Junior Doctor's contracts petition
Discussion
spaximus said:
There is no doubt equipment is not used at some periods of the day in hospitals.
Missing the point. It's not some periods of the day, it's weekends.In 2011, a Royal College of Surgeons study into emergency surgical patients and the Dr Foster Hospital Guide both highlighted how the closure of services at weekends was a significant factor in patient outcomes.
The lack of resilution in the current dispute is material. Neither side has managed to sort this.
jjlynn27 said:
thestew said:
nope it should be fairly similar, but if you just split your current work force into two shifts you would still have the same number of employees doing the same number of hours, so productivity would be the same (probably less on the night shift due to tiredness). I would imagine most traffic through the hospitals are on weekdays so there could be potentially more waste fully manning up for 24/7 operation.
The idiocy of comparing hospital to a factory and unskilled workers to doctors is entertaining if unsurprising.RYH64E said:
Obviously you need more staff if you're running extra shifts but you only bring in extra staff for the work that's forming the current bottleneck. In my case when I add an extra production shift I don't need to add extra salespeople, or accounts staff, or clerical support, or management, and I don't need to pay for extra plant and machinery, building mortgage costs, business rates etc. In theory, by adding two extra shifts I can get up to three times the output for maybe 30% extra costs, and when you're spending your own money these kind of sums make sense.
Laudable but rather misunderstanding of the problems. Firstly there isn't enough staff to run the current service so where are extra staff coming from? Secondly people don't make an appointment to become ill weeks in advance. It's very unpredictable but we know the majority of activity tends to occur during the week, hence staffing levels are higher then, but it's extremely difficult to draft in extra staff at short notice, particularly when that extra staff doesn't actually exist.turbobloke said:
Missing the point. It's not some periods of the day, it's weekends.
In 2011, a Royal College of Surgeons study into emergency surgical patients and the Dr Foster Hospital Guide both highlighted how the closure of services at weekends was a significant factor in patient outcomes.
The lack of resilution in the current dispute is maerial. Neither side has managed to sort this.
The current dispute has precisely nothing to do with whether scanners or radiographers are in action 24 hours a day. That's another staff group hunt will exploit in order to fulfill his manifesto pledge which is based on his misrepresentation of data. In 2011, a Royal College of Surgeons study into emergency surgical patients and the Dr Foster Hospital Guide both highlighted how the closure of services at weekends was a significant factor in patient outcomes.
The lack of resilution in the current dispute is maerial. Neither side has managed to sort this.
As has been said again and again, there isn't enough staff to run all these services all of the time and actually, often there's no clinical need. However if Hunt can find an additional 20-30bn a year, these services can be run continuously.
Quoting an article written by a government stooge doesn't make it more credible. Yes, he's right you could MRI scanners more but interesting he doesn't mention how much that would cost or where the money is coming from to fund this.
Edited by 968 on Saturday 13th February 20:42
The point that everyone seems to agree on is that demand for NHS services is increasing year on year, the disagreement is on how to deal with the extra demand. One camp appears to be arguing that the way forward is to throw as much money at the problem as is needed, without in anyway changing working conditions for the staff, while the other camp is saying that making better use of existing resources is a sensible starting point and if that means changes to long established working practices then so be it. Or have I missed something?
RYH64E said:
Obviously you need more staff if you're running extra shifts but you only bring in extra staff for the work that's forming the current bottleneck.
But it isn't "extra staff just for the current bottleneck". From what I can see Hunt wants hospitals operating 7 days per week. It's not just a case of running ad-hoc overtime shifts, it's a case of restructuring the entire operation froma 5-day week to a 7-day week. Do you as a factory supervisor think that this could be done without extra cost?Now factor in the fact that your suppliers aren't that bothered about having goods delivered at the weekend, and that you (as a factory) won't get any extra income from working those extra shifts. In fact all that will be happening is you will need to produce LESS output during the working week and MORE at the weekend. So overall your output stays the same, your fixed costs stay the same and your semi-fixed and variable costs increase.
This is only improving efficiency if you studied at the Zimbabwe School of Economics.
jjlynn27 said:
..comparing hospital to a factory and unskilled workers to doctors is entertaining if unsurprising...
Taking out your irrelevant intro, we get to the above strawman which is transparent.The entire point wasn't at all around likening a hospital to a factory or doctors to line workers, it was about the waste involved in having expensive kit lying idle, no matter where.
In the case of a hospital, the result of this has been made clear in the link I posted not long ago.
"...a Royal College of Surgeons study into emergency surgical patients and the Dr Foster Hospital Guide both highlighted how the closure of services at weekends was a significant factor in patient outcomes. A lack of routine diagnostic services was specifically highlighted as having an adverse effect, creating a bottleneck for getting patients to effective treatment."
Expensive, useful equipment left idle at weekends.
turbobloke said:
Missing the point there - equipment lying idle is a waste of valuable resources that patients could and would benefit from if available for use 24/7. There was an example on this thread from a PHer not long ago.
just out of interest, what sort of services would you like patients to receive on a 24/7 basis (apologies if this has already been stated, I haven't waded through all 68 pages)sawman said:
turbobloke said:
Missing the point there - equipment lying idle is a waste of valuable resources that patients could and would benefit from if available for use 24/7. There was an example on this thread from a PHer not long ago.
just out of interest, what sort of services would you like patients to receive on a 24/7 basis (apologies if this has already been stated, I haven't waded through all 68 pages)Could you in turn list the sort of services you'd like patients not to receive on a 24/7 basis? The kind that impact on diagnosis, treatment and therefore outcomes would do for starters. Admin can come later.
RYH64E said:
The point that everyone seems to agree on is that demand for NHS services is increasing year on year, the disagreement is on how to deal with the extra demand. One camp appears to be arguing that the way forward is to throw as much money at the problem as is needed, without in anyway changing working conditions for the staff, while the other camp is saying that making better use of existing resources is a sensible starting point and if that means changes to long established working practices then so be it. Or have I missed something?
Evidently quite a lot because that's a total misrepresentation of the situation which isn't surprising because you don't have experience of it. The actual situation is that you have a system barely coping with current levels of demand, not because 'working practices' are inefficient but because the demographics of the population are ever increasing whilst staff levels have stagnated and not kept up with demand. Then you have a moron as SoS who feels that the best way to utilise resources is to force the workforce into a huge pay cut to work much longer hours and in much more dangerous conditions as staff will be spread more thinly and the safeguards are effectively non existent for trusts to exploit their staff. No wonder the CEOs are rubbing their hands together. 
As the OP of this thread it has been frustrating how far off topic it has gone, it is about junior Doctors and their disagreement with the temporary Secretary for Health.
Hunt has spun that this is all about getting a 7 day NHS, there are junior doctors at work every second of every day, all 366 days this year.
Hunt claims the country pays a fortune for their training, but he not only counts the salary they are paid for doing their job but also ads the money the JDs pay for all their courses and exams, about £6,000 a year.
Hunt has announced he will now impose the contract, but which contract will he impose, the one he announced many moons ago or the final offer on the table, it would appear to be the latter.
One of the main original sticking points was the removal from trusts of financial penalties for exceeding working hours. This was regarded by JDs as a significant risk to patient safety. Having re-instated the fines many trusts say they will not introduce the contract.
The final sticking point is not should they work Saturdays, but should it be regarded as a non- standard working day and therefor been paid at a premium rate, the BMA made a compromise offer that was accepted by the negotiators but vetoed by Hunt.
He has therefore chosen to go toe to toe with a highly intelligent opponent.
Please keep this thread on topic and start your own threads for equally important but different subjects.
Hunt has spun that this is all about getting a 7 day NHS, there are junior doctors at work every second of every day, all 366 days this year.
Hunt claims the country pays a fortune for their training, but he not only counts the salary they are paid for doing their job but also ads the money the JDs pay for all their courses and exams, about £6,000 a year.
Hunt has announced he will now impose the contract, but which contract will he impose, the one he announced many moons ago or the final offer on the table, it would appear to be the latter.
One of the main original sticking points was the removal from trusts of financial penalties for exceeding working hours. This was regarded by JDs as a significant risk to patient safety. Having re-instated the fines many trusts say they will not introduce the contract.
The final sticking point is not should they work Saturdays, but should it be regarded as a non- standard working day and therefor been paid at a premium rate, the BMA made a compromise offer that was accepted by the negotiators but vetoed by Hunt.
He has therefore chosen to go toe to toe with a highly intelligent opponent.
Please keep this thread on topic and start your own threads for equally important but different subjects.
Countdown said:
But it isn't "extra staff just for the current bottleneck". From what I can see Hunt wants hospitals operating 7 days per week. It's not just a case of running ad-hoc overtime shifts, it's a case of restructuring the entire operation froma 5-day week to a 7-day week. Do you as a factory supervisor think that this could be done without extra cost?
Now factor in the fact that your suppliers aren't that bothered about having goods delivered at the weekend, and that you (as a factory) won't get any extra income from working those extra shifts. In fact all that will be happening is you will need to produce LESS output during the working week and MORE at the weekend. So overall your output stays the same, your fixed costs stay the same and your semi-fixed and variable costs increase.
This is only improving efficiency if you studied at the Zimbabwe School of Economics.
How would you respond to an ever increasing demand for services? Surely the obvious answer is to expand the working day/week and make more efficient use of the equipment and premises that you already have? Or would rather see many more hospitals built so that the working day can be kept as close to 9-5 Monday to Friday as possible? Now factor in the fact that your suppliers aren't that bothered about having goods delivered at the weekend, and that you (as a factory) won't get any extra income from working those extra shifts. In fact all that will be happening is you will need to produce LESS output during the working week and MORE at the weekend. So overall your output stays the same, your fixed costs stay the same and your semi-fixed and variable costs increase.
This is only improving efficiency if you studied at the Zimbabwe School of Economics.
What would happen if the Police Force worked on the same basis?
jjlynn27 said:
thestew said:
nope it should be fairly similar, but if you just split your current work force into two shifts you would still have the same number of employees doing the same number of hours, so productivity would be the same (probably less on the night shift due to tiredness). I would imagine most traffic through the hospitals are on weekdays so there could be potentially more waste fully manning up for 24/7 operation.
The idiocy of comparing hospital to a factory and unskilled workers to doctors is entertaining if unsurprising. Neither of two dentists that I visit are working with NHS. They own their 'machinery' and their premises. Yet they both only work from 10-5 and Wednesdays from 12-7. No weekends. Ever. Yet you wait at least a month for an appointment. If only they had someone to explain to them that if they worked 24/7 their machinery would be much better utilized.
turbobloke said:
The unavailable services they need at the weekend that are routinely available on a weekday. See previous links with evidence from FoIA requests for at least one illustration.
Could you in turn list the sort of services you'd like patients not to receive on a 24/7 basis? The kind that impact on diagnosis, treatment and therefore outcomes would do for starters. Admin can come later.
if they NEED it at the weekend, it must be an emergency, right? in that case its covered the NHS is 24/7 for emergency care already.Could you in turn list the sort of services you'd like patients not to receive on a 24/7 basis? The kind that impact on diagnosis, treatment and therefore outcomes would do for starters. Admin can come later.
I think most hospitals use diagnostic services like ultrasound, radiology and MRI 7 days a week - they certainly do in my area, but to start offering all aspects of elective care 7 days a week, such as surgery and outpatients is just going to add expense for the taxpayer simply in terms of staff (frontline and support) plus we will probably need more beds, so that will be another round of building and all the expense that goes along with it.
Edited by sawman on Saturday 13th February 21:17
turbobloke said:
jjlynn27 said:
..comparing hospital to a factory and unskilled workers to doctors is entertaining if unsurprising...
Taking out your irrelevant intro, we get to the above strawman which is transparent.The entire point wasn't at all around likening a hospital to a factory or doctors to line workers, it was about the waste involved in having expensive kit lying idle, no matter where.
In the case of a hospital, the result of this has been made clear in the link I posted not long ago.
"...a Royal College of Surgeons study into emergency surgical patients and the Dr Foster Hospital Guide both highlighted how the closure of services at weekends was a significant factor in patient outcomes. A lack of routine diagnostic services was specifically highlighted as having an adverse effect, creating a bottleneck for getting patients to effective treatment."
Expensive, useful equipment left idle at weekends.
Let's face it, you're splitting hairs here and avoiding the real problem. Whether that's just for the sake of an argument, for your entertainment, or a political agenda I can't fathom, you're over complicating it for a reason. Care to share?
For what it's worth, if you compare the situation to working in a car dealership, if the senior technician was off for the weekend, then certain diagnostic equipment would be left without use. Is this a waste? Or would employing another similarly qualified and trained technician who'd be idle for a long period of time, perhaps equate to more wastage (financially).
sawman said:
I think most hospitals use diagnostic services like ultrasound, radiology and MRI 7 days a week - they certainly do in my area...
Not all, it seems, see the second snip below. Published July 2015:"Hospitals and community services are already working together to create a better service 7 days a week, but we want to go further and faster to deliver safer care in this Parliament."
"MRI scans, CT scans, ultrasound scans and other important diagnostic tests are not consistently available in all hospitals at the weekends."
https://www.gov.uk/government/publications/7-day-n...
turbobloke said:
sawman said:
I think most hospitals use diagnostic services like ultrasound, radiology and MRI 7 days a week - they certainly do in my area...
Not all, it seems, see the second snip below. Published July 2015:"Hospitals and community services are already working together to create a better service 7 days a week, but we want to go further and faster to deliver safer care in this Parliament."
"MRI scans, CT scans, ultrasound scans and other important diagnostic tests are not consistently available in all hospitals at the weekends."
https://www.gov.uk/government/publications/7-day-n...
SpeedMattersNot said:
turbobloke said:
jjlynn27 said:
..comparing hospital to a factory and unskilled workers to doctors is entertaining if unsurprising...
Taking out your irrelevant intro, we get to the above strawman which is transparent.The entire point wasn't at all around likening a hospital to a factory or doctors to line workers, it was about the waste involved in having expensive kit lying idle, no matter where.
In the case of a hospital, the result of this has been made clear in the link I posted not long ago.
"...a Royal College of Surgeons study into emergency surgical patients and the Dr Foster Hospital Guide both highlighted how the closure of services at weekends was a significant factor in patient outcomes. A lack of routine diagnostic services was specifically highlighted as having an adverse effect, creating a bottleneck for getting patients to effective treatment."
Expensive, useful equipment left idle at weekends.
Posting about FoIA information and a Royal College of Surgeons study is hardly reliance, it's illustrative, just as your post is illustrative of a personal, nothing-much response.
Perhaps the information presented wasn't to your liking, never mind.
Climate threads rarely get FoIA information as climate 'scientists' find ways around them.
Perhaps the angry medics on here will respond to your slur against the Royal College of Surgeons study that was part of a link I cited. Presumably, in citing climate threads, you consider the above study to be based on computer model gigo rather than data.
Either way do you have data in a credible report to offer up that shows th FoIA information and the RCS study are inaccurate? Tick tock.
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