Junior Doctor's contracts petition

[968]

turbobloke said:

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...

Ah yes that impartial source of information.

Every trust I've worked in for the past 20+ years around the country, has offered emergency scans out of hours, and if they haven't got a particular scanner on site, such as an MRI scanner, and it's deemed clinically necessary, the patient is transferred to a unit that does offer that investigation, however, that's extremely rare. I'd like to know precisely which hospitals don't offer 'important diagnostic tests'. Of course, this is all just bks, because the SoS and his 7 day service is nothing of the sort, it's a 7 day elective service he wants to provide which will not change the death rates one iota, but will allow more elective cases to be done on a weekend, when there's barely the staff to accommodate these patients during the week.

[IroningMan]

968 said:

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.

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

So the RCS are government stooges, and we're back to the idea that outcomes are only worse at weekends in Jeremy Hunt's head?

Wasn't there a study published last year that showed that even neonatal outcomes were worse at weekends? Or is that down to alcohol and rugby, too?

[SpeedMattersNot]

turbobloke said:

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.

Too much fun

[turbobloke]

SpeedMattersNot said:

turbobloke said:

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.

Too much fun

Too little substance in your posts (evidence) but anyway.

[968]

IroningMan said:

So the RCS are government stooges, and we're back to the idea that outcomes are only worse at weekends in Jeremy Hunt's head?

Wasn't there a study published last year that showed that even neonatal outcomes were worse at weekends? Or is that down to alcohol and rugby, too?

Keogh is a government stooge. The figures Hunt quotes is a gross misrepresentation of the data.

http://www.independent.co.uk/news/uk/home-news/jer...

[RYH64E]

968 said:

Every trust I've worked in for the past 20+ years around the country, has offered emergency scans out of hours, and if they haven't got a particular scanner on site, such as an MRI scanner, and it's deemed clinically necessary, the patient is transferred to a unit that does offer that investigation, however, that's extremely rare. I'd like to know precisely which hospitals don't offer 'important diagnostic tests'. Of course, this is all just bks, because the SoS and his 7 day service is nothing of the sort, it's a 7 day elective service he wants to provide which will not change the death rates one iota, but will allow more elective cases to be done on a weekend, when there's barely the staff to accommodate these patients during the week.

Why should such scans only be available on an emergency basis? We've paid for the equipment, why not make full use of it?

[Countdown]

RYH64E said:

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?

Time is not the ONLY resource required. If you are going to USE the capital assets for a longer period of time you also need to employ more "labour" at the same time to operate the capital assets. I'm really not sure how much simpler it could be. Or do people genuinely believe that Doctors are sitting arund unpaid during the working week and moving them to weekends will "improve efficiency"?

Transferring "fully utilised" doctors from the working week and making them work weekends won't magically increase the number of patients they see. It just means that there will be less patients seen during the week and more at weekends. Except that you will also need to employ more ancillary staff at weekends to support the medics.

To use one of your earlier examples - could you make more widgets with the same amount of raw materials just by moving a shift to the weekends?

[Countdown]

RYH64E said:

Why should such scans only be available on an emergency basis? We've paid for the equipment, why not make full use of it?

My cornershop isn't open at 2am if I ever need a bottle of milk or a Ginsters pasty. The owner has paid for the equipment but feels that the extra cost doesn't justify the extra demand. He's managing to satisfy the demand for milk and pasties within working hours.

It is more efficient to be running at 100% capacity 5 days per week than 95% capacity for 7 days a week. The convenience of being able to turn up at weekends for routine work means MORE cost.

[RYH64E]

Countdown said:

He's managing to satisfy the demand for milk and pasties within working hours.

And is the NHS satisfying demand within working hours? If you had to wait as long for your pint of milk as my mum had to wait for her hip operation you might think differently. In the end, we booked her NHS hip op then paid for one to be done privately, the private one was done immediately and by the time she'd recovered from that the NHS one was due, 9 months later. Interestingly, both operations were carried out by the same surgeon, in the same hospital.

Edited by RYH64E on Saturday 13th February 22:29

[PRTVR]

Countdown said:

RYH64E said:

Why should such scans only be available on an emergency basis? We've paid for the equipment, why not make full use of it?

My cornershop isn't open at 2am if I ever need a bottle of milk or a Ginsters pasty. The owner has paid for the equipment but feels that the extra cost doesn't justify the extra demand. He's managing to satisfy the demand for milk and pasties within working hours.

It is more efficient to be running at 100% capacity 5 days per week than 95% capacity for 7 days a week. The convenience of being able to turn up at weekends for routine work means MORE cost.

Corner shops are going out of business, replaced by 24/7 supermarkets, Ginsters pasty availability 24 hrs a day.

[NoNeed]

Countdown said:

RYH64E said:

Why should such scans only be available on an emergency basis? We've paid for the equipment, why not make full use of it?

My cornershop isn't open at 2am if I ever need a bottle of milk or a Ginsters pasty. The owner has paid for the equipment but feels that the extra cost doesn't justify the extra demand. He's managing to satisfy the demand for milk and pasties within working hours.

It is more efficient to be running at 100% capacity 5 days per week than 95% capacity for 7 days a week. The convenience of being able to turn up at weekends for routine work means MORE cost.

I'm not so sure once you factor in lost working hours and business from people having to take time off for a monday appointment as opposed to a saturday/sunday one.

[Richjam]

RYH64E said:

Countdown said:

He's managing to satisfy the demand for milk and pasties within working hours.

And is the NHS satisfying demand within working hours? If you had to wait as long for your pint of milk as my mum had to wait for her hip operation you might think differently. In the end, we booked her NHS hip op then paid for one to be done privately, the private one was done immediately and by the time she'd recovered from that the NHS one was due, 9 months later. Interestingly, both operations were carried out by the same surgeon, in the same hospital.

Edited by RYH64E on Saturday 13th February 22:29

Totally agree waiting time for an MRI in our area is 6 weeks. My OH has been off work for 18 monts after failed back surgery the NHS takes ages to respond with any treatment options. She will now loose her job and have to try to claim off the state. With a more efficient NHS she may have recieved treatment to allow her to return to work.

[thestew]

just out of curiosity, what are the premium rates for JDs at the moment? as the basic salaries that are quoted of 22-23k don't seem a lot for someone who has been to uni for 5-6 years.

[NoNeed]

thestew said:

just out of curiosity, what are the premium rates for JDs at the moment? as the basic salaries that are quoted of 22-23k don't seem a lot for someone who has been to uni for 5-6 years.

That is a bit of a false figure as the doctors staring pay are for those still in training and it rises to 28k second year.





ETA Training doctors pay scale

http://www.bma.org.uk/support-at-work/pay-fees-all...

Edited by NoNeed on Saturday 13th February 23:50

[jjlynn27]

thestew said:

just out of curiosity, what are the premium rates for JDs at the moment? as the basic salaries that are quoted of 22-23k don't seem a lot for someone who has been to uni for 5-6 years.

I was agreeing with your previous post even if it didn't come out that way. There are no premium rates as such, but, to my understanding, there is a supplement, banding, based on scheduled rota.

As for people suggesting 24/7 to 'utilize' equipment; the same question as always still stands; who'll operate the machinery, and where will you find them, given that you can't even cover the exiting times properly.

Edited by jjlynn27 on Saturday 13th February 23:39

[jjlynn27]

NoNeed said:

That is a bit of a false figure as the doctors staring pay are for those still in training and it rises to 28k second year.

A fully trained junior doctor will start at 55k

ETA Training doctors pay scale

What is a 'fully trained junior doctor'?

SHO, Reg, Consultant?

[mph1977]

968 said:

<snip>
Every trust I've worked in for the past 20+ years around the country, has offered emergency scans out of hours, and if they haven't got a particular scanner on site, such as an MRI scanner, and it's deemed clinically necessary, the patient is transferred to a unit that does offer that investigation, however, that's extremely rare. I'd like to know precisely which hospitals don't offer 'important diagnostic tests'.

quite a few, also it;s only relatively recently that CT operator skills came into the pre-reg curriculum / 'on call' competencies for diagnostic radiographers ...

response and processign times for most pathology is slower especially where intransigence prevented the move to full shift working

never mind the hoop jumping for out of hours scans that were common 10 years ago and still remain in some places - gems such as consultant to consultant referral or requiring an inpatient speciality to request test not the ED or acute Medicine ...

[spaximus]

RYH64E said:

Why should such scans only be available on an emergency basis? We've paid for the equipment, why not make full use of it?

The equipment is available for use in emergencies. What Hunt has made you think is that somehow we have hundreds of people every week waiting to use this equipment, or else they will die. It is simply not true and if you listened to the people who work in the NHS you would get it.
If you want elective surgery, outpatient clinic running 24 hours per day seven days per week you need a lot more staff in every single area from nurses upwards and public willing to use it, they don't where it has been trialled.
Hospitals are not factories where you can just simply turn up the speed of the line.
As 968 has said the lies and spin of Hunt has been staggering. Hunt quotes outcomes are affected which was a small part of a larger report as if fact and that these would have lived otherwise , it is just bks.
Now if you want to talk about avoidable deaths, how about restricting life saving drugs, how about how many have committed suicide or murdered people because care in the community is cheaper than hospitals.
Or old people sent home to care for themselves when they should be in a care homes?
The list goes on and on. This has been about one thing in Hunts mind his leadership aspirations and to hell with the NHS

[NoNeed]

jjlynn27 said:

What is a 'fully trained junior doctor'?

SHO, Reg, Consultant?

Trying to find the website I just read but went through so many I'm not sure no



My mistake, the pay scale above is correct but I seem to have read a GP's starting pay at 55k

Edited by NoNeed on Saturday 13th February 23:49

[mph1977]

spaximus said:

RYH64E said:

Why should such scans only be available on an emergency basis? We've paid for the equipment, why not make full use of it?

The equipment is available for use in emergencies.

however it is not available for clinically urgent none emergency cases leading to delays and possible /; probable adverse outcomes as well as a throughput delays

spaximus said:

What Hunt has made you think is that somehow we have hundreds of people every week waiting to use this equipment, or else they will die. It is simply not true and if you listened to the people who work in the NHS you would get it.

eventually and soimetimes that eventually may be 3 or 4 days later - it;s not dividing 5 into 5 as the simplistic explanations give

spaximus said:

If you want elective surgery, outpatient clinic running 24 hours per day seven days per week you need a lot more staff in every single area from nurses upwards and public willing to use it, they don't where it has been trialled.

from the nurses upwards - well glad to see you have respect for None Medical HCPs ... NOT!

so why thend does extended day working work , why does some weekend provision work ? why are commissioners paying excessive premiums for elective work to be done on a Friday afternoon or Saturday morning ...

spaximus said:

Hospitals are not factories where you can just simply turn up the speed of the line.

again a simplistic arguement and exlcudes the artifical blockages created by the 4 and a half day NHS

spaximus said:

As 968 has said the lies and spin of Hunt has been staggering. Hunt quotes outcomes are affected which was a small part of a larger report as if fact and that these would have lived otherwise , it is just bks.
Now if you want to talk about avoidable deaths, how about restricting life saving drugs, how about how many have committed suicide or murdered people because care in the community is cheaper than hospitals.
Or old people sent home to care for themselves when they should be in a care homes?
The list goes on and on. This has been about one thing in Hunts mind his leadership aspirations and to hell with the NHS

the BMA spin and the spin fro mthe party politicla bandwagons jumpers has also been huge , never mind the inertia and desire by the party political bandwagon jumpers ( with their purple and green, green , or hammer and sickle badges and banners ) to maintain an out dated and not fit for purpose structure ...

i'm not aware of any 'life saving' drug that is restricted, the restriction is in 'death delaying' and ' prolonging suffering' drugs but of course becasue the Heily Fail paints these drugs as life savers ...

Are you really advocatign a return to the abusive dumping grounds of the county pauper lunatic asylum and the long stay geriatric 'hospitals' ...