Junior Doctors Prepare For First Full Walk-Out

If we want the NHS to be open 24/7 then we will have to employ not just junior doctors but everyone else with specialist skills.Doctors need lab technicians,radiographers,nurses and all the other myriad professions that keep the NHS working Monday to Friday..plus the missing extra doctors and nurses/midwives the NHS currently has shortages of.

However that costs and trying to provide on a shoestring won't cut it..

Also the best way to keep people out of A&E on any day is to make sure we address the acute shortage of GPs..My friend has just made an appointment to see her GP about her sinus headaches but can't have an appointment until the 2nd of June.

I'm pretty sure Hunt isn't really interested a 24/7 NHS but it merely trying to find ways and means of introducing us to the benefits of a privatised system based on the US nightmare of a healthcare system...

And I'm more than willing to pay higher taxes to fund the NHS..

Originally Posted by Mr K

So you want higher taxes now? A few weeks ago you were arguing that higher earners desperately needed tax cuts. Who are these taxes going to fall on? Which party is most likely to implement your radical plan? The Tories ?

Actually Labour are the party most likely to increase taxes .

Realistically though (and not in the socialist dreamland you seem to occupy)we will need to invest billions more in the NHS to maintain the service given the increased population and the increased age of the population.At some point we will have to raise more money to pay for it ,we could privatise it and have a service for the well off only or raise taxes and keep the service for everyone .

---------- Post added at 09:18 ---------- Previous post was at 09:11 ----------

Originally Posted by Mr K

I agree with increasing taxes too; however the Govt. is dogmatically opposed to raising taxes. The public aren't innocent here. Despite what they say to pollsters, they don't vote for parties that promise tax rises. Demands are increasing on the NHS quicker than its budget growing, yet they are expected to expand further. Its an impossible task and I suspect the Govt. knows it i.e. its being set up to fail.

What benefit for any government could there possibly be in letting the NHS fail ?

[nomadking]

Originally Posted by Maggy J

If we want the NHS to be open 24/7 then we will have to employ not just junior doctors but everyone else with specialist skills.Doctors need lab technicians,radiographers,nurses and all the other myriad professions that keep the NHS working Monday to Friday..plus the missing extra doctors and nurses/midwives the NHS currently has shortages of.

However that costs and trying to provide on a shoestring won't cut it..

Also the best way to keep people out of A&E on any day is to make sure we address the acute shortage of GPs..My friend has just made an appointment to see her GP about her sinus headaches but can't have an appointment until the 2nd of June.

I'm pretty sure Hunt isn't really interested a 24/7 NHS but it merely trying to find ways and means of introducing us to the benefits of a privatised system based on the US nightmare of a healthcare system...

And I'm more than willing to pay higher taxes to fund the NHS..

But you can't do the rest of it without doing ALL of it, otherwise nothing could ever get done. The junior doctors are first, that's all. Others will follow.

[TheDaddy]

Originally Posted by nomadking

Avoided? Based on the banners, there's meant to be more to it than that. There are to be restrictions on how much Saturday work they are allowed to do, a 30% addition for working a 2nd Saturday in a month, along with the 13.5% overall pay increase to covered reduced weekend rates. Why are Saturdays a problem for the BMA?

So all these studies over the years, by so many organisations, around the world are all skewed? Many have focussed on a single medical condition, often where there is NO question about whether somebody should be admitted or not.

The Lancet, May 2015

All these studies aren't the one hunt has been citing as the rationales for his proposals, the one he keeps using is wrong.

---------- Post added at 20:05 ---------- Previous post was at 20:02 ----------

Originally Posted by martyh

I think we are focusing too much on one thing here .Putting the "weekend effect" aside ,what's wrong with striving for a 7 day NHS anyway ? just about everything else in our lives is 7 days so why not our health care ?

Nothing is wrong with it if it can be staffed but if we haven't got the staff for 5 days 7 is going to prove tricky especially if you actually believe the hours are going to be cut

[nomadking]

Originally Posted by TheDaddy

All these studies aren't the one hunt has been citing as the rationales for his proposals, the one he keeps using is wrong.

---------- Post added at 20:05 ---------- Previous post was at 20:02 ----------
Nothing is wrong with it if it can be staffed but if we haven't got the staff for 5 days 7 is going to prove tricky especially if you actually believe the hours are going to be cut

What nonsense. The policy of a 7 day NHS came along LONG BEFORE that report. It was cited simply because it was recent.

The research by University Hospital Birmingham NHS Foundation Trusts and University College London, examined the effect of hospital admission day on death rates across NHS England hospitals for 2013-2014.

When these figures were adjusted, to account for patients’ higher levels of sickness, there was still a relative difference of up to 15 per cent.

Still higher death rates based on that report.

The Royal College of Surgeons said patients needed better access to senior staff and key tests at weekends.
Its president, Clare Marx, said: “Patients that need treating at the weekend are less likely to be seen by the right mix of junior and senior staff and experience reduced access to diagnostics.

Even in Accident & Emergency departments, there were twice as many senior doctors working during the week, compared with weekends.
A study of heart attack patients presented to cardiologists last week found those who were admitted on Saturdays had death rates 20 per cent higher than those who arrived at hospital during the week.

[TheDaddy]

Originally Posted by nomadking

What nonsense. The policy of a 7 day NHS came along LONG BEFORE that report. It was cited simply because it was recent.



Still higher death rates based on that report.

And it's simply wrong but what does that matter when it can be used to bolster an argument and I think you'll find it wasn't how recent it was that appealed but who wrote it.

[nomadking]

Originally Posted by TheDaddy

And it's simply wrong but what does that matter when it can be used to bolster an argument and I think you'll find it wasn't how recent it was that appealed but who wrote it.

This new report is meant to have removed the lower levels of sickness during the week. The original DID account for that as I QUOTED.

Some of this was because patients admitted at weekends are likely to be sicker, given that less hospital treatment is planned for this period.
...
When these figures were adjusted, to account for patients’ higher levels of sickness, there was still a relative difference of up to 15 per cent.

A difference of 15% even when variations taken account of, doesn't matter? We are talking about MORE deaths.

The report came out AFTER negotiations had started.

The Royal College of Surgeons says there is a "weekend effect", as would probably the BMA before these negotiations.
And guess what I've found from BMA website Oct 2013.

As such, the BMA has
welcomed the establishment of the Seven Day Forum by NHS England Medical
Director Prof Sir Bruce Keogh in December 2012, and looks forward to the Forum’s
findings
...
Quality
Evidence shows hospitals are not delivering equally high standards of care to
patients at night and at weekends compared to during normal working hours.
There is also evidence of higher mortality rates for hospital patients admitted at
the weekend. The Hospital Standardised Mortality Ratio (HSMR), which indicates
whether mortality rates are higher than would be expected for each hospital, is
produced annually by Dr Foster Intelligence and published in the Dr Foster Hospital
Guide. The 2012 Guide, Fit for the Future?, found that mortality rates for patients
admitted at weekends are higher than for those admitted on weekdays and that
higher levels of senior medical staffing at weekends are associated with lower
mortality rates.
...
The BMA position
Fundamentally, the BMA believes that NHS care should be of the same high quality
across seven days. The RCP and AoMRC quality standards for the care of acutely ill
patients set out a clear aspiration of what should be achieved in all NHS hospitals,
but it is clear that there are significant resource implications that require close
examination.
In order to achieve this, the BMA stands ready to work with all stakeholders to
achieve a clear understanding of what working patterns will be required, especially
for hospital consultants, as well as the resource implications. We will support GPs
taking part in the recently announced pilots that aim to extend access, although we
remain concerned that the current workforce is stretched trying to provide high
quality care within current access arrangements. We must ensure that the pilot is
used to assess the most cost effective way of improving patient outcomes by
extending access to general practice.

So how come the BMA suddenly disagree with all that?

[TheDaddy]

Originally Posted by nomadking

This new report is meant to have removed the lower levels of sickness during the week. The original DID account for that as I QUOTED.
A difference of 15% even when variations taken account of, doesn't matter? We are talking about MORE deaths.

The report came out AFTER negotiations had started.

The Royal College of Surgeons says there is a "weekend effect", as would probably the BMA before these negotiations.
And guess what I've found from BMA website Oct 2013.
So how come the BMA suddenly disagree with all that?

They don't disagree with all that, they disagree with how it's being implemented and it's not them that's disagreeing it's their members, the actual people being expected to do the job and the latest press release goes as far as saying this isn't simply about Saturday pay as we've been led to believe, who'd have thought it, politicians not being truthful.

http://web2.bma.org.uk/pressrel.nsf/...3?OpenDocument

[nomadking]

Originally Posted by TheDaddy

They don't disagree with all that, they disagree with how it's being implemented and it's not them that's disagreeing it's their members, the actual people being expected to do the job and the latest press release goes as far as saying this isn't simply about Saturday pay as we've been led to believe, who'd have thought it, politicians not being truthful.

http://web2.bma.org.uk/pressrel.nsf/...3?OpenDocument

"does not discriminate against women or any other group"What is that supposed to mean?
The statement is incredibly vague and non-specific. How does anything mentioned there justify a strike?

[TheDaddy]

Originally Posted by nomadking

"does not discriminate against women or any other group"What is that supposed to mean?
The statement is incredibly vague and non-specific. How does anything mentioned there justify a strike?

I'd say staff retention is important, it is vague though, they should have just come out and said a third of A&E staff have left in the last five years. When it comes to the machinations of politics they have a lot to learn, although it's probably why the public believe and support them and wouldn't spit on a politician if they were on fire.

[nomadking]

Originally Posted by TheDaddy

I'd say staff retention is important, it is vague though, they should have just come out and said a third of A&E staff have left in the last five years. When it comes to the machinations of politics they have a lot to learn, although it's probably why the public believe and support them and wouldn't spit on a politician if they were on fire.

Still vague and non-specific, with no specific proposals to remedy it. Perhaps the new contract should reduce hours? Oh what a surprise, it does exactly that.

[TheDaddy]

Originally Posted by nomadking

Still vague and non-specific, with no specific proposals to remedy it. Perhaps the new contract should reduce hours? Oh what a surprise, it does exactly that.

Perhaps the new contract should ensure as much as possible that they earn less to, that'd encourage even more of them to stay

[nomadking]

Originally Posted by TheDaddy

Perhaps the new contract should ensure as much as possible that they earn less to, that'd encourage even more of them to stay

a 13.5% increase isn't enough? I thought it wasn't about money. Where they are leaving A&E they are staying in medicine, therefore will be paid the same basic as if they has stayed. Perhaps the new contract should pay a Premia for certain grades and above in emergency medicine. Guess what, £1,500 for grades ST4 and above.

[TheDaddy]

Originally Posted by nomadking

a 13.5% increase isn't enough? I thought it wasn't about money. Where they are leaving A&E they are staying in medicine, therefore will be paid the same basic as if they has stayed. Perhaps the new contract should pay a Premia for certain grades and above in emergency medicine. Guess what, £1,500 for grades ST4 and above.

Most aren't getting an increase they're getting a decrease and they're not staying in medicine not ours at any rate they're emigrating

[nomadking]

Originally Posted by TheDaddy

Most aren't getting an increase they're getting a decrease and they're not staying in medicine not ours at any rate they're emigrating

Any that are getting a decrease, are because they are the ones overdoing the overtime. Silly question, but what have the BMA suggested be done about it?