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Strike!

hitmouse said:
Sorry to derail this fascinating exchange, but the BMA results are now out:
www.bma.org.uk

Pay restoration for junior doctors in England

During the last two years, junior doctors have made both an enormous contribution and a significant sacrifice. And yet none of this is recognised by the government. We are calling for NHS pay restoration.
www.bma.org.uk www.bma.org.uk

The results are in and members have delivered a huge mandate – with the highest-ever number of junior doctors voting for strike action and a record turnout. A huge thank you to all of those who voted.

We will inform members as soon as dates have been set for strike action.

If the Government refuses to give us full pay restoration, we will be calling for a full walkout of all junior doctors for 72 hours This will be our first round of action.

The ballot results are as follows:

  • Number entitled to vote: 47,692
  • Number of votes cast in the ballot: 36,955 (votes cast in the ballot as a percentage of individuals who were entitled to vote: 77.49%)
  • Number of YES votes: 36,218 (98.06%)
  • Number of NO votes: 716 (1.94%)
  • Number of spoiled or otherwise invalid voting papers returned: 21

Hearing they're looking at the 15th? ETA: my source might have been getting mixed up there, from the Guardian:
www.theguardian.com

Junior doctors in England to strike for 72 hours in March

Ten of thousands to take part in industrial action in escalation of row between NHS staff and government
www.theguardian.com www.theguardian.com
Junior doctors who are members of the Hospital Consultants and Specialists Association (HCSA) have already said they will strike for the first time in the union’s history. That action takes place on 15 March.

Tens of thousands of nurses in cancer wards, A&E departments and intensive care units in England will also stop work for 48 hours from 1 March. Ambulance staff in England and Wales will stage industrial action on 6 March and 20 March.
Click to expand...
Was in the 2% who voted No. For me this is a complicated issue. I do support pay restoration for jnrdrs but I believe Consultants are well paid. I don’t believe IA is the correct way of achieving pay restoration, as the risk:benefit ratio is off. Achieving significant pay rise- unlikely: risk of significant harm to patients from increased wait times- guaranteed. Speaking for my tiny corner of the service, there isn’t capacity to absorb IA without direct patient harm. Not emergency care- the Consultants will step down to doing junior work however long it takes them to write a discharge or do all their own cannulas or bloods. But wait lists, on top of covid backlog, on top of pre-existing backlog- disaster.

IA won’t save the NHS. I naively thought that when I went out in 2015/16. Political will is required and it’s not there- people keep voting for the Tories.

Jnrdrs are utterly shat on and hate their employer (the NHS). Me included. It’s profoundly dysfunctional and abusive system. I regularly work 72 hour plus weeks mixing standard working day and NROC shifts. And I get arm twisted into doing do with shady practices like signing out of EWTD, rota coordinators calling my personal phone OOA to ask me, I work hours overtime unpaid, regularly too busy for lunch, pay shit loads for exams. I’m in charge of the crash bleep, I lead medical emergencies, and I’m in charge of the hospital at night. I get £28 an hour. I’m ten years out of Med school and 15 years into my training. I could earn double elsewhere, tho I don’t much care about that.

I can see the argument that without pay restoration and pay rises for all HCPs the NHS is doomed. People- jnrdrs included- are just fucking off and the understaffing is compounding how incredibly stressful frontline work is. We all now watch patients suffering and dying because the nhs is failing.

But will walking out for 72 hours and not providing emergency cover solve this. It will not. It will expedite the end. Maybe this is a good thing? The end needs to come? I don’t know anymore. I just know it’s totally broken, and it needs to be completely rebuilt or radically changed.

I no longer know the answers. I just work as hard and fast and long as I can whilst protecting myself.

So no joy here about IA. No excitement. Just a kind of grim inevitability.
 
Edie said:
Was in the 2% who voted No. For me this is a complicated issue. I do support pay restoration for jnrdrs but I believe Consultants are well paid. I don’t believe IA is the correct way of achieving pay restoration, as the risk:benefit ratio is off. Achieving significant pay rise- unlikely: risk of significant harm to patients from increased wait times- guaranteed. Speaking for my tiny corner of the service, there isn’t capacity to absorb IA without direct patient harm. Not emergency care- the Consultants will step down to doing junior work however long it takes them to write a discharge or do all their own cannulas or bloods. But wait lists, on top of covid backlog, on top of pre-existing backlog- disaster.

IA won’t save the NHS. I naively thought that when I went out in 2015/16. Political will is required and it’s not there- people keep voting for the Tories.

Jnrdrs are utterly shat on and hate their employer (the NHS). Me included. It’s profoundly dysfunctional and abusive system. I regularly work 72 hour plus weeks mixing standard working day and NROC shifts. And I get arm twisted into doing do with shady practices like signing out of EWTD, rota coordinators calling my personal phone OOA to ask me, I work hours overtime unpaid, regularly too busy for lunch, pay shit loads for exams. I’m in charge of the crash bleep, I lead medical emergencies, and I’m in charge of the hospital at night. I get £28 an hour. I’m ten years out of Med school and 15 years into my training. I could earn double elsewhere, tho I don’t much care about that.

I can see the argument that without pay restoration and pay rises for all HCPs the NHS is doomed. People- jnrdrs included- are just fucking off and the understaffing is compounding how incredibly stressful frontline work is. We all now watch patients suffering and dying because the nhs is failing.

But will walking out for 72 hours and not providing emergency cover solve this. It will not. It will expedite the end. Maybe this is a good thing? The end needs to come? I don’t know anymore. I just know it’s totally broken, and it needs to be completely rebuilt or radically changed.

I no longer know the answers. I just work as hard and fast and long as I can whilst protecting myself.

So no joy here about IA. No excitement. Just a kind of grim inevitability.
Click to expand...

Thanks for writing that and raising some concerns Edie.

I'm not sure I totally follow your thinking though.

If you don't think striking is the way towards pay restoration (which you're clearly in favour of) what are you suggesting as an alternative?

Your conditions (and that of doctors generally) are horrendously bad. Again, how you suggest sorting that out if not striking?

The argument about patient harm is totally valid, but the union line (which I think is correct) is that due to the state of the NHS patients are getting less than ideal outcomes than they might otherwise daily, so what is the solution to sort that out if not industrial action? I think there's specific ward/departments where striking is higher risk for patients than not, but ultimately the Trust are responsible for that, and making it about individual doctors/nurses/other HCPs absolves them and the government from responsibility. (So it's not a surprise that the media constantly go on about 'risk to patients' with striking.) And cover will be sorted by the Trust with consultants usually, it's not like departments won't have people in. Sometimes the strike cover is actually better than day-to-day cover as they're legally mandated to provide strike cover at a certain level, unlike a normal day wher it can be below that.

I think what will hasten 'the end' is people not striking and feeling completely powerless to change things. I genuinely feel like if all these NHS worker strikes are beaten/fail to win some kind of victory then people will leave in their droves, and that the next 10-20 years will see the NHS change dramatically for the worse. That might happen if the strikes win, but it's much less likely I think.

What comes across mostly from what you've written is less about striking and any issues that raises, and more that you think it won't work and that the NHS is fucked whatever happens?

(All this is a bit reductive and leaves aside the discussions around striking and wider political struggle and social change of course.)
 
Last edited:
LDC said:
Thanks for writing that and raising some concerns Edie.

I'm not sure I totally follow your thinking though.

If you don't think striking is the way towards pay restoration (which you're clearly in favour of) what are you suggesting as an alternative?

Your conditions (and that of doctors generally) are horrendously bad. Again, how you suggest sorting that out if not striking?

The argument about patient harm is totally valid, but the union line (which I think is correct) is that due to the state of the NHS patients are getting less than ideal outcomes than they might otherwise daily, so what is the solution to sort that out if not industrial action? I think there's specific ward/departments where striking is higher risk for patients than not, but ultimately the Trust are responsible for that, and making it about individual doctors/nurses/other HCPs absolves them and the government from responsibility. (So it's not surprise that the media constantly go on about 'risk to patients' with striking.) And cover will be sorted by the Trust by consultants usually, it's not like department won't have people in. Sometimes the strike cover is actually better than day-to-day cover as they're legally mandated to provide strike cover at a certain level, unlike a normal day wher it can be below that.

I think what will hasten 'the end' is people not striking and feeling completely powerless to change things. I genuinely feel like if all these NHS worker strikes are beaten/fail to win some kind of victory then people will leave in their droves, and that the next 10-20 years will see the NHS change dramatically for the worse. That might happen is the strikes win, but it's much less likely I think.

What comes across mostly from what you've written is less about striking and any issues that raises, and more that you think it won't work and that the NHS is fucked whatever happens?

(All this is a bit reductive and leaves aside the discussions around striking and wider political struggle and social change of course.)
Click to expand...
Sadly I think that’s true LDC I think the NHS is fucked whatever. I fundamentally agree with healthcare funded by taxation and free at the point of use. But the NHS is too big, too complex, and too underfunded to cope with the inexorable rise in complexity, comorbidity, longevity and rise in medicalisation of human experience to ever function successfully. The Nation needs to rethink how we deliver healthcare and adopt a European model of care.

I recognise this is a defeated position. As such am trying to stfu and not get involved in the strikes one way or another. I will go out. I won’t accept scab positions such as below (this is SHO not SpR but there will be SpR) even at £100+ph.
5345439A-2DB4-4B68-901C-0F3F98B9DCC4.jpeg

But I do worry about the patients, us all!, long term. We don’t have a functional health service. In a lot of respects, having a semi functional service is a lot more dangerous than no service as patients assume it works when it doesn’t.

My best mate has endometrial cancer. Her 2ww diagnosis was delayed by 2/12, her pelvic USS was reported on the wrong patient (she doesn’t have a coil or they wouldn’t have known), and now her initial gyne oncology care will possibly be impacted by IA. I’m fighting the system for her using professional connections but 🤷🏻‍♀️ 😭

I know I don’t need to tell you what it’s like. I’m sorry I’m not more hopeful. Or maybe stronger. But there it is.
 
Sorry about your friend, that does sound familar, the fuck-ups and admin mess of it all is a disaster isn't it? I do think the majority of that could be sorted with staffing and funding, but there is a good chunk of truth to people saying there needs to be some reforms. It's just none of the politicians are able (or politically willing) to do them in the right way.

I think the BMA strikes are going to have a huge impact. I'm disappointed the RCN called theirs off, I think it's weak and a mistake. People at work were raging abaout it the other day as well.
 
The junior doctors are furious. To be fair you are shat on so hard and for so long. Nurses have a terrible time too- they work so hard and so relentlessly with understaffed rotas and insufficient pay.

But the insanity of what you’re expected to do as a junior is beyond. I remember surgical nights at Jimmies in Leeds when there was a rota gap and the reg was in theatre, holding two bleeps plus a crash bleep and covering the whole of Bexley Wing and Lincoln wing maybe ten wards of 32 patients. The bleep would never stop going off, you couldn’t cannulate or prescribe fluids or anything without incessant interruption and constant mounting pressure and varying acuity emergencies. Managing the panic within you to deliver care with shaking hands from the adrenaline. 13 hour shifts with no break and walking out like you’d survived an absolute ordeal. Getting like £12 an hour a decade ago.

I have a kind of ptsd type reaction when I go back there, I can still recall the feelings of utter terror :D It did all get better, I got better at handling it too got tough as anything, but I do massively feel for my more junior colleagues.

Ime Consultants get paid well. I’m not there yet but it’s not just the base rate, it’s the private work, legal work, locums etc. Most of them earn plenty in my (unpopular on medtwitter) opinion.
 
Notes from Below are doing a school bulletin thing:
notesfrombelow.org

A Bulletin for School Workers

by Notes from Below // In this article, we launch a new initiative of a rank-and-file bulletin for school workers.
notesfrombelow.org notesfrombelow.org

Also not a fan of the RCN calling their action off, but looking at the timing, would it be fair to say that whatever the government's offered to get them to do it is already a sign of the BMA mandate having an effect?
 
Edie said:
Was in the 2% who voted No. For me this is a complicated issue. I do support pay restoration for jnrdrs but I believe Consultants are well paid. I don’t believe IA is the correct way of achieving pay restoration, as the risk:benefit ratio is off. Achieving significant pay rise- unlikely: risk of significant harm to patients from increased wait times- guaranteed. Speaking for my tiny corner of the service, there isn’t capacity to absorb IA without direct patient harm. Not emergency care- the Consultants will step down to doing junior work however long it takes them to write a discharge or do all their own cannulas or bloods. But wait lists, on top of covid backlog, on top of pre-existing backlog- disaster.

IA won’t save the NHS. I naively thought that when I went out in 2015/16. Political will is required and it’s not there- people keep voting for the Tories.

Jnrdrs are utterly shat on and hate their employer (the NHS). Me included. It’s profoundly dysfunctional and abusive system. I regularly work 72 hour plus weeks mixing standard working day and NROC shifts. And I get arm twisted into doing do with shady practices like signing out of EWTD, rota coordinators calling my personal phone OOA to ask me, I work hours overtime unpaid, regularly too busy for lunch, pay shit loads for exams. I’m in charge of the crash bleep, I lead medical emergencies, and I’m in charge of the hospital at night. I get £28 an hour. I’m ten years out of Med school and 15 years into my training. I could earn double elsewhere, tho I don’t much care about that.

I can see the argument that without pay restoration and pay rises for all HCPs the NHS is doomed. People- jnrdrs included- are just fucking off and the understaffing is compounding how incredibly stressful frontline work is. We all now watch patients suffering and dying because the nhs is failing.

But will walking out for 72 hours and not providing emergency cover solve this. It will not. It will expedite the end. Maybe this is a good thing? The end needs to come? I don’t know anymore. I just know it’s totally broken, and it needs to be completely rebuilt or radically changed.

I no longer know the answers. I just work as hard and fast and long as I can whilst protecting myself.

So no joy here about IA. No excitement. Just a kind of grim inevitability.
Click to expand...
I know from my connections that in the UK locum doctors are well paid - much better paid than permanently employed doctors. Definitely think that perma doctors should be paid more!

BTW why do you work unpaid overtime? Do you not fill in the timesheet?
 
DebaterFan said:
I know from my connections that in the UK locum doctors are well paid - much better paid than permanently employed doctors. Definitely think that perma doctors should be paid more!

BTW why do you work unpaid overtime? Do you not fill in the timesheet?
Click to expand...
There’s no timesheets, just a rota. Sometimes you can handover, sometimes there’s understaffed on call rota and/or poorly patients and/or just jobs thatd be rude to handover. If your ward rounds gone on so long that you’ve not had time to review or do jobs on your outliers that’s not the business of the on call team.
 
Edie said:
There’s no timesheets, just a rota. Sometimes you can handover, sometimes there’s understaffed on call rota and/or poorly patients and/or just jobs thatd be rude to handover. If your ward rounds gone on so long that you’ve not had time to review or do jobs on your outliers that’s not the business of the on call team.
Click to expand...
Have you tried speaking to your work colleagues, tried to agreed to sign some sort of petition together, agreed to email complaints to your boss about lack of overtime pay etc etc?
 
DebaterFan said:
Have you tried speaking to your work colleagues, tried to agreed to sign some sort of petition together, agreed to email complaints to your boss about lack of overtime pay etc etc?
Click to expand...
I don’t think you understand the NHS. This is completely standard for all HCPs not just junior docs and there’s nothing you can do. Hence the strikes for better pay, leading to better staffed rotas, leading to improved staff retention, leading to better less stressed working conditions. That’s the theory anyway.
 
DebaterFan said:
I know from my connections that in the UK locum doctors are well paid - much better paid than permanently employed doctors. Definitely think that perma doctors should be paid more!

BTW why do you work unpaid overtime? Do you not fill in the timesheet?
Click to expand...

Some of it is the same as self-employed work generally though, the initial hourly rate still needs tax, NI, holiday, CPD costs, registration fees, etc. all making the actual wage you get much lower than it seems at first, plus with no security and holiday pay etc.

Lol at timesheets. What Edie says about NHS work, its standard this stuff. Problematic and part of the poor conditions, but some is also unavoidable and comes with the type of work.
 
LDC said:
Some of it is the same as self-employed work generally though, the initial hourly rate still needs tax, NI, holiday, CPD costs, registration fees, etc. all making the actual wage you get much lower than it seems at first, plus with no security and holiday pay etc.

Lol at timesheets. What Edie says about NHS work, its standard this stuff. Problematic and part of the poor conditions, but some is also unavoidable and comes with the type of work.
Click to expand...
I always believed it’s the law that if you are on a low enough wage employers have to pay overtime to avoid the wage falling below minimum wage. But many just don’t bother to enforce it with employers for fear of retaliation - direct or not. Also the stress that comes with proving it etc etc . I wonder if this was ever challenged at an employment tribunal
 
And from what i’ve read until these strikes occurred, everyone just assumed doctors get paid a lot!! They don’t!!! But locums.

In the USA, they do. yes. But here? NOOOO!!!!!!
 
DebaterFan said:
And from what i’ve read until these strikes occurred, everyone just assumed doctors get paid a lot!! They don’t!!! But locums.

In the USA, they do. yes. But here? NOOOO!!!!!!
Click to expand...
US residents get paid fuck all until they’re attendings. But US medical postgraduate training is shorter (they have to do undergrad then medicine as a postgrad degree tho and come out with insane debt). But they don’t then have as many years til Consultant/Attending. Attending physicians and surgeons get paid incredible amounts- far more than UK Consultants (and Consultants in RoI and EU and Aus get much more than UK Consultants. The brain drain is real esp of Junior Doctors.

We in turn then recruit IMGs, treat them like shit with service provision jobs, a good dose of systemic racism making it difficult for them to get training numbers (which you need to progress to Consultant).

That said I think we should have a lot more protectionism for British medic graduates (NOT white British, just British medical graduates) like they do everywhere in the world. But be upfront about this with IMGs about what the gig is.

There’s a massive bottle neck for juniors progressing getting specialty training numbers. Lots of capable juniors getting stuck in service provision post Foundation (the first two years post Med school) cos they can’t get a number- and surgical training and medical specialties and psych all fighting for training numbers. Not enough existing Consultants to train us despite desperate shortfall of senior registrars (my level) and Consultant posts empty.

The whole medical profession is a fucking car crash of poor workforce planning.

Ironically doctors will achieve pay restoration and then some once the NHS is fully privatised. Despite this, most emphatically support the NHS. But the anger over the shitshow and watching our patients suffer is real. It’s so frustrating.
 
moochedit said:
Amazon strike in coventry today....

www.coventrytelegraph.net

Striking Cov Amazon staff try to deter colleagues from going to work

GMB union workers are on strike outside the Amazon fulfilment centre in Coventry
www.coventrytelegraph.net www.coventrytelegraph.net
Click to expand...

Amazon coventry striking again today. I normally drive past amazon on my way to work and there were massive traffic jams as i approached the road they are on. Had to turn round in the end and find a different way to work. (i don't work for amazon).

www.theguardian.com

Amazon workers in Coventry to go on strike for seven more days

More than 310 staff to take part in stoppages after becoming first UK employees of online retailer to strike
www.theguardian.com www.theguardian.com
 
UCU announce a return to strike action, with an additional day of strikes (Wednesday March 15), so strikes on 15-17th March and 20-22nd March. This is despite Jo Grady assuring us that 'progress has been made'. Perhaps more progress would have been made if she hadn't postponed the strikes at a crucial time in the negotiations?

Obviously I hope, despite all evidence to date, she is playing a blinder and a brilliant outcome will result from her 'strategy'.
 
Looks like the whole of the BBC footie commentators, pundits etc are on "strike" today in solidarity with monsieur Lineker. Lots of programmes pulled and R5 live titally off air .
 
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