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

Mr_Relaxed

War Hero
Here's the rates for hospital doctors from the link I posted above
View attachment 593023Couple of years as a Foundation House officer before moving onto FHO2 or Senior House Officer when you can see that they are up to 33,950.
Quite short of your proposed 40k
And all being beaten for salary by entry level jobs in accountancy, banking, or law.

Then take into account it’s far more competitive to get into medicine and it’s a wonder why people do.
 
Here's the rates for hospital doctors from the link I posted above
View attachment 593023Couple of years as a Foundation House officer before moving onto FHO2 or Senior House Officer when you can see that they are up to 33,950.
Quite short of your proposed 40k

8 years to get to £40K? That's is the same as a main pay scale teacher in England, who would be on post threshold 2 at that point without any responsibility points.

Seriously, teaching is not in the same league as medicine.

Thanks for that FF, a real eye opener.
 
I hadn't realised basic pay was so low for doctors, though I am oblivious to what a typical 'junior' doctor's pay is per month once you factor in overtime, supplementals etc.

My SiL is a high school teacher (not even STEM) and she's on ~40k/ year for an actual 37 hour week. Amazing.
 

kandak01

Clanker
if you ignore the supplements that is, and most people (outside of unions for political purposes) regard your take home (including supplements) as your pay.
If you want to talk about take home pay, it's reasonable to include the supplements, but also the deductions (student loans, taxes, NI etc.). That adds to the variability of any answer about medical pay.

The incredible salary earned by Tube drivers on the London Underground is an interesting comparison.
Why come out of med school aged 24 with >100k debt, when you can join TfL age 18 doing this?


ETA: As for simply being apprentices, one view would be that until they are consultants, they are just apprentices (most people call them "junior doctors" until they reach consultant level). A more realistic view would be that they are as much an apprentice as a lieutenant, or a corporal: they're doing a paid job of work, acting under direction, but with varying degrees of autonomy, responsibility, and supervison depending on the nature of the work at hand. Many of even the most junior docs spend a significant amount of their time without direct supervision.
 
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If you want to talk about take home pay, it's reasonable to include the supplements, but also the deductions (student loans, taxes, NI etc.). That adds to the variability of any answer about medical pay.

The incredible salary earned by Tube drivers on the London Underground is an interesting comparison.
Why come out of med school aged 24 with >100k debt, when you can join TfL age 18 doing this?
A school friend of mine started down the usual university then graduate job route but got disillusioned. After periods in the RAF and running a small group of franchised shops he somehow ended up driving HSTs on the ECML and far as I can tell earns a small fortune. Makes you wonder why parents an teachers laugh at the childhood desire to be a train driver?
 

Mbongwe

Old-Salt
The incredible salary earned by Tube drivers on the London Underground is an interesting comparison.
Why come out of med school aged 24 with >100k debt, when you can join TfL age 18 doing this?
Why do med school instead of being a London Underground Tube driver?! Assuming you're being serious, I'd suggest the following:
  • Being a medical doctor would give you a higher uncapped ceiling if you went into the private sector;
  • More career variety in terms of specialisms; research opportunities etc; going into career; writing books;
  • Higher status job that's far more attractive to the opposite (or same!) sex;
  • Much better networking opportunities for a subsequent business career;
  • Portable career that you can take to different parts of the world.
Oh, and living in London is expensive, therefore £56k or whatever your link says Tube drivers earn doesn't go all that far in London.
 

kandak01

Clanker
Why do med school instead of being a London Underground Tube driver?! Assuming you're being serious, I'd suggest the following:
  • Being a medical doctor would give you a higher uncapped ceiling if you went into the private sector;
  • More career variety in terms of specialisms; research opportunities etc; going into career; writing books;
  • Higher status job that's far more attractive to the opposite (or same!) sex;
  • Much better networking opportunities for a subsequent business career;
  • Portable career that you can take to different parts of the world.
Oh, and living in London is expensive, therefore £56k or whatever your link says Tube drivers earn doesn't go all that far in London.
Do you know many 18 year old tube drivers year?
I don't know any train or tube drivers of any age.
The discussion is drifting from the premise in the OP, and I guess we could parse out hairsplitting details of this sort of thing until the cows come home, without changing many opinions.

I don't mind (or care tbh) whether you think NHS staff are over/under/appropriately paid, but, I hope that at least your views on the are better informed than at the start of this thread.
In any case, our views, whatever they are, won't alter the decision HMG takes about pay rises, nor the subsequent behaviours of NHS staff, and consequences for health care delivery.
 
I don't know any train or tube drivers of any age.
The discussion is drifting from the premise in the OP, and I guess we could parse out hairsplitting details of this sort of thing until the cows come home, without changing many opinions.

I don't mind (or care tbh) whether you think NHS staff are over/under/appropriately paid, but, I hope that at least your views on the are better informed than at the start of this thread.
In any case, our views, whatever they are, won't alter the decision HMG takes about pay rises, nor the subsequent behaviours of NHS staff, and consequences for health care delivery.

My view is that doctors aren't going to be on the poorhouse any time soon. Nurses pay could be better.
 

Blues&Twos

Swinger
My view is that doctors aren't going to be on the poorhouse any time soon. Nurses pay could be better.

which opens the door to asking who else deserves more, given just how many professions land on the same pay band as a nurse. Paramedic, physios, SALT, radiographers etc all start on band 5 much the same as nurse.
 
which opens the door to asking who else deserves more, given just how many professions land on the same pay band as a nurse. Paramedic, physios, SALT, radiographers etc all start on band 5 much the same as nurse.

Maybe, but my point was doctors pay isn't that bad, even if they do deserve more, I'm sure the poorer members of the NHS should be prioritised over them.
 
Defund the BBC and then raise the same amount as an NHS tax.
3.5 billion pounds.

That would give all staff a £2300 pay rise

If you restrict it to lower paid staff then of course the numbers grow.
Public no worse off.
 

green_slime

War Hero
assuming (most likely) that most or all of the 3% will have to come from the existing NHS budget there is a strong case for not increasing senior Dr pay (managed separate from nurses and junior drs) and keeping it in delivering clinical care.
 

Himmler74

On ROPS
On ROPs
Defund the BBC and then raise the same amount as an NHS tax.
3.5 billion pounds.

That would give all staff a £2300 pay rise

If you restrict it to lower paid staff then of course the numbers grow.
Public no worse off.
National insurance and income tax cover the NHS, they want a pay rise, stop wasting money.

I do agree that we should not have to be forced into paying for the BBC, ring fence the news, and let’s say £20 per year for that. Otherwise it can whistle, all those banging on about content, if it’s good enough it will get picked up by the commercial networks.

The NHS has rode on the back of the pandemic, rightly or wrongly however it’s current structure isn’t sustainable, we are an extremely modern democracy, with a socialist health care system. It can not survive unless it’s evolving,
 

kandak01

Clanker
assuming (most likely) that most or all of the 3% will have to come from the existing NHS budget there is a strong case for not increasing senior Dr pay (managed separate from nurses and junior drs) and keeping it in delivering clinical care.
Good idea- It's not like Senior doctors deliver any clinical care, is it?

Nurses and junior doctors have had separately negotiated pay rises over the last few years.
You could argue the case to refuse them a new pay rise is stronger (I'd disagree- the BMA managed to negotiate a below inflation pay rise for junior doctors, which is a mark of how uselss they are as a union, and there are similar issues with nurses, which helps explain the large and increasing shortfall between supply & demand....)

Consultants have had (IIRC) about 1% pay rise in the last decade, with significantly increased taxation (via pension contributions etc). As previously mentioned, real term consultant pay has fallen by c 25-30% over the last decade.

The erosion of medical T&C, and the cliff edge thresholds introduced with LTA/AA etc. inevitably reduce the number of hours doctors (particularly seniors) can work before falling foul of insane penalties (100% or more tax on income earned). The complexity of the relevant legislation (even HMRC struggle with it) makes it unwise for consultants to work as hard as previously.

That's a loss to the NHS, to clinical delivery, and to you as patients.
But, it's not my circus, so I can only play by whatever rules the spacktards in charge dream up.
 

green_slime

War Hero
Not entirely true.
I've had my pension T&C unilaterally changed (I now pay far more for a much reduced pension than when I joined.)
I've also had my contract conditions unilaterally changed by HMG. It's bonkers that, the more I work above a certain threshold, the less my takehome pay becomes (recent changes to tax etc). It's already led to me (and thousands of other doctors) reducing the number of hours/year we put in so we can remain below that threshold.

I'm sure there are parallels in other public services- my point is that the NHS isn't as special or protected as some seem to believe, and the effort:reward ratio applies to NHS recruitment and retention as much as to other jobs.
So you have stated (my bold) that you are already dropping work to ensure you earn less to remain under certain thresholds, so you (and your colleagues) are not dependant and too sensitive to higher pay increases. Thus it is a higher level Maslow issue than those who are paid much less.

I am aware of how important senior drs are (hence you have permitted me to post here), I am also aware that capital is a finite resource in the NHS and the current circumstances create a zero sum game. More more to staff = fewer clinical treatments.
 

kandak01

Clanker
he current circumstances create a zero sum game. More more to staff = fewer clinical treatments.
indeed. and less to staff (or worse T&C) means fewer staff, and fewer clinical treatments.

It's a difficult balance for even a competent government to achieve.

With increasing demand on healthcare, the answers are probably more money, or different delivery systems.

That's part of why we regularly see expensive "healthcare reforms" (few of which produce the purported efficiency gains)

I've dropped work because of the penalties associated with doing more.

If my take-home pay was linked to my hours worked, I'd happily increase what I do. So, the premise that I (or senior doctors) are insensitive to financial incentives (+ or -) is incorrect
 
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Nobody

RIP
RIP
indeed. and less to staff (or worse T&C) means fewer staff, and fewer clinical treatments.

It's a difficult balance for even a competent government to achieve.

With increasing demand on healthcare, the answers are probably more money, or different delivery systems.

That's part of why we regularly see expensive "healthcare reforms" (few of which produce the purported efficiency gains)
As a doctor, what’s your take on the multiple tiers of management and roles in the NHS?
Would you deny that it’s become a self-licking lollipop?
 

kandak01

Clanker
As a doctor, what’s your take on the multiple tiers of management and roles in the NHS?
Would you deny that it’s become a self-licking lollipop?
In the good old days, the NHS ran with a small number of administrators. That was efficient, but society has changed. As with the military, all sorts of stuff is now expected (H&S, budgetary responsibilities, due diligence etc etc.) that requires extra admin.

However, servicing some elements (internal market, PFI) is expensive, largely useless, and diverts resource from clinical care. A large proportion of that is a self licking lollipop

Other, large, ambitious, politically motivated and often badly thought through schemes (e.g. NHS act 2012) also just waste your taxes and are revised in the next reorganisation.

So, some management good, some bad
 
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