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The junior doctors strike - a solution.

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Skudd
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PostPosted: 22:52 - 05 Jan 2016    Post subject: Reply with quote

Send all the striking doctors back home. Shocked
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bigtin
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PostPosted: 23:54 - 05 Jan 2016    Post subject: Reply with quote

Or just hire more doctors and raise taxes a bit to pay for it. Do you really want to be treated by someone who's stressed and tired as fuck?
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Ste
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PostPosted: 00:18 - 06 Jan 2016    Post subject: Reply with quote

"Just hire more doctors" Good plan, apart from you can't just pull them out of a hat. Wink

When the only space hospitals have for patients is on a trolley in a corridor, more doctors isn't going to fix that.

The NHS would be rich if it didn't use agency staff and bank staff so much.

Only falling ill Monday to Friday wouldn't be necessary if people didn't make so many unnecessary trips to A&E.

Do away with the four hour A&E time limit / target whilst you're at it. Thumbs Up
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Llama-Farmer
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PostPosted: 01:17 - 06 Jan 2016    Post subject: Re: The junior doctors strike - a solution. Reply with quote

mpd72 wrote:
I've got it!

If the general public and migrants could make sure we only fall ill Monday to Friday, 9am-5.30pm, there would be no issue.

How selfish are we?

Maybe we could do the same for the fire service, the police, the coastguard, the breakdown companies?

It's all our fault! How dare we get ill outside of office hours?



People getting ill in the evenings and on the weekends isn't an issue. If someone needs to be seen, they will be seen. No matter what time it is, what day it is.

Even the people who turn up at A&E when they really shouldn't be at A&E (and even shouldn't be bothering their GPs) get seen too. They may have to wait, several hours, but thats what happens if you are at the bottom of the triage list... it's a spectrum from Actively Dying to Couldn't Be Better, and the ones at the bad extreme end are seen first, and the ones at the very good end seen last. It's a logical system, thats why triaging is used in medical care universally across the globe.

Those complaining that they've had to wait hours to be seen should:
a) be grateful they're not in a condition to be seen quickly
b) be grateful they're being seen for free
c) and perhaps the most important point, not even be there in the first place.


The NHS is there to provide a NEED service... not a WANT service.
If patients need treatment, the NHS provides it, when they need it.
What it shouldn't have to do is provide a service someone wants at a time that they don't need it.


Emergency care never stops. Elective and non-emergent care and treatment does, because that isn't a time-critical need.





But like Ste says, more doctors take 5 or 6 years of medical school, plus 2 years of foundation training before they are competent and trained enough to be fully licensed and unsupervised. That's 8 years so not something you can do overnight.

The big problem is the way the NHS is run by politicians and bureaucrats.



For example... It's 11pm on a Saturday night. You're an average person in their 50s-60s, you're upstairs in your bed and feeling pretty unwell, it's getting progressively worse. So you go down to the kitchen to get some painkillers. As you're going down the stairs you stumble and lose your footing, you fall to the bottom.
You're taken to hospital in an ambulance and into Resus.
You've got a broken arm on one side and broken wrist on the other, possibly broken or dislocated one of your ankles too. You've got a pretty bad looking cut to the head. You remember vaguely what happened, but not really sure if you tripped or collapsed, and having a bit of confusion and some short term memory problems.
You need to see someone from orthopaedics about your broken bones, your wrist might need an operation... so they'll come down to see you in A&E.
But first you need to see the specialist stroke team, because the A&E doc suspects you've had a stroke. So the stroke team is called down to see you.
The good news is that even though its now midnight to early hours on a Saturday night/Sunday morning, and A&E is overrun by people who've drunk too much or got into fights, you're still seen quickly by the specialists, because all these people are already in the hospital anyway, providing round-the-clock cover.
But all these doctors and surgeons coming down to A&E from other departments to see you... Even though they're in the same hospital, the A&E department is having to pay for the referral. So the hospital charges itself if someone from one department has to go to see a patient in another department. But that money doesn't balance out. Nobody really knows how or why, but it doesn't. It mostly ends up in the pockets of the hospital board executives.
Because the hospital is run by bureaucrats and not clinicians, they have to have measurable KPIs to demonstrate how good they're doing or how bad someone else is doing.
Turns out you haven't had a stroke, but you definitely are "altered", so there's something going on at a neurological level... the stroke team refer you to a neurologist instead. Yet more monies.

Sounds ridiculous no?! Welcome to the inner workings of the NHS.
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Last edited by Llama-Farmer on 16:38 - 06 Jan 2016; edited 3 times in total
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Llama-Farmer
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PostPosted: 01:26 - 06 Jan 2016    Post subject: Reply with quote

Oh and another thing...




DON'T LISTEN TO JEREMY CUNT.


Or any of the other fucktards.


https://pbs.twimg.com/media/CX_Yyd6WAAQGvoF.jpg:large
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Llama-Farmer
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PostPosted: 01:41 - 06 Jan 2016    Post subject: Reply with quote

https://www.theguardian.com/healthcare-network/views-from-the-nhs-frontline/2016/jan/05/doctor-suicide-hospital-nhs?CMP=share_btn_tw
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Itchy
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PostPosted: 01:45 - 06 Jan 2016    Post subject: Reply with quote

Um it's actually like this in Asia.

Hospitals open at 9am close at 6pm and won't accept non emergency cases.

They also stagger weekday closing during the day time sort of like how 24h pharmacy is done in the UK one pharmacy in the area will always be open as will be a clinic.


Then again you can go into a pharmacy and buy any medicine you want without a prescription. There are also private clinics to give you a diagnosis (no need for registration) for £15 a pop. Also a whole load of tertiary (herbal/traditional) medicine providers.
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Aky208
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PostPosted: 04:41 - 06 Jan 2016    Post subject: Reply with quote

Itchy wrote:
Then again you can go into a pharmacy and buy any medicine you want without a prescription.


One of the main reasons why antibiotic resistant bugs (superbugs) are on such a rise!
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Rogerborg
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PostPosted: 08:37 - 06 Jan 2016    Post subject: Re: The junior doctors strike - a solution. Reply with quote

Llama-Farmer wrote:
b) be grateful they're being seen for free

Wut?

How about queuing up in order of net contribution to the public purse?

At some point, with an ageing, sickening population, the system is just going to collapse. It seems like in some areas, at some times, it already has.

The greatest burdens should be culled first, bonum commune communitatis.
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Llama-Farmer
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PostPosted: 09:51 - 06 Jan 2016    Post subject: Re: The junior doctors strike - a solution. Reply with quote

Rogerborg wrote:
Llama-Farmer wrote:
b) be grateful they're being seen for free at point of service

Wut?

How about queuing up in order of net contribution to the public purse?

At some point, with an ageing, sickening population, the system is just going to collapse. It seems like in some areas, at some times, it already has.

The greatest burdens should be culled first, bonum commune communitatis.


Taxes aside. But you knew what my point was.

In America you have lots of taxes towards healthcare but are then hit with the cost of healthcare and/or insurance at the point of treatment as well. We're lucky we only contribute tax towards our healthcare and not topping it up each time we need treatment or care.
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Rogerborg
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PostPosted: 10:14 - 06 Jan 2016    Post subject: Re: The junior doctors strike - a solution. Reply with quote

Llama-Farmer wrote:
Taxes aside.

Oh, are they optional?


Llama-Farmer wrote:
But you knew what my point was.

I know, I'm just refuting it. I've pre-paid. Why don't I get priority over some career parasite who's only ever taken?

This question is not remotely rhetorical.
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stinkwheel
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PostPosted: 12:45 - 06 Jan 2016    Post subject: Reply with quote

I don't think they have an issue about working weekends as such.

It's just the inept way the contract has been worded would potentially leave them working ludicrously long hours which they aren't prepared to do.

Interesting thing about this proposed strike is it's pretty much entirely over conditions. They are happy with their pay.

Also worth remembering, they don't have to work in the NHS if they don't want to. They could just decide they aren't going to accept the proposed contract.
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Ste
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PostPosted: 12:56 - 06 Jan 2016    Post subject: Reply with quote

stinkwheel wrote:
Interesting thing about this proposed strike is it's pretty much entirely over conditions. They are happy with their pay.

Isn't it always about pay as everything else is weighed up against that?
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mentalboy
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PostPosted: 14:16 - 06 Jan 2016    Post subject: Reply with quote

Skudd wrote:
Send all the striking doctors back home. Shocked


Don't be daft, that'd halve UK literacy rates. Rolling Eyes
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t121anf
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PostPosted: 14:20 - 06 Jan 2016    Post subject: Reply with quote

The details in that PDF look entirely like the normal european rules.

I'm sure I was sent home from ASDA years ago because I was over 48hours in a week (run up to Xmas and wanted overtime) but they won't allow it. Also signed something in a previous job to say I opted out (Factory job during uni years).

I bet in reality it won't stop at a 13hours shift and a maximum of 48hrss a week.

Lastly, like fuck do I want some doc whose just worked 12.5 hours looking after me, even the best in the world get tired.
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stinkwheel
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PostPosted: 15:17 - 06 Jan 2016    Post subject: Reply with quote

I have a lot of sympathy with them.

If my boss wanted to make me to work 'till 10pm so many nights a week, I'd tell him to go do one and would find a job elsewhere if he tried to force it on me.

He'd need to offer me so much more money or time off than I currently get to compensate me for the upheaval and disruption it would cause to my home life and sleep patterns, it wouldn't be worth his while.
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I did the 2010 Round Britain Rally on my 350 Bullet. 89 landmarks, 3 months, 9,500 miles.
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Rogerborg
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PostPosted: 15:48 - 06 Jan 2016    Post subject: Reply with quote

Is it a well kept secret that people get sick at night, weekends and bank holidays? Because it seems to be coming as a surprise, and I'm not sure that it's practical or reasonable to expect to be able to pick and choose your hours as a junior doctor.

Presumably they want to end up as 9-to-5 GPs or consultants, and then whom will they be relying on to provide unsociable hours cover?

Actually, the smart ones with the right equipment could qualify then immediately embark on babyfarming. A few years of that, some agitating about being given a position based on the experience, seniority and training that they would have received if you weren't off mitosifying and lactating, and then off you go to run your own practice.
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Llama-Farmer
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PostPosted: 16:47 - 06 Jan 2016    Post subject: Reply with quote

mpd72 wrote:
You've fallen for the left wing propaganda. They are NOT being asked to work more hours. They are being asked to include weekends and evenings in the time frame which their shifts can appear in.

Not more hours, just some of their shifts which cover times when doctors are actually needed. In return for this they are all getting an 11% pay increase.



The unsociable hours, for which they get paid extra, is being cut massively.

A massive portion of their income is from this unsociable pay.

The "11% pay increase" is to basic salary, not total income.
Their basic is going up a bit, their perks are coming down a lot. It doesn't balance out.




But that isn't the main issue.


They're also reducing the accountability of hospitals, and the penalties those hospitals face for overworking the doctors.

If Jeremy Hunt is so certain that doctors working weeks will have fewer hours in under these new contracts, then there should be no problem about continuing to penalise the hospitals if they breach these limits. Because mathematical logic dictates if they work less then they'll breach limits less.
But the new contract isn't going to work like that.



Not so much falling for left wing propaganda as you're falling for spin and lies from the right.
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Itchy
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PostPosted: 16:51 - 06 Jan 2016    Post subject: Reply with quote

stinkwheel wrote:
I have a lot of sympathy with them.


Urban legend time. But back in the 1990s when there were numerous gang wars going on, the Chinese brotherhood gang were rumoured to have a vet and a dentist who would operate on them (gang members) if they were ever injured in a territory war or something as it was rather hard to explain bullet wounds if they went to the NHS.
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stinkwheel
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PostPosted: 18:02 - 06 Jan 2016    Post subject: Reply with quote

Rogerborg wrote:
Is it a well kept secret that people get sick at night, weekends and bank holidays? Because it seems to be coming as a surprise, and I'm not sure that it's practical or reasonable to expect to be able to pick and choose your hours as a junior doctor.

Presumably they want to end up as 9-to-5 GPs or consultants, and then whom will they be relying on to provide unsociable hours cover?


The way it's heading in my (almost entirely commercial) sector is you either work exclusively covering out of hours or work normal hours. Not both.

My practice is unusual these days in that the day vets also cover the on-call. Most vets wouldn't even consider a job where they have to do on-call these days.

Interestingly, it's lead to emergency medicine becoming much more of a specialism to the point where your pet is almost better to be run over by a car outside normal office hours. The guy who's job it is to shovel it up and stop it bleeding out is going to be very good at it. He keeps it alive and stabilises it. The day guy, who's good with bones screws it back together again after the weekend.

Mrs stinkwheel was working as an emergency vet for a while. 2-weeks on, 2-weeks off. The money was very good.

So. If you follow a commercial model for a type of healthcare provision in the UK (I think the only other one legally required to provide 24h emergency cover), you'd have an entirely different staff covering out of hours provision. They are specially trained to deal with emergencies and are well paid for the work they do.

As an aside, they also have nothing else they ought to be doing (like sleeping before their next 12 hour shift), it's not an onerous extra duty they've been saddled with, it's their primary job. As such they tend to give the job in front of them their full attention rather than trying to put it off or do the bare minimum so the quality of care is generally excellent.

Where it doesn't transpose to the NHS is people taking animals to the vet are paying for their care. Emergency care from an out of hours vet is much more expensive so people tend not to take the piss and turn up with a two week old septic anal fistula at 2am, they wait 'till morning and make an appointment. The not having to pay at the point of delivery must make spurious visits all too common.

What I do think is they could do with broader daytime provision at weekends and do normal work then. I think that applies to many professions.

I think the 5:2 work:off ratio is a good formula but that not everyone should be on the same 5:2, they should be spread out to maintain continuous staffing levels. This could actually really suit working couples with kids. They could potentially work it so there is only one day a week where one or other parent isn't home, thereby vastly reducing childcare costs.
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I did the 2010 Round Britain Rally on my 350 Bullet. 89 landmarks, 3 months, 9,500 miles.


Last edited by stinkwheel on 18:05 - 06 Jan 2016; edited 1 time in total
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