Paying a 3% increase in NHS salaries... viable?

kandak01

Clanker
The problem is that compensation is a package, of which salary is only one part. Public sector workers often look at private sector salaries and complain that they're "underpaid", conveniently overlooking their gold-plated pensions and cast-iron job security which no-one in the private sector can match. They want the best of both worlds and it's just not a reasonable request.
company car, free parking, gym membership, subsidised food, health insurance packages etc. are common in private land, far less so in the public sector.

So, I agree that it can be difficult to directly compare public/private overall packages.
There are few comparators for a typical medic (primary degree-regarded as a level 7 (Masters) qualification, plus usually 2-3 higher degrees at level 8 or above).

Historically, a public sector "gold plated pension" was seen as compensation for poorer wages. Now, that gold plating has worn off (affecting different staff groups very differently), it's unsurprising that the public sector are wanting jam today instead of broken promises about jam tomorrow.

As I said before, if you think it's such an easy gig, there's nothing stopping you from joining the NHS: we're short-staffed across the board, in every part of the country. All you need are the right skills, aptitude, qualifications, etc.

Or, there's life as a keyboard warrior instead...
 
company car, free parking, gym membership, subsidised food, health insurance packages etc. are common in private land, far less so in the public sector.

So, I agree that it can be difficult to directly compare public/private overall packages.
There are few comparators for a typical medic (primary degree-regarded as a level 7 (Masters) qualification, plus usually 2-3 higher degrees at level 8 or above).

Historically, a public sector "gold plated pension" was seen as compensation for poorer wages. Now, that gold plating has worn off (affecting different staff groups very differently), it's unsurprising that the public sector are wanting jam today instead of broken promises about jam tomorrow.

As I said before, if you think it's such an easy gig, there's nothing stopping you from joining the NHS: we're short-staffed across the board, in every part of the country. All you need are the right skills, aptitude, qualifications, etc.

Or, there's life as a keyboard warrior instead...
Company car - now not very common unless travel for work is required and you will get hammered on tax.

Free parking - depends on location

Gym membership - normally via salary sacrifice rather than free.

Subsidised food - not very common these days

Health insurance - again depends on seniority.
 

Mr_Relaxed

War Hero
company car, free parking, gym membership, subsidised food, health insurance packages etc. are common in private land, far less so in the public sector.

So, I agree that it can be difficult to directly compare public/private overall packages.
There are few comparators for a typical medic (primary degree-regarded as a level 7 (Masters) qualification, plus usually 2-3 higher degrees at level 8 or above).

Historically, a public sector "gold plated pension" was seen as compensation for poorer wages. Now, that gold plating has worn off (affecting different staff groups very differently), it's unsurprising that the public sector are wanting jam today instead of broken promises about jam tomorrow.

As I said before, if you think it's such an easy gig, there's nothing stopping you from joining the NHS: we're short-staffed across the board, in every part of the country. All you need are the right skills, aptitude, qualifications, etc.

Or, there's life as a keyboard warrior instead...
Cars tend to be specific to job. Other benefits tend to go to senior management - but the benefits you describe are generally to be found in very large firms, not in the SME’s that most people work for. 16 smallish companies in my current group where revenue is <£10m each, where pension is the legal minimum, there’s no gym, healthcare is for directors or senior managers and no staff bonus. That’s reality for most of us. And if we don’t make a return of 25% on revenue, stand by for a very uncomfortable time with head office. Every investment decision, whether that’s staff or a new piece of machinery, has to be supported with the profit that will come from it.

I’d agree this country doesn’t value qualifications that are the wrong sort - my firm works with post-Doc’s in research fields and they’re on <£50k, but it’s a fairly easy life from what I’ve seen. When they move to industry, the rewards are there but so is the commercial pressure.
 

kandak01

Clanker
Olaf/ Relaxed.
TY
that just emphasises the fact that making sweeping generalisations based on old, inaccurate, predjuiced information and assumptions (really common behaviour in this thread) about T&C in the NHS isn't helpful if people want to meaningfully participate in a discussion about whether a 3% payrise is justified and feasible.
 

Mr_Relaxed

War Hero
Olaf/ Relaxed.
TY
that just emphasises the fact that making sweeping generalisations based on old, inaccurate, predjuiced information and assumptions (really common behaviour in this thread) about T&C in the NHS isn't helpful if people want to meaningfully participate in a discussion about whether a 3% payrise is justified and feasible.
The point you make about the whole package is well founded as well. Holidays, overtime, pension all come into the package, but it’s what makes a straight comparison almost impossible.

Quite a few of Mrs R’s mates are coming to the end of their NHS time, so retiring on a nice pension, but the pension in the case of the medical side of the NHS (or uniformed police/military/fire service for that matter) is deferred pay to my mind. It’s why I disagree with changing T&C for vocational types of roles. If you’re only offering 4% pensions, then the salary has to be higher.
 
So, I agree that it can be difficult to directly compare public/private overall packages.
There are few comparators for a typical medic (primary degree-regarded as a level 7 (Masters) qualification, plus usually 2-3 higher degrees at level 8 or above)

This is very public-sector thinking if you'll forgive me for saying so - no-one in the private sector thinks that having a Masters degree entitles a person to a certain salary. You would be laughed out of the room if you brought this up in a negotiation.

Historically, a public sector "gold plated pension" was seen as compensation for poorer wages. Now, that gold plating has worn off (affecting different staff groups very differently), it's unsurprising that the public sector are wanting jam today instead of broken promises about jam tomorrow.

Defined-benefit pensions hardly exist any more in the private sector. And neither does the sort of job security the public sector take for granted. A company can evaporate tomorrow taking with it your job and your pension scheme. This risk is why private sector workers typically have higher salaries - not "degrees" or "levels".

As I said before, if you think it's such an easy gig, there's nothing stopping you from joining the NHS: we're short-staffed across the board, in every part of the country. All you need are the right skills, aptitude, qualifications, etc.

Dancing on social media behind closed doors? :p

You're also welcome to come join us if you think we're all cruising around in company cars, between free parking spots, stuffing our faces with subsidised food (!)
 

Tool

LE
company car, free parking, gym membership, subsidised food, health insurance packages etc. are common in private land, far less so in the public sector.

So, I agree that it can be difficult to directly compare public/private overall packages.
There are few comparators for a typical medic (primary degree-regarded as a level 7 (Masters) qualification, plus usually 2-3 higher degrees at level 8 or above).

As others have mentioned, most of the "perks" in the private sector are through salary sacrifice. I've never had subsidised meals, company cars are the company's and you have use of them. Free parking? Usually a subsidised amount, but waiting lists are usually in the years, so not guaranteed. Gym membership is rare, but again, via sarary sacrifice.

In the private sector, there are usually short-ish lists of preferred suppliers that you can spend your salary sacrifice on, and it is hot and miss as to whether they are genuinely a cost saving or not.
 

Tool

LE
As others have mentioned, most of the "perks" in the private sector are through salary sacrifice. I've never had subsidised meals, company cars are the company's and you have use of them. Free parking? Usually a subsidised amount, but waiting lists are usually in the years, so not guaranteed. Gym membership is rare, but again, via salary sacrifice.

In the private sector, there are usually short-ish lists of preferred suppliers that you can spend your salary sacrifice on, and it is hit and miss as to whether they are genuinely a cost saving or not.
Editted for spulleng mistooks
 

Slime

LE
This is very public-sector thinking if you'll forgive me for saying so - no-one in the private sector thinks that having a Masters degree entitles a person to a certain salary. You would be laughed out of the room if you brought this up in a negotiation.



Defined-benefit pensions hardly exist any more in the private sector. And neither does the sort of job security the public sector take for granted. A company can evaporate tomorrow taking with it your job and your pension scheme. This risk is why private sector workers typically have higher salaries - not "degrees" or "levels".



Dancing on social media behind closed doors? :p

You're also welcome to come join us if you think we're all cruising around in company cars, between free parking spots, stuffing our faces with subsidised food (!)

You make an excellent point about a masters degree.
The way the NHS treat such things is very different to a lot of other businesses, both in pay and status.

In short, the bin man or women with a masters degree is on the same pay as those with no qualifications, and gets no job priveliges.

Bin workers sprang to mind as I was surprised to find how many had degrees etc when I worked on a recycling study.
 

kandak01

Clanker
This is very public-sector thinking if you'll forgive me for saying so - no-one in the private sector thinks that having a Masters degree entitles a person to a certain salary. You would be laughed out of the room if you brought this up in a negotiation.
I probably didn't make my point properly (this is the internet after all). To even get out of the starting blocks in a medical career, you need to demonstrate the skillset necessary to get a Masters degree. To progress successfully beyond that, you have to put in the long hours, and in parallel, obtain a number of higher qualifications, and successfully compete for limited training posts. By the end of the process, the effort you've put in requires a certain level of compensation (otherwise people just wouldn't bother). The Masters degree is as much a marker of ability/aptitude to get in the game, as a thing worthy of reward in it's own right.

Adam Smith wrote "We trust our health to the physician... Such confidence could not safely be reposed in people of a very mean or low condition. Their reward must be such, therefore, as may give them that rank in the society which so important a trust requires.". Uwe Reinhardt (Princeton economics professor) reckons that to attract and retain suitable people in medicine (rather than losing them to finance, law, business etc., doctors should be paid in the 95th centile. You could do similar cost analyses for other jobs, both in the private sector and other public sectors. (FYI, UK medical pay isn't in the 95%)

Defined-benefit pensions hardly exist any more in the private sector. And neither does the sort of job security the public sector take for granted. A company can evaporate tomorrow taking with it your job and your pension scheme. This risk is why private sector workers typically have higher salaries - not "degrees" or "levels".
My job security (in Anaesthesia & Intensive Care) comes largely from having a bunch of skills that are in demand, and not easily or quickly provided by others. The UK is a few thousand warm bodies short of people like me already (c.12-15% consultant shortfall in 2020), and this supply:demand gap is going to get bigger as demographic demand is met with increasing loss of supply (b/c people like me reduce our hours and retire early etc, which is a function of adverse changes in our T&C). To an extent, the same is true through the NHS (100,000 nurses short etc).

If the country were overfull of appropriately skilled doctors, nurses, radiographers, paramedics etc., then your point about job security would be a point. But, we'd still be left with the question of how big a pay rise would you have to give NHS staff to compensate for the loss of security etc., and to compensate for the destabilising effects of an essential service being subject to bidding wars between various providers?

Ultimately, whatever resentments people may feel about paying for the NHS, the economic realities will determine outcomes: By & large, the UK population votes for "lower tax" parties, rather than "enough tax" parties, which then manifests as suboptimal service (whether defence procurement, NHS capability, or frequency of bin collections etc)
 
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I probably didn't make my point properly (this is the internet after all). To even get out of the starting blocks in a medical career, you need to demonstrate the skillset necessary to get a Masters degree. To progress successfully beyond that, you have to put in the long hours, and in parallel, obtain a number of higher qualifications, and successfully compete for limited training posts. By the end of the process, the effort you've put in requires a certain level of compensation (otherwise people just wouldn't bother). The Masters degree is a much a marker of ability/aptitude to get in the game, as a thing worthy of reward in it's own right.

Adam Smith wrote "We trust our health to the physician... Such confidence could not safely be reposed in people of a very mean or low condition. Their reward must be such, therefore, as may give them that rank in the society which so important a trust requires.". Uwe Reinhardt (Princeton economics professor) reckons that to attract and retain suitable people in medicine (rather than losing them to finance, law, business etc., doctors should be paid in the 95th centile. You could do similar cost analyses for other jobs, both in the private sector and other public sectors. (FYI, UK medical pay isn't in the 95%)


My job security (in Anaesthesia & Intensive Care) comes largely from having a bunch of skills that are in demand, and not easily or quickly provided by others. The UK is a few thousand warm bodies short of people like me already, and this supply:demand gap is going to get bigger as demographic demand is met with increasing loss of supply (b/c people like me reduce our hours and retire early etc, which is a function of adverse changes in our T&C). To an extent, the same is true through the NHS (100,000 nurses short etc).

If the country were overfull of appropriately skilled doctors, nurses, radiographers, paramedics etc., then your point about job security would be a point. But, we'd still be left with the question of how big a pay rise would you have to give NHS staff to compensate for the loss of security etc., and to compensate for the destabilising effects of an essential service being subject to bidding wars between various providers?

Ultimately, whatever resentments people may feel about paying for the NHS, the economic realities will determine outcomes: By & large, the UK population votes for "lower tax" parties, rather than "enough tax" parties, which then manifests as suboptimal service (whether defence procurement, NHS capability, or frequency of bin collections etc)


How much does a doctor make without overtime?
 

kandak01

Clanker



Clap for our heroes
1. The Government makes lots of contingency plans for all sorts of stuff
2. When demand overtakes supply, you need to consider/implement some form of triage
3. Old age is one of the strongest markers for adverse clinical outcomes (death) from covid infection, so providing care to the elderly INSTEAD of others (since demand>supply) not only doesn't really work well (the oldies die anyway), but also denies the oportunity of life to younger people. There are a number of ethically sound ways to triage treatment in a resource limited situation, and this would be one of them. As it happens, denial of NHS treatment (e.g. for ICU admission) based solely on chronological age was specifically excluded as a triage mechanism.

So, is your point that this planning was "a good thing", or that it was "a bad thing"?
Like so many other posts here, this is taking superficial knowledge/headlines and torturing them to fit in with your preconceived belief system. Not infrequently, that has little to do with the truth/reality/ground facts.
 
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kandak01

Clanker
How much does a doctor make without overtime?
I typed a long reply with far too much detail, but maybe a better answer is:
"How much do you think they should get as an hourly rate of pay?"

(FYI: Invariably, people tell me a number that's far higher than actual medical pay)
 

Mbongwe

Old-Salt
I typed a long reply with far too much detail, but maybe a better answer is:
"How much do you think they should get as an hourly rate of pay?"

(FYI: Invariably, people tell me a number that's far higher than actual medical pay)
And therein lies the rub in terms of why it's so difficult to compare public sector salaries with private sector salaries.

A GP I am tenuously acquainted with told me her basic salary. It is the same salary as mine, but my job doesn't involve saving lives or diagnosing people who may have life-threatening conditions.

My job does, however, generate eight- to nine-figures income per annum for my employer and create hundreds of jobs per year. Hers doesn't. It's like comparing apples with oranges...
 
I probably didn't make my point properly (this is the internet after all). To even get out of the starting blocks in a medical career, you need to demonstrate the skillset necessary to get a Masters degree. To progress successfully beyond that, you have to put in the long hours, and in parallel, obtain a number of higher qualifications, and successfully compete for limited training posts. By the end of the process, the effort you've put in requires a certain level of compensation (otherwise people just wouldn't bother). The Masters degree is as much a marker of ability/aptitude to get in the game, as a thing worthy of reward in it's own right.

You could say exactly the same about Engineering. And probably all the professions, law, accountancy etc.
 
This is very public-sector thinking if you'll forgive me for saying so - no-one in the private sector thinks that having a Masters degree entitles a person to a certain salary.
Largely because few jobs in the private sector require multiple Masters' degrees to become proficient. A clinical Consultant post usually will.
 
And therein lies the rub in terms of why it's so difficult to compare public sector salaries with private sector salaries.

A GP I am tenuously acquainted with told me her basic salary. It is the same salary as mine, but my job doesn't involve saving lives or diagnosing people who may have life-threatening conditions.

My job does, however, generate eight- to nine-figures income per annum for my employer and create hundreds of jobs per year. Hers doesn't. It's like comparing apples with oranges...
I have had the same, but my job does put people at risk to life if not done right...and allows the company to actually bill for the work we have done...
 
You make an excellent point about a masters degree.
The way the NHS treat such things is very different to a lot of other businesses, both in pay and status.

In short, the bin man or women with a masters degree is on the same pay as those with no qualifications, and gets no job priveliges.

Bin workers sprang to mind as I was surprised to find how many had degrees etc when I worked on a recycling study.

Never done it myself, but bin work is honest work. And when you consider the knock on effects of it, like removing rubbish before rats can get at it keeping the rat population down, a bin man probably saves more lives over his career than any nurse and most doctors.

And the bins were collected over COVID whilst the hospitals and GP surgeries were turning patients away.
 

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