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Do you support or oppose junior doctors in all-out strike?

Today is the first day ever that a Junior Doctor’s strike will effect cover in Hospital Accident and Emergency departments across the country.

Jeremy Hunt and senior ministers have insisted they must win the battle with junior doctors, who are staging a historic walkout that will disrupt services including maternity and intensive care in addition to accident and emergency.

The health secretary dashed any lingering hopes of a last-minute compromise when he told MPs that he was determined to impose the unpopular new contract to help turn the NHS into a seven-day service.

A very large majority of junior doctors are likely to strike, with only a tiny number expected to defy the picket lines, although the exact figures will be closely scrutinised.

NHS bosses believe plans are in place to ensure care will be safe, but say the situation will be monitored closely during the stoppage.

Further all-out strike action is due to take place on Wednesday as well.

When we asked the question back in November 2015 “Would you support Junior Doctors if they go on strike?”  62% of our Silversurfers voted ‘YES’ in support of the Junior Doctors.

5 months down the line, and this is the fifth strike to have taken place, how do you feel about this? Who do you blame?  Is it the Government who won’t compromise or the Junior Doctors who are being unreasonable or are they both to blame?

Do you support or oppose junior doctors in all-out strike?

540 people have already voted, what's your opinion? Support Oppose

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Capricorn
9th Aug 2016
0
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One of my many jobs was working P/Time as a receptionist in various clinics.

1. Hunt was chosen because Cameron valued his Business acumen. ......BIG MISTAKE!!!! He had no experience about how the NHS is run.

2. The NHS is a sprawling mass out of control and should be administered by someone at the head who knows how it is run.

3. Don't blame Young Doctors for striking, they work long hours because they care for the Patients so why shouldn't they protest.

4. Doctors in Practice are too generous with the most expensive
prescription items, cheaper items are just as good.

5. Young girls and boys are given free contraceptives , the boys
blow theirs up like balloons and the young girls don't take them because they know if they get pregnant they only need a letter from their Mother saying they can't cope with a baby in the house and the girl would have a 2 bedroom House , rent paid, family allowance, , unemployment benefit etc.

I could go on , but those at the top of the NHS are not fit for purpose , Hunt should be given a golden handshake and someone from the DHSS take over .

Rant over LOL
Riversiderouge
4th May 2016
1
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“And it ought to be remembered that there is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things.”

– Niccolo Machiavelli (1469 – 1527), The Prince, Chapter 4

Nothing stays the same, and it's my view that if the junior doctors value the NHS as we all do, and want it to survive in its present unique state, then they should think again about what they are doing. Junior doctors will eventually earn more than any of us could dream of, and more and more G.P's are retiring very early because of a pension ceiling and the tax implications. I have no problem with what they earn, but I do believe that they are losing a lot of respect by resisting important changes in their workplace as the rest of us did years ago,and suggesting that the elected government are implementing these contract changes to the detriment of patients.
jeanmark
5th May 2016
2
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Unfortunately Riversiderouge, they are changing the contracts to the detriment of patients. The new contract will put patient safety at risk and that is what their concern is.

Qouting Machiavelli is probably a good way of looking at the proposal when considering the term Machiavellianism. This is defined as "the employment of cunning and duplicity in statecraft or in general conduct". As you are aware the word comes from the Italian Renaissance diplomat and writer Niccolò Machiavelli. Jeremy Hunt is not "taking the lead in the introduction of a new order of things", indeed it appears he is trying to change the 'unique state' of the NHS by taking a backwood step. If you have the time please read my comment on the actual reality of what is being proposed. This is not about pay.
Riversiderouge
5th May 2016
0
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I respect your point of view jeanmark, but despite being a simple man I am intelligent enough (I think) to understand the difference between fact and propaganda. I hold the view that the NHS has a long way to go if it is to save itself. The service in my part of the world ranges from the absolutely brilliant to the very worst imaginable.

I have no time for politicians. However I do believe in democracy. This current bunch of politicians have been given the responsibility to set about making the NHS work in todays world, because we can't live in yesterdays world.
Riversiderouge
6th May 2016
2
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Yes but he surely has to start somewhere. The Tories cannot introduce a 7 day service if NHS employees will not cooperate.
jeanmark
6th May 2016
0
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Sorry Riversiderouge it isn't about them cooperating but about not having the capacity to provide a 7 day service. Why only make changes in England, the NHS is just that a national service. I tried to write an explanation about the issues on this page 27 April, if you have the time to read that, maybe it will help explain what is being proposed and that is not propaganda but fact. I agree changes need to be made but there is a big cost implication which the government are not willing to address.
jeanmark
6th May 2016
0
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I don't disagree with your sentiment Riversiderouge but imposing a change is not democratic (I accept that Jeremy Hunt is having a rethink). I am sorry the service you receive is not always the best but I can assure you the NHS does not live in yesterdays world. I started working in the NHS in 1965 and it changed dramatically from then to when I retired in 2014 including public perception on what was achievable.

The current Health Minister has been given the responsibility of making the NHS work in todays world and most of us would not disagree that change is necessary to meet patient need. However, Jeremy Hunt has not informed the public on how he intends to honour the Tory manifesto for the NHS to provide a 24 hour, 7 days a week, 52 weeks a year complete service (rather than emergency service only) without additional resources that would require more than doctors. Lets not forget the changes to doctors contracts he is imposing only applies to England, there are no changes in Scotland, Wales and Northern Ireland. What effect does that have on the NHS?
Lionel
28th Apr 2016
2
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Allow me to say first, Jeanmark, and the very many like her, deserve a round of applause and much gratitude from us all. She and her colleagues have devoted a working lifetime to other's healthcare, often to their own cost.

It follows then, Jeanmark provides us all with a large amount of insight into this matter of junior doctors and the state's demands upon them. Insight also into the inner workings of the NHS. Thank you. We should all pay attention to her in these matters, if not always agree.

Yet, I can't help wondering two things.

First, is this dispute a matter we ordinary folk, people dependent on the NHS, should have an opinion about? With the exception of those on the front line of the NHS, few, if any, of us know what we're talking about! It is the state which has made this a political football; the state which is attempting to sway public opinion against the junior doctors (it was the nurses not so long ago). The state demonises everyone who dares to disagree with it! Tell me I'm wrong.

The second point which bothers me is ... the NHS, is it a political matter? Is it something which should be controlled from Whitehall and made an election issue? Should the NHS be a political football? Should the state determine who may live and who may not, in terms of the Liverpool Care Pathway?

The NHS, and it's dedicated staff, all have a very special place in all our hearts. It does the impossible, care from cradle to grave. Can not this, the finest of British institutions, be separated from the state, given a special status and funding.

How many of us here, if, over the years, were asked to pay a little more towards maintaining the NHS, would decline? I would not! If you would, be ashamed!

The NHS is nothing without it's devoted people like Jeanmark. We all believe we deserve our pay cheques and probably less for more working conditions. So do the NHS staff, and we should be pleased to pay.

For a very long time I was in a similar occupation - farming, as a farm worker. We were among the lowest paid people in this nation and yet a greater range of skills was demanded of us than anyone except doctors and nurses, I think. It wasn't a career, it was a vocation, to the land, to livestock and to the rich agricultural heritage passed down to us. The great British public, egged on by governments, demanded cheap food. We subsidised your cheap food with a very low rate of pay and so many working hours unpaid. A little like NHS frontline staff!

Allow me also to state, I do not know Jeanmark; our lives have touched briefly on Silver Surfers. That's all. But, for what she and countless others have spent their lives doing, some of it for my benefit, I salute you.

Take the NHS out of the political arena and give the junior doctors a better deal. That's my stance.
Munsterlander
29th Apr 2016
5
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Great comments here Lionel and I think the main one is that health is our most important concern for all of us. If we are very will we would all pay anything to be healthy. Same regarding food. We are too complacent in the wealthy west about our food. If we didn't have it we would pay anything to get it
Lionel
29th Apr 2016
3
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Hello Munsterlander, and thanks for your reply. Is that Munster in Ireland? Worked in Ireland, farming, for a couple of years. Dairy.

Food is desperately important to us. More important, the quality of the food we eat. We in the wealthy West have indeed become very complacent about what we eat. And that, I contend, is one of the reasons for so much sickness among us.

We have lost the link between good nutrition and health. Here, I'm writing as a long time farm worker who still grows as much of his own food as he can.

I'd be delighted if Jeanmark would come in here too.

Food, nutrition and health are inextricably linked. Put in the simplest possible way, poor food = poor long term health and thus even greater demands upon an over stretched NHS. One diet nut wrote some time ago, we are what we eat. She said that for the wrong reasons, but essentially she's right. Stretching a point, we are responsible for ourselves in the first instance.

To abuse our bodies with processed food, takeaways or whatever is sold on the high street, will land us in hospital sooner or later. I don't think anyone would disagree with that.

As a kid in a Norfolk hamlet a doctor visited our pub once a fortnight, held surgery there. If is was something personal a curtain would be drawn. He didn't prescribe endless pills and potions. No, he'd more likely tell us to eat this, or that ... foods and plants readily available to us. That was in the days when elderly people, as I am now, wouldn't see him; they believed there was still a charge. The cottage hospital, four miles away was a place of last resort.

In 2006 I went to my home village after half a century away. Had a beer in the pub. It was amazing the number of men and women, many over ninety, who were there enjoying a pint or a game of darts! Healthy, vigorous people I known as a kid. Why? How?

They ate garden food, kept off a lot of the pills and followed a strong self help regime, as I do.

The more we put processed food down our necks the more sick we'll all become and thereby more dependent on the NHS. It's my belief we could do so much more for ourselves but we don't We prefer a pill and a kind word from a person who's spent seven years training to diagnose, prescribe and move on.

This Health Service is the best in the world! It's failing because too many people don't take responsibility for themselves, as we used to!
Munsterlander
29th Apr 2016
1
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I agree Lionel-if we all eat much more natural food , did not drink and smoke we would all be a lot more healthy. And probably live longer as you suggest. Just look at some Italians on Mediterranean diets they seem to have a longer lifespan
jeanmark
28th Apr 2016
2
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Thank you for your comments and I agree wholeheartedly that the NHS should be taken out of the political arena. Alas, that will never happen as in all public services such as education, police and other emergency services it is the only thing governments can control financially and use as political footballs when seeking election.
Lionel
29th Apr 2016
2
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Thank you Jeanmark. Although I've never been in the NHS that doesn't mean to say there's no understanding with me, no empathy. The NHS should never be a political football. We must be prepared to pay what it takes for people like your good self to deliver the health care we look to.

The NHS, Police and education are three areas where budgets are irrelevant. We must be willing to pay for the service we expect. The service we need.
HEAPUS
28th Apr 2016
-1
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I bow to superior intellects .
janetburgoyne
28th Apr 2016
2
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We can't manage without junior doctors,and junior doctors can't manage without proper sleep and rest.They can't perform their duties if they are tired and that is when mistakes happen.
I am all for these doctors striking,what would we do without them,the NHS is on its knees at the moment what would happen if they went abroad,it doesn't bear thinking about.
HEAPUS
28th Apr 2016
1
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It would appear that the people in favour of the strike are complete angels and anybody disagreeing is just misguided and heartless ,this is the same in the" In- Out " forum where the condescension of the Remain camp is nauseating . I don't have time unfortunately to submit a novel (Jeanmark N.B.) , have to work
Wilf
28th Apr 2016
2
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Sorry I don't agree with you Heapus. the beauty of the UK is we have democracy and we all have opinions that's what makes this GREAT Britain! I agree with the strike just because I don't like the UK government dictating anything. We are a free nation and doctors should be negotiated with not dictated to.
lindz64
30th Apr 2016
0
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jeanmark
28th Apr 2016
0
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What an odd thing to say about people expressing an opinion that differs from yours. I don't think anyone supporting the junior doctors consider themselves angels and neither would they suggest anybody disagreeing are heartless and misguided - misinformed maybe. Incidentally, I didn't write a novel (that would have been much longer) just tried to explain what the issue was and the length of this demonstrated the complexities of the issue.
issy1234
28th Apr 2016
2
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I don't agree with the dr's strike as my late husband was a doctor for about 50 years he worked all hours as a GP it should be remembered he was once a juniour doctor and worked even harder back then and for less, his patients always came first, and he had me his wife at home to help him as the surgery was at home and he was in singled handed practise.
Junior Doctor's have to rely a lot on the nursing staff for a lot, just being a Dr is more the a job it's a life and we had 6 children so it wasnt easy at times but the children didnt get sent to boarding school and didnt miss out. I miss him so much today would have been his birthday and I would have cooked him his favorite meal keeping it warm if he got called out in the middle of it, nobody was turned away.
Munsterlander
29th Apr 2016
1
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I agree doctors work very hard I just think they should do say 4-50 hour week max like most people. They need to relax and nobody is at their best if they are over tired
nannyp
27th Apr 2016
1
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The doctors will only get public support for so long, if people die because of the strike people will turn against them.
jeanmark
28th Apr 2016
1
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I don't disagree with that comment as no one holds the government to account but always demand a scapegoat!
lindz64
28th Apr 2016
8
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If there is a tragedy during the Junior Doctor's strike, the blame lays fairly and squarely with this wretched government. Doesn't it say anything that the doctor's are striking for the first time EVER? In my opinion, Cameron knew that this would happen in his quest to crush the NHS, leaving the way open for his rich pals to line their already over stuffed pockets when tenders are put out, it's called privatisation. The difference between Junior Doctors and this so-called government is that the doctors CARE!
jeanmark
28th Apr 2016
1
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fanny71
27th Apr 2016
5
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Strike action doesn't get anyone anywhere in real terms. I do feel the Junior Doctors are now being used as pawns. It is becoming a case of who blinks but the Government would be unwilling to do this as other Unions are watching the situation very carefully.
latin
27th Apr 2016
4
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This is a case of Unions versus a govenment!
Dr Grumpy
28th Apr 2016
0
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and? Isn't this the case in any dispute about pay & conditions or the imposition of a new contract?
Munsterlander
29th Apr 2016
2
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I think this is now about Jeremy Hunt being a bully
4
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they have been given a 13.5% pay rise and will not have to work every weekend but on a rota basis, it cost thousands to train them and tax payers are funding them, recently a class of trainees were asked how many of them would be seeking positions outside of England and nearly 70% said they would ,why should we train them to go elsewhere.
jeanmark
28th Apr 2016
0
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Maybe they had decided to work in Scotland, Wales or N Ireland who are not making changes although its the same NHS.
Dr Grumpy
28th Apr 2016
5
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13.5% pay rise? Where? That is the case now that not every Dr is on duty at weekends but they are all on rotas including consultants. This is about NHS England trying to run an ELECTIVE NHS 7 days a week since NHS has always had a 24/7 emergency service but using only the current number of Drs in post It follows that if you factor in annual leave and study leave who is going to cover for the absent Drs on the rota? It will mean many Drs working long hours for 12 to 14 days without a break Even airline pilots are prohibited from working these hours and they may be against EWTD and hence illegal.
Please note that we need support services like imaging pathology portering physiotherapy to run a 7 day service and these aren't being uprated at the moment so how will it work is beyond me Also this doesnt apply to Wales Scotland and N Ireland
Wilf
27th Apr 2016
2
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I agree its madness they should be incentivised to stay and work on the NHS in the UK
jeanmark
28th Apr 2016
1
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The change to contracts relates to England only not the UK as a whole.
lindz64
28th Apr 2016
6
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The only incentive they want is to remove this contract. They're not striking for more money, they are striking because most of the time they're exhausted! It's on this government's agenda to run down the NHS... why else would Cameron refuse requests for him to step-in, he IS the PM after all. I'm sickened in more ways than one when I see what is happening to our once lovely country (and I don't know any Junior Doctor's in case anyone is wondering).
123Siobhan
27th Apr 2016
6
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Junior Doctors are now expected to treat patients who just a few years ago would have been treated in intensive care or high dependency. Many of these patients have multiple medical issues all of which have to be treated. The knowledge these young people are expected to have is absolutely phenominal and would normally have been what the consultant had. The hours they work and the shear number of patients they are treating is far to much. This gov't is out to destroy the NHS as we know it. Good luck to the Drs.
lindz64
28th Apr 2016
3
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Well said 123Siobhan, I couldn't agree more
latin
27th Apr 2016
5
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I think it's the volume of people the NHS is treating that is breaking the NHS (and yes that's is down to the Govenments open door policy and stupidly enticing people here with benefits housing and free health care all pId for with our tax money)
The volume of people flooding in is breaking all our infrastructures.
Housing shortages ,GP sugerys full to breaking,schools at breaking point,roads pot holed up with sheer volume of traffic ,police stretched to breaking,prisons full to breaking.
Hospital waiting times being extended at hospitals and more and more tax money needed to keep funding every new person that comes through their door plus massive bills for interpreters . Hospitals cannot continue to treat the WHOLE world at yours and my expense and the govenment must close the doors to our country and send people back to country of origin and then start to deal with the rest of the migrants that should not have been allowed in given all the same rights as us with no questions asked .
If it's not stopped at source -you will lose everything you take for granted such as your NHS .What other country would be so stupid as to allow a free from all paid by us/them ,we are all suckers!
Spain makes you pay first along with other EU country's ,we fail badly on collecting the money!
Also if you think for one minute that Labour or anyone else will do better you are wrong as its New Labour that has flooded our country.It was Blair who sighned everything away and joined the Human Right act so that we have to keep every criminal and can't send anyone back!
lindz64
30th Apr 2016
0
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You're so right Latin, particularly about Blair. He colluded with Bush about the non-existent WMD's, sent our lads to war, for what? To get a name for himself? And THEN, he was given the Peace Prize, fgs!! I don't know why he's still breathing our air... sorry, I digress from the main point. More power to the Junior Doctor's collective elbows, we all need them, we don't need this bullying Tory government
willy57
30th Apr 2016
1
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I agree with u whole heartedly well said
jeanmark
28th Apr 2016
-2
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Latin, I agree with your first statement 'it's the volume of people the NHS is treating that is breaking the NHS' but this is not caused by immigrants but by advances in medicine.
lindz64
30th Apr 2016
0
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I agree with Latin on this one jean, you can't have hundreds of thousands of extra people descending on any one country and say that it doesn't make a difference. It makes a big difference to our NHS, schools, housing, services. I read recently that a house needs to be built every seven minutes just to house the immigrants... no mention of our people who have been on the 'housing list' for years. Yes, it makes a massive difference
Wilf
28th Apr 2016
2
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Yes I do agree jeanmark. Its because we are all staying so much older. i have an aunt who has been in c are for ages and she is 96!
latin
28th Apr 2016
1
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No I do not agree ,people are not flooding in from all over the world for the our advances in medicine!
Open borders,Cameron Blair Unions etc encouraging the flooding of our nation,how many more people can our infrastructures cater for and who is going to pay?You ?
This is why other nations don't do it and charge and collect at point of use otherwise they could not continue!
We are the fools .
fanny71
27th Apr 2016
5
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I couldn't agree more. Well said. It's not just Spain/EU that demand payment up front with either your E111 card or insurance for anywhere else in the world. All patients at hospitals, GP surgeries, minor injuries clinics should show some sort of ID and be checked. Some people are fortunate in this country that don't live with the results of this mass influx of people but a lot of us do and the strain is beginning tell.
lindz64
28th Apr 2016
3
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My heart breaks for those living with the 'mass influx' but it will be most of the country before very long, apart from Gloucester where Cameron and his buddy/neighbour Jeremy Clarkson live
mariangrove
27th Apr 2016
4
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When they refused to provide emergency cover they lost my support. You cannot put people's lives at risk. "First do no harm"
Lynne1954
27th Apr 2016
2
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Thank you for your clear explanation of the Issues. I totally support the Doctors and am concerned about the implications for those who are also parents. I was a teacher, I often had to work long hours planning and marking but I did a lot of it sat at my own kitchen table. I wouldn't have been able to do a job I loved if I'd had to stay at school every night until 10 pm. Who would have looked after my 3 children?
123Siobhan
27th Apr 2016
5
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it was the best time to be taken ill. Emergency cover was provided by registrars and consultants, most of whom support the junior doctors.
Dr Grumpy
28th Apr 2016
1
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Registrars are junior doctors so many would have been on the picket line
jeanmark
28th Apr 2016
2
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Not registrars, they fall into the 'junior doctor' category
jeanmark
27th Apr 2016
2
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But emergency cover was given, just not by junior doctors. Surely it was Mr Hunt putting peoples lives at risk?
lindz64
28th Apr 2016
0
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Yes indeed it was jeanmark, I don't know how he sleeps at night. Just devoid of conscience
latin
28th Apr 2016
-1
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He sleeps as well as the Unions do.
Remember the debacle Unions caused by sending much of your/mine union subs directly to the Labour party to keep it afloat without asking the members if they agreed/wanted their sub money going to a political party.
Well this is why its about a fight by Unions versus Torys.
If Labour were in power the Unions would be in charge and there would not be a strike . The Unions would have our tax money to throw around as they pleased .
Its lets bring down the Torys with Unions!
Also too many migrants sucking the life blood out of all infrastructures.
We were not and are not and cannot afford or cater for the whole world !
jeanmark
28th Apr 2016
2
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This is a section taken from my comment below

'When a strike ballot (of, let’s face it, intelligent reasonable and educated people) has a 75% turnout and 98% vote in favour, it is clear that there is a serious problem with the DH’s thought processes and they need to listen. It is highly improbable that a small bunch of radical lefties have brainwashed 50000 intelligent doctors who have been trained to analyse information and draw conclusions, much as the press like that idea'.

You obviously didn't feel the need to try and understand what the real issue is because it is not about union versus Tory.
jeanmark
27th Apr 2016
1
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How sad that some people on this site have no understanding of the true issue relating to junior doctors. The following, though long, gives some insight into the issue from a 'junior' doctors perspective and who has asked for this to be shared. I sincerely hope those supporting Mr Hunt will take the time to read it to the end.

I have kept quiet until now about the junior doctor's strike but the time has come to stand up and say what needs to be said. Apologies in advance for the long essay, I will try to keep it simple. This is aimed at those of you who are not medical; those who are will know exactly what I am talking about.

If you simply believe what is said in the media, you might think that this is all about Saturday pay or even that junior doctors don't want to work at nights or weekends. It is depressing to overhear people express these views but hardly surprising given the public coverage of the issue.

So what exactly is going on? A junior doctor is any doctor who is not a GP or consultant who is in training to be one of those two. Most doctors spend 8-9 years as a junior but many stay as juniors for longer, especially female doctors who may take time out for families, academics who take time out to do research and doctors in specialities where training in two specialties is needed such as paediatric intensive care. I myself spent 14 years as a junior doctor so was still one aged 37. Junior doctors are the doctors you will see first when you go to A&E or get admitted to a ward and will be responsible for delivering your day to day care when you are in hospital. Junior doctors are covering the hospital 24/7, 365 days a year and always have done. And contrary to what you might believe from the papers, they don't have any choice in the matter, their contracts say they have no choice in working evenings, nights and weekends.

So what is all the fuss about? Well it is about being able to be safe. When I was a JD, I used to work ridiculous hours. In one job in my 1st year, every 3rd weekend I would go to work at 9am on a Saturday and leave at 5pm on a Tuesday. That was 80 hours in a row with sleep grabbed when the chances arose. It was dangerous and dehumanising and the even crazier thing was that I was actually paid at a lower rate for the unsocial hours than basic pay (1/3 of basic in fact).

Fortunately my generation of juniors was amongst the last to have to do that and things slowly changed. Now junior doctors get paid at a higher rate than basic for unsocial hours, that rate determined by the intensity of work in that specialty e.g. emergency room work would be a higher rate than dermatology. Standard hours are defined as 7am-7pm Monday to Friday (which are not exactly standard working hours for most people) and there are rules on the maximum number of hours per week and consecutive hours that can be worked. There are also safeguards in place so that if employers are consistently making juniors work beyond these rules, they can be fined; hence there is a disincentive for employers to overwork junior doctors, therefore they are not tired and dangerous 1990-style.

But work done outside standard hours is NOT overtime. These hours are contracted hours and have to be worked and, quite rightly, are paid at a higher rate than basic pay. In specialties where there is not a lot of emergency work, the majority of work is in routine hours, but areas like A&E, paediatrics, intensive care have a lot of work done in unsocial hours and attract a higher rate of pay for those hours. I stress again that this is not overtime; overtime is work done in addition to contracted hours. All doctors and nurses do overtime - staying late to complete work and ensure patient safety and very rarely if ever does anyone claim for these overtime hours.

But Jeremy Hunt wants to change the contract for junior doctors, his logic being that doing this will help to deliver the “7-day NHS”. Nobody is really sure what exactly this means. It may mean that he wants routine services such as outpatient clinics and planned surgery or scans for non-urgent problems to take place on Saturdays and Sundays, not just Monday to Friday. If this is the case then changing the juniors’ contract is not going to make this happen as without doing the same for (deep breath) consultants, nurses, porters, receptionists, pharmacists, operating department assistants, radiographers, physiotherapists and many other staff these things won’t be able to happen at weekends.

The 7-day NHS may refer to emergency work. If this is the case then it already exists. Junior doctors are already there at night and at weekends. The proposed contract changes are not going to change the numbers who are there as there is no plan to increase the total number of junior doctors. What is proposed is that the definition of normal time changes from 7am-7pm to 7am-10pm Monday to Friday and from 7am to somewhere between 5pm and 10pm on Saturday. This means that employers could make junior doctors work more unsocial hours as they have redefined as standard hours. It is true that the basic rate of pay for standard hours will be increased by 13%, which sounds great doesn’t it? Except that for the emergency specialties as above that routinely have a lot of evening, night and weekend work, what is currently paid at an enhanced rate will be paid at standard rate; even at 13% higher for standard rate, total pay for junior doctors in these specialties will drop considerably, maybe by as much 30% for some. Doesn’t sound so good now really.

And, of course, there will be the same number of doctors but spread over 7 days rather than 5 so there will be weekdays where there will be fewer juniors than there are now. A great analogy I heard was to imagine that you have a 10-inch pizza cut into 5 slices. You decide that 5 slices isn’t going to fill you up so your mum cuts the same pizza into 7 slices and tells you that you’ll be full with that. But she won’t get you a bigger pizza.

So same number of junior doctors spread more thinly is going to reduce cover on weekdays as compared to now. And weekdays are when not only emergency work but also routine planned work that also needs input from junior doctors takes place so this will have a detrimental effect on waiting lists for clinics and operations as well.

Junior doctors with children will be hit particularly hard, especially those who have junior doctors spouses, as more unsocial hours will be worked. Childcare is generally difficult to get hold of outside of 8-5 on weekdays; the department of health have actually said (with no hint of irony) that in this situation, family members who are non-medical and don’t work evenings or weekends should be asked to provide child care to get over this problem! It is very likely that couples could go several days without actually seeing each other or their families if rotas do not coincide.

But what about the increased deaths at weekends we have been hearing about? Actually, the statistics have been completely misrepresented and even the authors of the research paper that gets quoted regularly have pointed this out. The statistic was that if you are admitted to hospital on a weekend, your risk of dying within 30 days of that admission was higher than if admitted midweek. Your risk of dying is very low anyway and that very low risk is marginally higher (but still very low) if admitted on weekends. This is probably because admissions to hospital in the week consist of not only sick people but also well people coming in for routine things, whereas at weekends you would tend to avoid hospital unless you were desperately unwell and most likely would leave things as long as possible and so be sicker when you got there. Interestingly they also showed that if you were already in hospital on a weekend, having been admitted in the week, your risk of death within 30 days was lower than it would have been. Either way, there is no evidence of cause and effect in terms of numbers of junior doctors around at weekends. The so-called weekend effect has also been seen in the USA and Australia too so it isn’t peculiar to state-funded health as opposed to private insurance-based systems.

Interestingly the misrepresentation of this study has led to ill people actually avoiding hospitals on weekends and delaying presenting till Monday with potentially devastating consequences. Have a look online for the ‪#‎hunteffect‬. Scary.

Another worrying thing about the proposed new contract is that it takes away the safeguards against juniors being made to work ridiculously long hours. Whereas currently there is a mechanism that makes it in the interests of an employer to ensure the hours are not exceeded, the new contract removes these safeguards. It does suggest that each hospital trust has a “guardian” to whom junior doctors can flag up concerns about their hours but this “guardian” will also be a senior member of the trust who has no obligation to actually do anything about these concerns. I think back to my days as an exhausted junior doctor and it scares me to think that such unsafe and dangerous hours could make a return.

The pay scales are also changing. There has been automatic pay progression as you gain experience and seniority until now. The new system means that there are fewer points where pay is raised. This is not necessarily a bad thing as it can be argued that you shouldn’t get a pay rise unless you deserve it. But remember that over 10 years can be spent as a junior doctor in which time you are likely to acquire husbands, wives, children and mortgages; many existing junior doctors have made their financial plans for the next few years based on the expectation that there will be pay progression. One part-time junior doctor who has worked with me told me that if the new contract came in she would no longer be able to pay her mortgage and would have to sell her home. Bear in mind that these are young people who have spent at least 5 years at university accruing debts from both student loans for living expenses and now also £45000 in tuition fees before even starting work. The new pay scales do not reflect the levels of responsibility taken by junior doctors at different stages of their training at all which makes no sense whatsoever. For female doctors who are likely to take time out to have children and then return to work part-time, the consequences on their income will be huge. The department of health actually acknowledged that women would be hit unfairly but suggested that this had to be accepted as an unfortunate consequence.

The BMA junior doctors committee walked out of talks with the department of health because the DH’s definition of negotiation was that they would reserve the right to do what they wanted if they didn’t agree with what the committee was suggested. In other words, they did not want to negotiate so there was not point in the BMA trying. This is why industrial action was proposed because there was no other way to try to get Jeremy Hunt to talk. Sadly, even when negotiations restarted, he could not see that without a bigger pizza nothing was going to improve patient care and in fact things would be worse and so talks stopped. He has now said he is imposing the contract and that is that, he won’t talk anymore. When a strike ballot (of, let’s face it, intelligent reasonable and educated people) has a 75% turnout and 98% vote in favour, it is clear that there is a serious problem with the DH’s thought processes and they need to listen. It is highly improbable that a small bunch of radical lefties have brainwashed 50000 intelligent doctors who have been trained to analyse information and draw conclusions, much as the press like that idea.

If you have read this far, please take it on board and share with your friends. I’ve tried to keep it simple (even though it may not seem that way!) The public is not getting the full story from the TV and newspapers and if this contract is imposed then we will all be on the receiving end of the consequences eventually.
lindz64
28th Apr 2016
2
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Bravo, thank you for that, I'm going to print it off and show it to anyone who DARE tell me that it's the Junior Doctor's fault. Thanks again
123Siobhan
27th Apr 2016
5
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Good for you thank you for this information it puts it all in perspective
scandiman
27th Apr 2016
3
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Jean mark, thank you for your report. I was a police officer for thirty years. At regular intervals we were subject to tinkering by politicians, determined to get more for less money. Morale was at rock bottom, depression was rife and recruitment stagnated. In the doctors' case, it appears that Hunt is being nothing less than a bully. Yet another politician who refuses to listen. Good luck to the doctors I say. Enough is enough.
latin
28th Apr 2016
2
Thanks for voting!
If only it was that simple.
What the Unions or Hunt want will solve nothing as its what is happening to all our infrastructures through mass migration that is bringing the whole house of cards down .
The pressure is building in every infrastructure and we are NOT coping -and sticking plasters will not take the pressure away!
Marley444
27th Apr 2016
3
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I totally support the Junior Doctors .... Jeremy Hunt needs a serious rethink about his tactics! Time for him to step down I think!
HEAPUS
27th Apr 2016
-4
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Totally agree with Annie2406. The deal offered is totally acceptable.Weekend working is a fact of modern life ,get used to it .This is about sections of the BMA trying to give the government a kicking.The problem that needs to be overcome is the inherent waste and top heavy management in the NHS .
latin
28th Apr 2016
1
Thanks for voting!
Good comment but we need to stop treating the world and close the doors and make all who use it pay as in the rest of the EU.
But first we must stop mass migration using our facilities free!
jeanmark
27th Apr 2016
2
Thanks for voting!
The issue isn't about weekend working, junior doctors have always worked weekends. I suggest you read my post about the issue.

I would be interested in how do you define 'inherent waste' and 'top heavy' management.
latin
28th Apr 2016
1
Thanks for voting!
When did you retire .
jeanmark
28th Apr 2016
1
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2014 having started in 1965 and worked full time throughout.
Kyp15
26th Apr 2016
2
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I was a ward clerk for a while, and saw the treatment junior doctors had to put up with, unfortunately, by going on strike, they are playing into the governments hand, this government want to get rid of our NHS, which we who have worked all our lives have paid into, it is only free on point of actually seeing a doctor and being treated, why should we have now to take out private medical care. Government are too powerful and only want to line their own pockets, bet you they will all become shareholders of a private medical company. Doctors be aware the only people loosing out are yourselves, loosing money whilst striking, don't let the government win, work to rule, do your daily hours, coat off and out the door, this will hurt them even more than striking.
jeanmark
26th Apr 2016
6
Thanks for voting!
Don't disagree with your sentiment Kyp15 but in all my 45 plus years of nursing I don't think I ever met a doctor that would walk out on a patient that needed them, even though it was their time to go off duty. Working to rule doesn't work, it's been tried.
lindz64
28th Apr 2016
4
Thanks for voting!
My daughter-in-law assists in the operating theatres and it's not unusual for her to have to go from one theatre directly to the next and quite often doesn't eat/drink for five/six hours. We need this government and any future government to stop sending £35 million every WEEK to Europe (which hopefully won't be for much longer) and billions in overseas aid and get our own country back on it's feet. Austerity? What's that about? We're suffering severe cutbacks on the one hand and giving away billions on the other. Enough is enough!!
latin
28th Apr 2016
3
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That would be a start!
Annie2406
26th Apr 2016
4
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Has anyone actually read the offer that they've rejected? This is all about politics. The NHS would have more than enough funding to ensure they recruited enough staff to cover 24/7/365 if we hadn't employed layer upon layer of management and actually charged anyone who had no right to free treatment. When did we become the International Health Service? As a political comment, what is managements use of agency staff if it's not using the private sector?? They employ enough useless pen pushers to run their own recruitment agency. These agency nurses and doctors cost the NHS ten times as much as ordinary members of staff do. Shame on them. Having said that, I totally disagree with the strike, but like everything else, it's just a job nowadays, not a vocation.
latin
28th Apr 2016
3
Thanks for voting!
This is right. Its not just the Health Service in crisis is it? Schools GP surgerys Prisons the list is endless !
We are a small country not equipped for what is happening and are being brought to our knees!
The Unions think they have the answers?
I think not!
Also Immigration is classed as a dirty racist word with the Westminster ministers which means nothing will be addressed and we will sink!
jeanmark
26th Apr 2016
3
Thanks for voting!
Wrong, it is still a vocation and yes I have read the offer they have 'rejected' and no there would not be sufficient funding to provide the level of service required in a modern health service. It may be about politics but not from the doctors perspective. I worked in the NHS for over 45 years and the use of agency staff was a last resort to try and keep a service running and yes they were incredible expensive, I know because I was in nursing management from ward sister upward. I would like to see how you could ensure 24 patients received safe care when 2 staff were on sick leave, 2 staff are on annual leave and usually 1 member of staff on maternity leave leaving you with possible 8 staff (whole time equivalent, not necessarily full time) to run a service 24 hours a day, 7 days a week and you certainly needed more than 2 staff to care for acutely ill patients, or maybe you believe people in a vocation should never have time off after all it's a vocation who needs reasonable hours and money to pay bills......
latin
28th Apr 2016
1
Thanks for voting!
Jean as I said before other people have their opinions and you have yours,it does not mean that other people are wrong .
Negotiations would not work if everyone was so sure that they were right.
jeanmark
28th Apr 2016
1
Thanks for voting!
Can't disagree with what you have said. In relation to negotiations, the BMA junior doctors committee walked out of talks with the department of health because the DH’s definition of negotiation was that they would reserve the right to do what they wanted if they didn’t agree with what the BMA junior doctors committee was suggesting. In other words, they did not want to negotiate so there was not point in the BMA trying!
sycamoremurphy
26th Apr 2016
3
Thanks for voting!
The Government are just trying to bully the junior doctors, and what do you do with bullies, you stand up to them!
This Governmet is determined to get rid of our very precious NHS, we must not let this happen. We all must support the NHS and all of the staff who work there.
Wilf
26th Apr 2016
3
Thanks for voting!
I just looked at the Silversurfers Facebook site on this post and the one word that croips up a lot and the British hate is "BULLY". that is what Mr Hunt is doing to the doctors and I don't think the Brits will back him. How dumb is he not to just sit down and negotiate. Everything in life is negotiable it may just take a little more time.......
Hawke008
27th Apr 2016
1
Thanks for voting!
While I believe Hunt is wrong to impose a settlement, it takes 2 to negotiate; while Hunt make be digging his toes in on this remember that 1 of the junior doctor's ring leaders does not want to work at weekends because he has a very lucrative sideline in wedding photography; weekend working for the NHS would put a sizable dent in his sideline income.

My sympathy for the junior doctors case disappeared when they decided that they would not provide emergency cover for babies ans children.
Alicia
26th Apr 2016
-2
Thanks for voting!
I oppose the strikes, they are paid to work and should do so.
jeanmark
26th Apr 2016
0
Thanks for voting!
I am assuming that when one of your loved ones comes to harm because the doctor has been working without a break for more than 48 hours you will try and sue, after all they are paid to work and should never make a mistake!
latin
28th Apr 2016
2
Thanks for voting!
Oh dear!
People have different views and opinions!
lindz64
28th Apr 2016
0
Thanks for voting!
Well said jeanmark
Munsterlander
26th Apr 2016
0
Thanks for voting!
Yes but is it right they work 91 hours a week and this is now going down to 72 hours. This is in the Times today and is a government admission. Nobody works those hours and its madness when doctors are looking after patients. If a shopworker was to give the wrong change after working 72 hours thats fine but a doctors misjudgement due to tiredness is something different. I bet Jeremy Hunt has never worked more than 40 hours a week in his whole life!
lindz64
28th Apr 2016
1
Thanks for voting!
Well said Munsterlander! Most people who were told they'd work 72 hours a week would tell the 'boss' where to go. It's a travesty that the doctors we look to for help are themselves tired to the point of exhaustion. It's time Cameron did the work he's paid for and step in!
latin
28th Apr 2016
3
Thanks for voting!
Don't ask boy Cameron to step in for goodness sake,Its because of him Blair and Brown that we are sinking fast!
They have not got a brain cell amongst them,but they know how to shaft people!

This is why Merkel has got him under her thumb,she can see he is way out of his depth and can be easily led.
jeanmark
26th Apr 2016
0
Thanks for voting!
I think he may have work longer than 40 hours a week but not to the extent doctors are working. I emailed my MP to ask when MP's were going to work 24 hours a day, 7 days a week, 52 weeks a year with no extra pay or additional staff. I've yet to receive a reply!
jennys59
26th Apr 2016
2
Thanks for voting!
I fully support the Junior Doctors they already work long hours with very few breaks. Jeremy Hunt is just a naieve,stubborn fool who has no idea on how the NHS works.If he insists the BMA implements this new contract they would have to sack every Junior Doctor in the country and then reinstate them under the new contract, if they dont then they are in breach of Employment laws.
latin
28th Apr 2016
2
Thanks for voting!
I would be interested to know how you think hospitals and schools prisons GPs etc will cope when Merkel and Cameron fast track Turkey and several other countrys on the side lines waiting to use our free services.
Where will the tax come from to pay to keep the Western world healthy!
Cameron Blair the Unions haven't a clue and only think of today.
I am taxed up to the hilt for what?
Crumbling services that I pay for.
I think I can spend my tax far better than Westminster ,something is going to have to give.
Munsterlander
26th Apr 2016
5
Thanks for voting!
I support it as I think the junior doctors have been bullied into this. Jeremy Hunt has said he will not negotiate any more? If he will not what are the doctors supposed to do? Its all very un-British on behalf of the UK Government and smacks of a dictatorship. The Brits do not like that. For goodness sake Mr Hunt get round the table and sort it out the patients are suffering!

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