Junior Doctor's contracts petition

[Countdown]

sidicks said:

Countdown said:

If they "didn't understand", isn't that just a politer way of saying "they're thick"?

1) No.
2) I didn't explicitly say they didn't understand, I said either they didn't understand or they deliberately choose to mislead.

It's not an either/or question. With regards to them "not understanding", as I keep saying, they're advised by Actuaries. Both sides are. I'm sure they have a reasonably good understanding of the impact. If it wasn't going to be negative there would literally be no point in the Govt. trying to implement it. I've said all this before but you keep insisting that somehow it isn't negative and the Govt are only doing it "because they must be seen to be doing something" which is a weak argument by any stretch of the imagination.

Anyway you said there was plenty of evidence of them misleading. As I asked above - Can you provide proof of this?

sidicks said:

Countdown said:

And again, do you think TUs rely on their own reps to evaluate pension schemes? I can tell you for a fact that that isn't the case. Both sides have actuaries advising them. I'm currently aware of one ongoing discussion where the same firm of actuaries is advising both sides. So to suggest that either side doesn't fully undertsand the implications of the changes which have been implemented is completely wrong.

Again. I've said no such thing.

Errr...what? You've said (even in your last post) that either they don't understand or they are deliberately misleading????

sidicks said:

Countdown said:

If there's plenty of evidence then please show me an example where they (the TU reps) are "deliberately misleading".

When defending public sector pensions they often focus on the average pension being relatively modest (deliberately ignoring the number of years accrual or contributions).

IIRC £7k is the average PS pension. Modest describes it fairly well. How does that compare to what people pay in NI contributions in order to get a £7.5k annual State pension?

sidicks said:

I believe that some time ago, Unison were planning on changing their own scheme from Final salary to a CARE scheme due to the size of the deficit / ongoing costs.

Yes, they are there to defend their members, but they do some to be able to avoid economic realities when it suits them!

The economic reality being that a CARE scheme costs less to the employer and provides a lower level of benefits for its members?

sidicks said:

Countdown said:

We're possibly going round and round in circles. I agree that those people whose salaries doesn't increase above the "revaluation" level may be better off. I doubt that is "most" people. That is partly why the TU reps fought so hard against it.

The only conclusion is therefore that the majority of people in these schemes are expected to be earning salary increases of more than 1.5% above inflation each and every year.

That is certainly inconsistent with the message from the public sector about 'austerity'.

Indeed. But it doesn't change the fact that CARE schemes are worse than FS for most employees. Which is why the TUs fought against them, and which is why the Govt. pushed them through.

sidicks said:

Countdown said:

I asked you a question you neatly avoided earlier so I'll try again. IF you were in the LGPS scheme would you prefer the CARE or the FS scheme?

My response was appropriate given the vague and incomplete nature of the question.

In the naive case, if I was expecting annual pay increases of more than inflation plus 1.5% then clearly the final salary version is more advantageous, all other things being equal.

Yay! we got there in the end

sidicks said:

countdown said:

If I understand correctly you're suggesting that CARE is, on average, no worse for employees than an FS scheme. I think this is wrong.

I'm suggesting no such thing. I've been quite explicit about when CARE is better and when it is worse. My point has been to highlight the implications (for salary) if you claim that CARE is worse.

CARE is worse, for most members of FS schemes

sidicks said:

Countdown said:

"Fairer" insofar as those whose salary increases significantly over their career are significantly worse off, and those whose salary increases by less than CPI over the entirety of their career, are "better off" - one can only be amazed at why the Public Sector employees weren't grabbing this amazing opportunity with both hands!

Fairer in the sense of affordable for those funding the vast majority of the benefit and more directly-linked to contributions actually paid?

Ah...so CARE is more affordable for the Govt? Silly me, I thought you suggested that it had no effect on Govt finances and they were only implementing it so they were seen to be doing something....

[sidicks]

Countdown said:

It's not an either/or question. With regards to them "not understanding", as I keep saying, they're advised by Actuaries. Both sides are. I'm sure they have a reasonably good understanding of the impact. If it wasn't going to be negative there would literally be no point in the Govt. trying to implement it.

The conclusion is therefore that public sector pay rises are much more generous then are repeatedly claimed. Which was the point I was trying to get you to understand.

It's certainly not what is claimed when 'austerity' is discussed.

Countdown said:

I've said all this before but you keep insisting that somehow it isn't negative and the Govt are only doing it "because they must be seen to be doing something" which is a weak argument by any stretch of the imagination.

As I've clearly said it can only be negative if you accept certain conclusions about public sector pay rises.

Countdown said:

IIRC £7k is the average PS pension. Modest describes it fairly well.

Only if you fail to acknowledge the number of years of service and contributions made in order to achieve such a pension. Which is the fundamental point about why these are 'gold-plated' schemes.

Countdown said:

How does that compare to what people pay in NI contributions in order to get a £7.5k annual State pension?

Irrelevant.

Countdown said:

The economic reality being that a CARE scheme costs less to the employer and provides a lower level of benefits for its members?

Depending on the assumptions used...

Remind me where the Unions have acted that public sector pay rises are expected to repeatedly average more than inflation plus 1.5% p.a.

https://www.ft.com/content/f9a10356-46ae-11e7-8519...
https://www.theguardian.com/society/2017/jul/10/te...
http://www.bbc.co.uk/news/uk-politics-39416869
https://www.theguardian.com/society/2016/mar/08/un...

Countdown said:

Indeed. But it doesn't change the fact that CARE schemes are worse than FS for most employees.

Depending on pay progression (see above).

Edited by sidicks on Thursday 10th August 14:36

[Countdown]

sidicks said:

Countdown said:

It's not an either/or question. With regards to them "not understanding", as I keep saying, they're advised by Actuaries. Both sides are. I'm sure they have a reasonably good understanding of the impact. If it wasn't going to be negative there would literally be no point in the Govt. trying to implement it.

The conclusion is therefore that public sector pay rises are much more generous then are repeatedly claimed. Which was the point I was trying to get you to understand.

Ok. So for the avoidance of doubt you’re no longer claiming that the CARE scheme is as good as or better than the FS scheme? You keep going on about public sector pay rises. That’s a separate argument. For a start you would need to differentiate between automatic annual increases and those related to career progression/promotion. A person’s salary might increase by 20% during any one year even when the pay award is NIL %. Under CARE that person’s pension will be worse off than the previous FS scheme

sidicks said:

It's certainly not what is claimed when 'austerity' is discussed.

Not claimed by me,

sidicks said:

Countdown said:

I've said all this before but you keep insisting that somehow it isn't negative and the Govt are only doing it "because they must be seen to be doing something" which is a weak argument by any stretch of the imagination.

As I've clearly said it can only be negative if you accept certain conclusions about public sector pay rises.

The conclusions being that people get promoted, or receive incremental progression, or PRP, or any of the other payments which are pensionable? The “R” element of CARE is only better for those whose TOTAL PAY doesn’t increase above above CPI plus 1% for the entirety of their career. Yippee….

sidicks said:

Countdown said:

IIRC £7k is the average PS pension. Modest describes it fairly well.

Only if you fail to acknowledge the number of years of service and contributions made in order to achieve such a pension. Which is the fundamental point about why these are 'gold-plated' schemes.

sidicks said:

Countdown said:

How does that compare to what people pay in NI contributions in order to get a £7.5k annual State pension?

Irrelevant.

Not really. Back-of-a-fag packet calculations suggest that the average PS pension is roughly the same as the State Pension, but contributions to the State pension can be significantly less. Would you suggest that the State Pension is “gold plated”?

sidicks said:

Countdown said:

The economic reality being that a CARE scheme costs less to the employer and provides a lower level of benefits for its members?

Depending on the assumptions used...

Remind me where the Unions have acted that public sector pay rises are expected to repeatedly average more than inflation plus 1.5% p.a.

https://www.ft.com/content/f9a10356-46ae-11e7-8519...
https://www.theguardian.com/society/2017/jul/10/te...
http://www.bbc.co.uk/news/uk-politics-39416869

And again you’re conflating annual pay rises with total pay rises over somebody’s working life. They’re not the same. The fact that FS schemes are based on FS is one of the things that makes them so expensive. Because Joe Bloggs’ contributions will have been less during the early part of his working life but his pension will be based on the highest income during the last 3 years of pensionable service.

sidicks said:

Countdown said:

Indeed. But it doesn't change the fact that CARE schemes are worse than FS for most employees.

Depending on pay progression (see above).

Yes. As long as somebody’s salary over a 40-year career doesn’t increase by more than CPI+1.5% they’ll be better off……Yippee (as I said)

[sidicks]

Countdown said:

Ok. So for the avoidance of doubt you’re no longer claiming that the CARE scheme is as good as or better than the FS scheme? You keep going on about public sector pay rises. That’s a separate argument.

No, it's a fundamental input in determining which is best.

Countdown said:

For a start you would need to differentiate between automatic annual increases and those related to career progression/promotion. A person’s salary might increase by 20% during any one year even when the pay award is NIL %. Under CARE that person’s pension will be worse off than the previous FS scheme

Of course, never in dispute. That does not mean that the FS version was fair or affordable.

Countdown said:

Not really. Back-of-a-fag packet calculations suggest that the average PS pension is roughly the same as the State Pension, but contributions to the State pension can be significantly less. Would you suggest that the State Pension is “gold plated”?

To get a full state pension, you will have contributed for 30 or 40 years. The average pension you refer to is the result of a much smaller amount of accrual.

For average earners and below the state pension most certainly is 'gold-plated' - the key is the amount paid in versus the benefit received...

Countdown said:

And again you’re conflating annual pay rises with total pay rises over somebody’s working life. They’re not the same. The fact that FS schemes are based on FS is one of the things that makes them so expensive. Because Joe Bloggs’ contributions will have been less during the early part of his working life but his pension will be based on the highest income during the last 3 years of pensionable service.

Which is exactly why they are not fair, not justifiable and not affordable!

[Dixy]

As usual Sidicks takes the thread totally off course arguing over semantics of how good the pension is rather than the real problem that there are too few doctors staying in the NHS.

[sidicks]

Dixy said:

As usual Sidicks takes the thread totally off course arguing over semantics of how good the pension is rather than the real problem that there are too few doctors staying in the NHS.

It wasn't me that claimed that doctors were leaving the NHS for better pay and pensions.

jjlynn27 said:

McKinsey has an open offer for people who poach JDs from NHS. JDs get 2.5-3 times increase in salary + much better pension, for less demanding work

It also wasn't me that asked for information about the NHS pension, do make up your mind!!

Dixy said:

Perhaps you would like to lay out what the NHS pension is in your own words, as having looked at it recently it is certainly not the end of the rainbow it use to be.

Edited by sidicks on Thursday 10th August 16:40

[Dixy]

And the needle is still stuck.

[sidicks]

Dixy said:

And the needle is still stuck.

And your solution to too many doctors leaving the NHS is?

[4567231]

Improving the working conditions?
Providing proper training for the juniors?
Treating the workforce with respect?

I am the RCP associate clinical tutor for a large northern hospital and CMT CT1 gaps are so worrying that I genuinely fear for medical patient safety.

[sidicks]

4567231 said:

Improving the working conditions?

Wasn't that part of what the new contract was aiming to achieve?

4567231 said:

Providing proper training for the juniors?

What sort of training?

4567231 said:

Treating the workforce with respect?

I am the RCP associate clinical tutor for a large northern hospital and CMT CT1 gaps are so worrying that I genuinely fear for medical patient safety.

Who is this aimed at?

[4567231]

(1) Working conditions will not be improved while the workforce is understaffed. We have lots of people "exceptional-reporting" (i.e. logging overtime and getting reimbursement) that did not use to occur in the old contract. The NHS will soon find out how much goodwill they have relied on juniors staying behind for free in the past, when they have to pay out the overtime claimed by the doctors.

(2) Training as part of junior doctors' work. F1 and F2 should have "protected teaching time" - 1 hour / week is the usual. In many trusts it is so busy that doctors cannot go and some have even failed their end-of-year assessments because their attendance has fallen off the required percentage. It is the same for other training grades. If it is busy they cannot go and that is that.

Training in surgical rotations (not my expertise as I'm in medicine, other surgical trainees / consultants will have more to say I'm sure) is also getting worse since the EWTD has come in, "improving working conditions" but actually meaning that training opportunities is poorer. The solution? More (training grade) doctors will be needed to cover the gaps and more training places, more consultant posts etc. need to be made at the end of the training programme.

(3) Respect for juniors from the admin staff I mean - they are often asked to cover gaps at short notice, not allowed to take annual leave even for family events or medical exams (that they MUST take to progress), berated for taking any sick leave (doctors are supposed to be super-human), expected to take phone calls when driving, going home after 13 hour night-shifts (no accomodation is provided)...

In my role (unpaid) I help provide training to the Core Medical Trainees (about 2 years post-grad until they become a registrar), and I see how many gaps there are. Let's just say it is less than half filled.

[Countdown]

sidicks said:

4567231 said:

Improving the working conditions?

Wasn't that part of what the new contract was aiming to achieve?

Yes. That'll probably be why the Doctors were striking against the proposals.

[sidicks]

4567231 said:

(1) Working conditions will not be improved while the workforce is understaffed. We have lots of people "exceptional-reporting" (i.e. logging overtime and getting reimbursement) that did not use to occur in the old contract. The NHS will soon find out how much goodwill they have relied on juniors staying behind for free in the past, when they have to pay out the overtime claimed by the doctors.

(2) Training as part of junior doctors' work. F1 and F2 should have "protected teaching time" - 1 hour / week is the usual. In many trusts it is so busy that doctors cannot go and some have even failed their end-of-year assessments because their attendance has fallen off the required percentage. It is the same for other training grades. If it is busy they cannot go and that is that.

Training in surgical rotations (not my expertise as I'm in medicine, other surgical trainees / consultants will have more to say I'm sure) is also getting worse since the EWTD has come in, "improving working conditions" but actually meaning that training opportunities is poorer. The solution? More (training grade) doctors will be needed to cover the gaps and more training places, more consultant posts etc. need to be made at the end of the training programme.

(3) Respect for juniors from the admin staff I mean - they are often asked to cover gaps at short notice, not allowed to take annual leave even for family events or medical exams (that they MUST take to progress), berated for taking any sick leave (doctors are supposed to be super-human), expected to take phone calls when driving, going home after 13 hour night-shifts (no accomodation is provided)...

In my role (unpaid) I help provide training to the Core Medical Trainees (about 2 years post-grad until they become a registrar), and I see how many gaps there are. Let's just say it is less than half filled.

Thank you for your reply.

[spaximus]

sidicks said:

4567231 said:

(1) Working conditions will not be improved while the workforce is understaffed. We have lots of people "exceptional-reporting" (i.e. logging overtime and getting reimbursement) that did not use to occur in the old contract. The NHS will soon find out how much goodwill they have relied on juniors staying behind for free in the past, when they have to pay out the overtime claimed by the doctors.

(2) Training as part of junior doctors' work. F1 and F2 should have "protected teaching time" - 1 hour / week is the usual. In many trusts it is so busy that doctors cannot go and some have even failed their end-of-year assessments because their attendance has fallen off the required percentage. It is the same for other training grades. If it is busy they cannot go and that is that.

Training in surgical rotations (not my expertise as I'm in medicine, other surgical trainees / consultants will have more to say I'm sure) is also getting worse since the EWTD has come in, "improving working conditions" but actually meaning that training opportunities is poorer. The solution? More (training grade) doctors will be needed to cover the gaps and more training places, more consultant posts etc. need to be made at the end of the training programme.

(3) Respect for juniors from the admin staff I mean - they are often asked to cover gaps at short notice, not allowed to take annual leave even for family events or medical exams (that they MUST take to progress), berated for taking any sick leave (doctors are supposed to be super-human), expected to take phone calls when driving, going home after 13 hour night-shifts (no accomodation is provided)...

In my role (unpaid) I help provide training to the Core Medical Trainees (about 2 years post-grad until they become a registrar), and I see how many gaps there are. Let's just say it is less than half filled.

Thank you for your reply.

How dare you come on here 4567231 and give some accurate facts. No doubt some will be busy trying to find an obscure report to quote to prove you wrong as a journalist knows more than someone like you.

You are spot on with what my Daughter has told me, especially getting time to do core training and portfolios signed off by the consultants as everyone is too busy.

Your mention of the admin staff is very familiar, because they are under pressure, they ask stupid things of Dr's. After three straight 12 hour nights shifts, getting a call at midday asking if she can do another that evening, waking her up obviously. Booking holidays was met with an almost, "must you" and trying to dictate when they can take days off and almost using emotional blackmail to get them to do more.

Many Dr's like my daughter have done many hours extra with no pay and now they are less likely to want to when they get abuse.
She has done this willingly as it is the patients who suffer if there is no one there.

[968]

Murph7355 said:

No, I'm not a fan of retrospective legislation generally, though it doesn't stop governments often.

If it were me I would make wholesale changes with the funding situation on university/education places. I'd rather see full funding for key qualifications rather than see any sort of subsidy (of which loans are one type when you consider the repayment terms and the expected "default" rate) for anything falling outside of that.

But with that there would need to be some tie in/payback if the individual elects not to use that education here.

I'm sure none go into these things expecting not to follow through. But that doesn't address the holes we need to repair. There are plenty of things in life we do not anticipate doing but that result in penalty.

We need some radical solutions IMO. Both the supply and demand sides of the equation need addressing.

Trouble is, I don't think the general public/people in these key roles/etc are up for material change. So the system cannot improve.

What radical solutions do you propose and what change do you think is needed, to people in these key roles? How do you think their job plans could change to make them better, in your view?

[dmsims]

4567231 said:

(3) Respect for juniors from the admin staff I mean - they are often asked to cover gaps at short notice, not allowed to take annual leave even for family events or medical exams (that they MUST take to progress), berated for taking any sick leave (doctors are supposed to be super-human), expected to take phone calls when driving, going home after 13 hour night-shifts (no accomodation is provided)...

And they have more of this utter ste to look forward as they progress. NHS managers are the scum of the earth

You do not find this disrespect in Australia / NZ

[sidicks]

dmsims said:

4567231 said:

(3) Respect for juniors from the admin staff I mean - they are often asked to cover gaps at short notice, not allowed to take annual leave even for family events or medical exams (that they MUST take to progress), berated for taking any sick leave (doctors are supposed to be super-human), expected to take phone calls when driving, going home after 13 hour night-shifts (no accomodation is provided)...

And they have more of this utter ste to look forward as they progress. NHS managers are the scum of the earth

You do not find this disrespect in Australia / NZ

Do they respect their managers?

[IanA2]

sidicks said:

dmsims said:

4567231 said:

(3) Respect for juniors from the admin staff I mean - they are often asked to cover gaps at short notice, not allowed to take annual leave even for family events or medical exams (that they MUST take to progress), berated for taking any sick leave (doctors are supposed to be super-human), expected to take phone calls when driving, going home after 13 hour night-shifts (no accomodation is provided)...

And they have more of this utter ste to look forward as they progress. NHS managers are the scum of the earth

You do not find this disrespect in Australia / NZ

Do they respect their managers?

Ask Kevin Beatt, Raj Mattu, Prof Steve Bolsin, Otto Chan, Jane Hamilton, Prof Zygmunt Krukowski, Antoinette Geoghegan, Peter O'Keefe, Prof David Ferry, what they think of NHS managers. you can find details of them all very easily if you wish.

[NoddyonNitrous]

MrJuice said:

I'm a junior doctor. Wouldn't mind tripling my salary at McKinsey or an 800k golden hello at the end of specialist training

What exactly do these medics do that merits/warrants an 800k golden hello. Genuine question

Thanks

FWIW, I feel massively underpaid. I'm doing an a+e rotation at the moment where I work 10, 12 or 13 hour shifts. There are shorter shifts on my rota. 9 days in four months where I'd work 8 hours but I have to take my leave on those days. I work approx 47 hours a week on average and the overtime (above 40 hours) is paid at £14 per hour. I work about an extra hour per shift just because otherwise I'd be sat around not doing work. When you start seeing a patient at 5pm and you're scheduled to finish at 6pm, it ends up taking until 7pm by the time you've done your bit and handed over.

I paid 9k in fees and don't feel any commitment to the NHS. I do feel commited to the patients though and that's probably what will keep me in the NHS until the level of privatisation gets unbearable. Fyi, the minors bit of my a+e department is already run by a private company.

I am lead to believe that it is skills in risk assessment/management as well as logical analysis and assessment of uncertainty that is of value.

[968]

sidicks said:

Do they respect their managers?

Yes. Even though they are treated with contempt and often vindictiveness by the management, they treat them professionally because they are educated professionals who have the patients best interests at heart. They often fail to get any adequate notice of working arrangements, times etc, they almost always are working in teams which are understaffed but are expected to fill in without any additional recompense, are required to adopt roles that they aren't necessarily trained to deal with.