ve got a leaky bucket, fix the hole before pouring more water in.)

[161BMW]

E63eeeeee... said:

161BMW said:

ZedLeg said:

Ok, you said the nhs mostly helps people with self inflicted conditions with no evidence to back it up then said it was obvious because

some

people are fat.
overweight according to the BMI.

• most

I didn’t mention BMI once that something you mentioned.
I said body fat percentage.

Obesity annual costs the nhs 6 billion. If population were healthier than this could be good annual cost saving. https://www.gov.uk/government/news/new-obesity-tre...

Edited by 161BMW on Friday 30th June 17:12

Edited by 161BMW on Friday 30th June 17:16

6bn out of a 160bn budget? Most of what the NHS does is look after old people. Arguably getting old is self inflicted, so you're not completely wrong, I guess. It's just that the ways of avoiding it aren't very palatable.

Even a 6 billion saving every year would pay massive dividends in the sense could you used in other areas of healthcare to improve or used in defence or education or for homeless etc.

[Brainpox]

Unfortunately the biggest idea they’ve had for retention is to fiddle with the pension to encourage people to work longer. Which sounds a lot like making the pension worse and raising the retirement age. We will see.

[E63eeeeee...]

161BMW said:

E63eeeeee... said:

161BMW said:

ZedLeg said:

Ok, you said the nhs mostly helps people with self inflicted conditions with no evidence to back it up then said it was obvious because

some

people are fat.
overweight according to the BMI.

• most

I didn’t mention BMI once that something you mentioned.
I said body fat percentage.

Obesity annual costs the nhs 6 billion. If population were healthier than this could be good annual cost saving. https://www.gov.uk/government/news/new-obesity-tre...

Edited by 161BMW on Friday 30th June 17:12

Edited by 161BMW on Friday 30th June 17:16

6bn out of a 160bn budget? Most of what the NHS does is look after old people. Arguably getting old is self inflicted, so you're not completely wrong, I guess. It's just that the ways of avoiding it aren't very palatable.

Even a 6 billion saving every year would pay massive dividends in the sense could you used in other areas of healthcare to improve or used in defence or education or for homeless etc.

So having an extra £6bn a year to spend would make the NHS fit for purpose? Why would it matter whether that was from magically turning off obesity, or from additional funding?

[161BMW]

E63eeeeee... said:

161BMW said:

E63eeeeee... said:

161BMW said:

ZedLeg said:

Ok, you said the nhs mostly helps people with self inflicted conditions with no evidence to back it up then said it was obvious because

some

people are fat.
overweight according to the BMI.

• most

I didn’t mention BMI once that something you mentioned.
I said body fat percentage.

Obesity annual costs the nhs 6 billion. If population were healthier than this could be good annual cost saving. https://www.gov.uk/government/news/new-obesity-tre...

Edited by 161BMW on Friday 30th June 17:12

Edited by 161BMW on Friday 30th June 17:16

6bn out of a 160bn budget? Most of what the NHS does is look after old people. Arguably getting old is self inflicted, so you're not completely wrong, I guess. It's just that the ways of avoiding it aren't very palatable.

Even a 6 billion saving every year would pay massive dividends in the sense could you used in other areas of healthcare to improve or used in defence or education or for homeless etc.

So having an extra £6bn a year to spend would make the NHS fit for purpose? Why would it matter whether that was from magically turning off obesity, or from additional funding?

Maybe to you it is small change but it would represent an improvement. Anyone with a brain can see this. Why do you think the NHS is spending so much on raising awareness on o obesity when literally most people know what to do but just don’t do it. There been people with stomach problems and all sorts their doctors can’t sort out or are depressed and countless money spent on therapy and it was nothing that diet and exercise didn’t sort out. In fact in medical school not much attention is spent on the important on diet and exercise and how it can be essentially “preventable maintaince” rather than dealing with it when it becomes a symptom.

Then the poor decision making, very badly mismanaged money would mark cost savings elsewhere. Posters have already shown many examples of just what a poor state the NHS is in and how many BILLIONS of pounds are wasted every year.

Edited by 161BMW on Friday 30th June 21:07

[E63eeeeee...]

161BMW said:

Maybe to you it is small change but it would represent an improvement. Anyone with a brain can see this. Why do you think the NHS is spending so much on raising awareness on o obesity when literally most people know what to do but just don’t do it. There been people with stomach problems and all sorts their doctors can’t sort out or are depressed and countless money spent on therapy and it was nothing that diet and exercise didn’t sort out. In fact in medical school not much attention is spent on the important on diet and exercise and how it can be essentially “preventable maintaince” rather than dealing with it when it becomes a symptom.

Then the poor decision making, very badly mismanaged money would mark cost savings elsewhere. Posters have already shown many examples of just what a poor state the NHS is in and how many BILLIONS of pounds are wasted every year.

Edited by 161BMW on Friday 30th June 21:07

Can I just gently drag you back to some kind of coherent point. Earlier you said that the NHS wasn't fit for purpose, and then justified that opinion by listing some ways it was wasteful. Why does having some waste bear on whether the NHS is fit for purpose? What do you think the purpose of the NHS is? Is its purpose to be perfectly efficient, or to contribute to a healthy population?

[161BMW]

E63eeeeee... said:

161BMW said:

Maybe to you it is small change but it would represent an improvement. Anyone with a brain can see this. Why do you think the NHS is spending so much on raising awareness on o obesity when literally most people know what to do but just don’t do it. There been people with stomach problems and all sorts their doctors can’t sort out or are depressed and countless money spent on therapy and it was nothing that diet and exercise didn’t sort out. In fact in medical school not much attention is spent on the important on diet and exercise and how it can be essentially “preventable maintaince” rather than dealing with it when it becomes a symptom.

Then the poor decision making, very badly mismanaged money would mark cost savings elsewhere. Posters have already shown many examples of just what a poor state the NHS is in and how many BILLIONS of pounds are wasted every year.

Edited by 161BMW on Friday 30th June 21:07

Can I just gently drag you back to some kind of coherent point. Earlier you said that the NHS wasn't fit for purpose, and then justified that opinion by listing some ways it was wasteful. Why does having some waste bear on whether the NHS is fit for purpose? What do you think the purpose of the NHS is? Is its purpose to be perfectly efficient, or to contribute to a healthy population?

I just think NHS is good thing to majority. Money needs to be spent far more efficiently and wisely and cost savings made by better management decisions, less agency staff etc before asking for bigger handouts because is just a giant black hole. I think we can agree on this. Perhaps tie in staff to longer contracts so they cannot have subsidised training and then go off to other countries to make more money else where leaving the NHS more ducked than it already is. I think hopefully we can agree on this. Obesity IMO is largely preventable. Heart attack, stroke and cancer are three biggest critical illnesses out there and could be preventable with healthy lifestyle.

[Logistix]

If you are suggesting tying staff into NHS contracts then you would have to actually subsidise their training rather than them funding it through student loans (as the military do for their sponsored trainees who are then tied into short term commissions.)

That would be around £90,000 per junior doctor, ie it would cost more not less I’m afraid to tell you.

The fact is, in this country we have had medical staff on the cheap for too long and many are no longer willing to put up with it.

Edited by Logistix on Friday 30th June 22:50

[asfault]

If houses were cheaper id imagine all these professions would feel better.
Lets face it a big house price crash is coming now and they are in some of the safest jobs that wont be affected by it.
I guess that is why the government dont want to raise the wages too much

[161BMW]

Logistix said:

If you are suggesting tying staff into NHS contracts then you would have to actually subsidise their training rather than them funding it through student loans (as the military do for their sponsored trainees who are then tied into short term commissions.)

That would be around £90,000 per junior doctor, ie it would cost more not less I’m afraid to tell you.

The fact is, in this country we have had medical staff on the cheap for too long and many are no longer willing to put up with it.

Edited by Logistix on Friday 30th June 22:50

Aren’t the true costs of medical courses much higher than £9k per year etc ? Don’t internationals subsidise this ? Aren’t the student loans paid for by taxes most of which won’t get paid back and written off ? Given true cost of course is higher than £9 or so thousand is it not essentially subsidised by the public and are the public not correct in expecting them to work for the NHS for a reasonable length of time instead of asking for pay rises for a well paid profession or wanting to go to another country and leaving the NHS no better off ? Not to mention putting lives at risk by striking and long waiting lists even longer.

Giving pay rises won’t help because everyone be asking for it then country will be broke. House prices would go up even more not down.

[Logistix]

161BMW said:

Logistix said:

If you are suggesting tying staff into NHS contracts then you would have to actually subsidise their training rather than them funding it through student loans (as the military do for their sponsored trainees who are then tied into short term commissions.)

That would be around £90,000 per junior doctor, ie it would cost more not less I’m afraid to tell you.

The fact is, in this country we have had medical staff on the cheap for too long and many are no longer willing to put up with it.

Edited by Logistix on Friday 30th June 22:50

Aren’t the true costs of medical courses much higher than £9k per year etc ? Don’t internationals subsidise this ? Aren’t the student loans paid for by taxes most of which won’t get paid back and written off ? Given true cost of course is higher than £9 or so thousand is it not essentially subsidised by the public and are the public not correct in expecting them to work for the NHS for a reasonable length of time instead of asking for pay rises for a well paid profession or wanting to go to another country and leaving the NHS no better off ? Not to mention putting lives at risk by striking and long waiting lists even longer.

No, medical graduates starting salary means that they start paying back straight away and most if not all will have to pay back all of their loans plus interest. This is unlike many other graduates who never end up paying back their loans and so could genuinely be said to have been subsidised by the public.

Are you happy that the public pays off the loans of say an arts graduate, but expects the junior doctors to fund themselves?

Yes the cost of training is more than the direct cost that a medical student pays, but how else are we to train doctors? Make it more expensive and you will return medicine to the preserve of the upper middle class, is that what you want?

Make no mistake, there is real anger throughout the medical
Profession and people are voting with their feet.

At the end of the day it’s less a moral argument than a purely transactional one as in any job.

Remember when we were told that bankers’ bonuses were essential to retain talent, and we obviously needed talented bankers?

How much do we need talented doctors and nurses? That’s the nub of it, it’s no more complex than that. There’s a price on that which will eventually be discovered when the government reluctantly come to the negotiating table.

Job satisfaction, relative security and respect from the public (which is notably absent here) doesn’t cut the mustard any more.

As I have said, doctors are well paid and at the same time underpaid, why is that so hard to understand?

Edited by Logistix on Saturday 1st July 08:49

[161BMW]

Logistix said:

161BMW said:

Logistix said:

If you are suggesting tying staff into NHS contracts then you would have to actually subsidise their training rather than them funding it through student loans (as the military do for their sponsored trainees who are then tied into short term commissions.)

That would be around £90,000 per junior doctor, ie it would cost more not less I’m afraid to tell you.

The fact is, in this country we have had medical staff on the cheap for too long and many are no longer willing to put up with it.

Edited by Logistix on Friday 30th June 22:50

Aren’t the true costs of medical courses much higher than £9k per year etc ? Don’t internationals subsidise this ? Aren’t the student loans paid for by taxes most of which won’t get paid back and written off ? Given true cost of course is higher than £9 or so thousand is it not essentially subsidised by the public and are the public not correct in expecting them to work for the NHS for a reasonable length of time instead of asking for pay rises for a well paid profession or wanting to go to another country and leaving the NHS no better off ? Not to mention putting lives at risk by striking and long waiting lists even longer.

No, medical graduates starting salary means that they start paying back straight away and most if not all will have to pay back all of their loans plus interest. This is unlike many other graduates who never end up paying back their loans and so could genuinely be said to have been subsidised by the public.

Are you happy that the public pays off the loans of say an arts graduate, but expects the junior doctors to fund themselves?

Yes the cost of training is more than the direct cost that a medical student pays, but how else are we to train doctors? Make it more expensive and you will return medicine to the preserve of the upper middle class, is that what you want?

Make no mistake, there is real anger throughout the medical
Profession and people are voting with their feet.

At the end of the day it’s less a moral argument than a purely transactional one as in any job.

Remember when we were told that bankers’ bonuses were essential to retain talent, and we obviously needed talented bankers?

How much do we need talented doctors and nurses? That’s the nub of it, it’s no more complex than that. There’s a price on that which will eventually be discovered when the government reluctantly come to the negotiating table.

Job satisfaction, relative security and respect from the public (which is notably absent here) doesn’t cut the mustard any more.

As I have said, doctors are well paid and at the same time underpaid, why is that so hard to understand?

Edited by Logistix on Saturday 1st July 08:49

This

Giving pay rises won’t help because everyone be asking for it then country will be broke. House prices would go up even more not down.

Everyone is underpaid. Medical profession isn’t only one. Clearly the oath doesn’t mean much anymore by putting lives at risk by striking.

Also yeah graduates of other professions should be made to pay back.

It just pure greed and selfishness. If you were running a country and gave 33% pay rise knowing country be broke and other public sectors would strike.

Anyone can see it could go down this route then the country be more messed up than it is.

Why don’t they help managers / make better decisions instead of wasting energy on pay rises ? The better decisions can give cost savings. Then maybe later in time pay rises can be given if enough cost savings made ? Examples of some of the management decisions that could be made better are earlier in the thread.

[Logistix]

161BMW said:

This

Giving pay rises won’t help because everyone be asking for it then country will be broke. House prices would go up even more not down.

Everyone is underpaid. Medical profession isn’t only one. Clearly the oath doesn’t mean much anymore by putting lives at risk by striking.

Also yeah graduates of other professions should be made to pay back.

It just pure greed and selfishness. If you were running a country and gave 33% pay rise knowing country be broke and other public sectors would strike.

Anyone can see it could go down this route then the country be more messed up than it is.

Why don’t they help managers / make better decisions instead of wasting energy on pay rises ? The better decisions can give cost savings. Then maybe later in time pay rises can be given if enough cost savings made ? Examples of some of the management decisions that could be made better are earlier in the thread.

Medics have seen their lay fall further behind than other groups, largely due to the one sided nature of the supposedly independent review body - this is one of the main things the BMA Consultants’ commuter wants reformed to make it truly independent of Government.

Making all graduates pay back their degrees in full will, as I pointed out, restrict many children from less well of and deprived backgrounds the chance to go to university. Do you really desire that?

Doctors ability to influence large scale decisions is very limited due to micro management from the DOH, so hardly reasonable to make their pay dependent on it. In any case what do you mean by efficiency - rationing? Why should medics pay for the Governments mismanagement of the health service?

You repeatedly fail to acknowledge that poor pay and conditions is part of the problem, and so addressing this has to be part of the solution.

(Very few doctors take any sort of oath by the way, that’s Dr Kildare stuff)

The realisation by medics (and other healthcare groups) that it’s just a job at the end of the day is a genie that can’t be put back in the bottle. You may get a few crusty retired docs warbling on about vocation but the younger generation are more world wise, and their immediate seniors are catching on fast.

Not wanting to be continually abused by the government is hardly selfish.

The Government (and you?) seem to think that a bit of playing hardball by Steve Barclay will make this issue go away, but speaking to many colleagues (and seeing the evidence of people disengaging from the NHS) leads me to think otherwise.

[vaud]

I guess the alternative to pay rise is something more creative with taxation for those professions. Maybe more junior staff pay lower than standard income tax until they hit a certain threshold?

[E63eeeeee...]

161BMW said:

This

Giving pay rises won’t help because everyone be asking for it then country will be broke. House prices would go up even more not down.

Everyone is underpaid. Medical profession isn’t only one. Clearly the oath doesn’t mean much anymore by putting lives at risk by striking.

Also yeah graduates of other professions should be made to pay back.

It just pure greed and selfishness. If you were running a country and gave 33% pay rise knowing country be broke and other public sectors would strike.

Anyone can see it could go down this route then the country be more messed up than it is.

Why don’t they help managers / make better decisions instead of wasting energy on pay rises ? The better decisions can give cost savings. Then maybe later in time pay rises can be given if enough cost savings made ? Examples of some of the management decisions that could be made better are earlier in the thread.

No. You seem to have decided that current rates of pay are correct, despite all the evidence indicating that low pay is part of the problem. Broadly, there's an optimal pay structure across medical roles that is enough to attract the calibre of people we need, stop them leaving to other jobs or employers, and both motivate them to do a good job and prevent them from being distracted by the pressures of low pay. Just listening to medical professionals should be enough to tell you we're not there. Or noticing that people are on strike. Or looking at the number of vacancies. Or looking at how many people are leaving. Or looking at how many people are joining training programmes.

Your idea that this is pure greed and selfishness says far more about you than it does about the people who do these critical and difficult jobs and just don't want to get worse off every year. You rarely solve problems in a complex system by top down intervention. One thing that does reliably work is to increase the number of good, motivated people. Continually cutting away at their standard of living is the exact opposite of this.

[Logistix]

vaud said:

I guess the alternative to pay rise is something more creative with taxation for those professions. Maybe more junior staff pay lower than standard income tax until they hit a certain threshold?

And how would that help to retain senior staff who will be desperately needed to train those junior doctors (and remember that the plan is to cram their training into 4 years and double their numbers which will require more not less seniors)?