Junior Doctor's contracts petition

[arp1]

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?

Are you going to pay for the extra wages required to staff and run the equipment and services that go along with it though?

[arp1]

Ps, the costs involved setting up 'normal' working on a weekend vs the number of DNA's, well, is it worth it?

[CorbynForTheBin]

CorbynForTheBin said:

arp1 said:

CorbynForTheBin said:

Which general tenets of 'business' do you think don't apply?

Efficiency?
Quality of service?
Sustainability?

Do you think those three exist at present? Especially point three...

Not for profit, kinda a biggy! You failed to answer how we will sustain a 24/7 service without the funding...

Where did I state profit?

You seem to be putting words in my mouth...

Edited by CorbynForTheBin on Saturday 13th February 10:41

When talking about costs, don't forget that i apparently stated a profit must be made

[spaximus]

mph1977 said:

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?

Because there are not enough staff to go around to cover the extra days.

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

See above

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!

Stop trying to score cheap points, as I said my wife is a finance director in the NHS, they work 37 hours flexi time, but without then nothing gets paid, they are a cog in the wheel. However, no matter how much money they push through unless you have all the staff needed, which I can list if you wish, no way it can work as Hunt magically says it will.

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 ...

If you work in the NHS as you say you will know that there are some things that can be done at any time, you could run a endocronolgy clinic cheaply as it needs little extra resource to run other than the immediate staff, but you still need more staff or they are forced to work longer hours.

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

It may be simplistic but no less true.

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 ...

To that patient isn't that the same thing?

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

Of course not, the point being that everything has a risk. Care in the community is a case in point where the support is not enough, proven over and over again. Why should any mental hospital these days be an abusive place?

As for geriatric Hospitals, no. Many old people are discharged as they have no clinical need, but they cannot cope easily at home alone. My FIL had a knee op, they sent him home as he could walk up a stair, but as his physio instructions were given as what to do he tried but failed to complete as they hurt. The net result was he had to have it done again.
A place where he could convalesce and have daily physio would have been cheaper in the long run.

I have never said that we should not have change, we should get better value from everything but this was about the Junior Doctors contract and what Hunt has done is wrong as it does not address how he can do what he says without forcing Doctors to work much longer hours.
Most people can see this is impossible. Most people can see the wrong that the EU has a 48 hour working directive and Hunt has proposed reducing the 92 hour maximum allowed at present to 62 and even then there are not enough hours.

I suspect we shall disagree on this subject

[turbobloke]

arp1 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?

Are you going to pay for the extra wages required to staff and run the equipment and services that go along with it though?

How much weekend working would half of the annual £10+bn lost to fraud / waste / error pay for...just half, given that those on the ground made a concerted effort and got somewhere, as opposed to exhortations from politicians. This is surely the firat avenue as opposed to yet more tax.

[PRTVR]

arp1 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?

Are you going to pay for the extra wages required to staff and run the equipment and services that go along with it though?

Why not a skeleton (pun intended) service? I hope things have improved from when I was in hospital about 20 years ago with a blood clot, the specialist said he would send me for a scan, but because it was a bank holiday Friday then a weekend then another bank holiday on Monday it was Tuesday before the scan was carried out, if the specialist wanted a scan surely it is important to get the scan as soon as possible and not have to wait 3 days.

[RYH64E]

One thing (of many) that I don't understand is, if life as a Junior Doctor is so bad, why is there so much competition for places at Medical School? Long hours and poor pay for Junior Doctors have been complaints for as long as I can remember, and that's a long time, yet according to the BMA there were 11.2 applicants per place at Medical School in 2013 compared to a higher education average average of 5.5. That doesn't suggest a recruitment crisis to me, maybe because longer term prospects for doctors are very good?

[spaximus]

RYH64E said:

One thing (of many) that I don't understand is, if life as a Junior Doctor is so bad, why is there so much competition for places at Medical School? Long hours and poor pay for Junior Doctors have been complaints for as long as I can remember, and that's a long time, yet according to the BMA there were 11.2 applicants per place at Medical School in 2013 compared to a higher education average average of 5.5. That doesn't suggest a recruitment crisis to me, maybe because longer term prospects for doctors are very good?

I will answer that for my Daughter. She saw the treatment that Doctors gave my Mother in Law and my wife when she was in hospital. From then on she was driven to chose the right subjects to get into medical school so she could do the same for others. She did not do it for the money, but yes long term she knew that financially she would be okay if it all goes to plan.
Yes there are lots of applicants for med school but those who fail are simply not good enough, or better than those who apply that year. It is not just on academic matters it is getting the whole package right.

What has upset her so much is that what she agreed to as did all the others, Hunt has torn up. He has also made the medical staff aware of how little regard he has for their well being or ultimately the patient, regardless of what he says.
If Hunt was keen to give a true long term commitment to 24/7 care they would find the money to train more Doctors, but that would inevitably lower the bar standard wise in some ways. But there is no more money for training positions to Hospitals so we are back to square one.

Will my daughter give less care, no, will her friends, no will they leave the English NHS probably as it stands at present as this is the start of a much bigger issue long term for the NHS

[mph1977]

PRTVR said:

arp1 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?

Are you going to pay for the extra wages required to staff and run the equipment and services that go along with it though?

Why not a skeleton (pun intended) service? I hope things have improved from when I was in hospital about 20 years ago with a blood clot, the specialist said he would send me for a scan, but because it was a bank holiday Friday then a weekend then another bank holiday on Monday it was Tuesday before the scan was carried out, if the specialist wanted a scan surely it is important to get the scan as soon as possible and not have to wait 3 days.

that was the skeleton service ...

the 4 and a half day NHS is still a reality ( 3 and a half or less on a bank holiday, you may as well block the week out at easter and christmas )

meanwhile we've 'wasted' the bed days and Nursing hours ...

[turbobloke]

spaximus said:

What has upset her so much is that what she agreed to as did all the others, Hunt has torn up.

Good to hear that your daughter did well at school, won a place at medical school and is now on her preferred career track.

As to the comment above, what perspective is there when people think that conditions at one time will remain in place? Is it naiveté, public sector mentality, or something else? After the recent crunch and crash, through 2009-11, the businesses I was running could not command the same contract pricing as previously. What point would there have been in complaining about it rather than accepting it and taking any possible positive steps? One of the businesses I subbed for laid off over half of their workforce and the rest accepted a pay cut. Liam Byrne (Labour, muppet) said there's no money left when Labour were booted out. Complaints might be better directed at him.

[Dixy]

RYH64E said:

One thing (of many) that I don't understand is, if life as a Junior Doctor is so bad, why is there so much competition for places at Medical School? Long hours and poor pay for Junior Doctors have been complaints for as long as I can remember, and that's a long time, yet according to the BMA there were 11.2 applicants per place at Medical School in 2013 compared to a higher education average average of 5.5. That doesn't suggest a recruitment crisis to me, maybe because longer term prospects for doctors are very good?

What a 17 year old filling out a UCAS form perceives and is frequently misled by a school wishing to massage its Oxbridge/medschool stats and what it turns out in the real world to be are another significant reason for so many dropping out of medicine. By which time both the country and the student have invested a huge amount of wasted capital, time and effort.

What is the next thing you don't understand?

[RYH64E]

spaximus said:

He has also made the medical staff aware of how little regard he has for their well being or ultimately the patient, regardless of what he says.

If patient care was the priority everybody would be united in a push for 24/7 provision, it's ludicrous to think that there's no need for a service on weekends, bank holidays or evenings. You can shop on a weekend, go to the gym on the weekend, but if you break a leg on the weekend you'll get patched up in A&E and told to come back on Monday to get properly seen to (which makes no sense financially as the same job has to be done twice).

[mph1977]

RYH64E said:

spaximus said:

He has also made the medical staff aware of how little regard he has for their well being or ultimately the patient, regardless of what he says.

If patient care was the priority everybody would be united in a push for 24/7 provision, it's ludicrous to think that there's no need for a service on weekends, bank holidays or evenings. You can shop on a weekend, go to the gym on the weekend, but if you break a leg on the weekend you'll get patched up in A&E and told to come back on Monday to get properly seen to (which makes no sense financially as the same job has to be done twice).

with regard to your assertions over A+E for trauma , the reality is whatever the day of the week A+E have the same three options with that kind of injury (usually orthopaedic and/or plastics final responsibility) or something like an abscess that will require a 'proper' Incision and drainage

1. provide initial treatment until review in a 'trauma / urgent / fracture ' OP clinic in the next day or two
2. provide tempororay treatment and have you return the next day for more definitive treatment |
3. there is a good clinical reason to admit you

2 historically didn;t happen when we carried large numbers of alleged to be acute beds ( but weren;t by current definitions)


the bigger issue with weekends is the lack of progression for those who have been admitted , in the week it is likely that you will be reviewed by the appropriate subspeciality within 24 hours - this simply does not happen at the weekend as well as the delays to investigations, procedurs and the inability to discharge many patients due to a lack of provision of services and a lack of medical staff to complete documnentation which is considered / required to be 'a Doctor's job' ...

[spaximus]

turbobloke said:

Good to hear that your daughter did well at school, won a place at medical school and is now on her preferred career track.

As to the comment above, what perspective is there when people think that conditions at one time will remain in place? Is it naiveté, public sector mentality, or something else? After the recent crunch and crash, through 2009-11, the businesses I was running could not command the same contract pricing as previously. What point would there have been in complaining about it rather than accepting it and taking any possible positive steps? One of the businesses I subbed for laid off over half of their workforce and the rest accepted a pay cut. Liam Byrne (Labour, muppet) said there's no money left when Labour were booted out. Complaints might be better directed at him.

It's a fair point. To me the NHS is special not just because of my Daughter but because of what it stands for, delivering care where needed regardless of ability to pay. My Dad, a miner from South Yorks, tells tales of when it was formed and queues of women many with prolapsed wombs tied in a cloth between their legs as they could not afford to be treated before.
To keep it special we need to treat those that work in it well, so we keep them in the UK for ever.
There are many many things wrong and waste is biblical but that is outside this issue.

Perhaps the staff were naïve to suspect that such a measure could be taken against them, but what this has done is show to every single public sector worker their terms and rights are not set and will be changed at a whim and we will see whole swathes of workers terms changed in the NHS especially after this.

Some on here will say that is right, I don't change could be done better, savings can be made elsewhere in the NHS.

No battle has ever been won when the General has beaten up his own troops. The battle to improve needs everyone going the same way.

[Fermit The Krog]

I think the first question on Thursdays Question Time hit the nail on the head. 'Who is right, 53,000 junior doctors, or Jeremy Hunt?'

[mph1977]

Fermit The Krog said:

I think the first question on Thursdays Question Time hit the nail on the head. 'Who is right, 53,000 junior doctors, or Jeremy Hunt?'

or who has swallowed the propaganda ...

unfortunately any change in the NHS will be obstructed by some on the basis of a myth told by the loony left and it's fellow travellers ...

[turbobloke]

Fermit The Krog said:

I think the first question on Thursdays Question Time hit the nail on the head. 'Who is right, 53,000 junior doctors, or Jeremy Hunt?'

Seriously? Surely you realise that a number of votes or supporters indicates popularity not veracity?

Also the right or wrong dichotomy is an oversimplification, apparently there were several points on the table about which compromise had been reached during talks, but one point or some points could not be resolved.

[jjlynn27]

Dixy said:

RYH64E said:

One thing (of many) that I don't understand is, if life as a Junior Doctor is so bad, why is there so much competition for places at Medical School? Long hours and poor pay for Junior Doctors have been complaints for as long as I can remember, and that's a long time, yet according to the BMA there were 11.2 applicants per place at Medical School in 2013 compared to a higher education average average of 5.5. That doesn't suggest a recruitment crisis to me, maybe because longer term prospects for doctors are very good?

What a 17 year old filling out a UCAS form perceives and is frequently misled by a school wishing to massage its Oxbridge/medschool stats and what it turns out in the real world to be are another significant reason for so many dropping out of medicine. By which time both the country and the student have invested a huge amount of wasted capital, time and effort.

What is the next thing you don't understand?

Think you are wasting your time. He doesn't understand that skeleton provision of services is in place. He doesn't understand that to operate 24/7 you need to have a lot more people on not all of them medical, and unlike factory you need to have skilled, trained people to operate machinery. But hospital is the same as a factory, or a shop, or a gym. Tells you all you need to know of how some perceive medical staff. They need to prove that they care for patient by working 24/7. If that's not the case, 'ah see, they don't care!'.

But it's clearly jds' fault that his mom had to wait on hip replacement, if they pulled together, and worked 24/7 he wouldn't need to pay for her to go private. They are just lefties wanting to do 9-5.

[968]

mph1977 said:

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 ...

Utter nonsense. If there was clinical need, scans were and are done out of hours. I've never worked in a trust in 20 years where such facilities didn't exist or there was a contingency in place. Hoop jumping as you call it was sensible precautions by the radiologists to ensure that scans were requested for appropriate reasons which isn't always the case. If they had 5 scanners then maybe it wouldn't happen but guess what, it comes down to money again. Also having worked in America where an MRI is standard practice for allergy related sinus disease, I can say that clinical judgement is an important thing to have. I'm not sure what experience you actually have, but it bears no relationship to a doctor who's worked in the system for 20 years.

[numtumfutunch]

mph1977 said:

the bigger issue with weekends is the lack of progression for those who have been admitted , in the week it is likely that you will be reviewed by the appropriate subspeciality within 24 hours - this simply does not happen at the weekend as well as the delays to investigations, procedurs and the inability to discharge many patients due to a lack of provision of services and a lack of medical staff to complete documnentation which is considered / required to be 'a Doctor's job' ...

I dont know where you got the above from but my local hospital works to this NHS document from 3 years ago

https://www.england.nhs.uk/wp-content/uploads/2013...

To save you reading it mandates a consultant presence in the acute specialities from 8am -8pm every day including Saturday and Sunday and immediate access to investigations as necessary