Dear Other Normal Human Beings

I am writing to you, because, like myself, you are a normal human being.

You, like me, wake up in the morning and sleep at night, eat meals, sometimes with loved ones, sometimes alone. We are alike in our requirement for other people, for happiness, for security, for food, for warmth, for shelter.

You may have children, you may have brothers or sisters. You have, or had, parents, and perhaps were lucky enough to know your grandparents.

You may have noticed that many health professionals were becoming uncharacteristically vocal, leading up to the General Election. You may have thought them self-serving, morally bankrupt individuals, upset over their own pay packets.

I would like to explain to you, from one normal human being to another, what is going on.

I am a doctor. I decided to be a doctor before I really knew what decisions were, and can never remember wanting to do anything else. Once I knew how, I found the path, and worked my arse off. Six years, in secondary school, studying. Two years, in college, studying. I took four A-levels, I had 25% less free time than my friends, and when they were out, doing whatever they wanted, I was not. I was studying. Another six years at medical school, studying, and sometimes working to pay for the studying. The last three years of medical school I worked harder than I ever had, and the same hours as a full-time professional, sometimes way more. It even made me sick- in my final year I developed acute gastrointestinal bleeding. But, becoming a doctor was all that meant anything to me. So, I took my top grades and turned them in, in return I got fourteen years hard graft, and £50,000 worth of debt. [2]

Why is this important? Because, from the very beginning, I knew about sacrifices. As thousands of my colleagues have, as millions before me have, and millions will. I knew about sacrifice when I worked for a year before university, so I could afford the rent, when I missed my first family Christmas to work as a warden in student halls, so I could afford to stay at medical school. I knew about sacrifice when I missed nearly every other Christmas since, working, or sometimes studying. I knew about sacrifice when I’ve missed my friends weddings, my nieces and nephews birthdays, when everyone I knew was travelling, and I was studying, or working. Being a doctor, and it’s inherent position in society and in the hearts of the public, is irrevocably tied to sacrifice- it’s the dedication it takes to become, and to stay, a doctor, that by definition requires sacrifices to time, to personal satisfaction. All over the country right now, doctors and nurses, physiotherapists and occupational therapists, radiographers and ward clerks and all the other medical professionals are sacrificing their lives, minute by minute, to try to give you or your loved ones minutes, hours, days or years more. So, when, as a normal person, someone tells you doctors don’t understand ‘vocation’, you know now- it is beat into us before we even get through the door.

But, as a normal person, of course you understand why doctors would defend the NHS, would fight to protect it, and so vociferously attack it’s detractors. They have a vested interest, they want to keep their cushy salaries and great jobs, and the NHS is great for that.

Let me tell you straight: if I didn’t care about you, or my patients, I would be out there campaigning to close the NHS right now. I would make more money in the private sector in a  day than I would in two weeks of NHS work. I could also take my UK Medical degree, one of the most respected qualifications anywhere in the world, and go and earn 50-200% more in the US, Australia, New Zealand [3]. In the private sector, if I stayed after 5pm to look after you, the next thing you see after my smiling face as you exit the hospital, will be the bill on the doormat; ‘overtime’, ‘time in lieu’, ‘additional hours rates’ aplenty.

But, I, like you, have a family. I went to state school, and worked and grafted to pay for my six years at University. Without the NHS my grandmother would have gone blind, my father would have had several heart attacks, my mother would have died. I might have died. A private system would’ve bankrupted them, ended their hopes for a better future in order to pay to survive. I, like you, would do anything for the ones I love, and that is why I campaign to protect and improve the NHS. And that is why, when 5pm comes and goes, as does 6pm, 7pm and all the other hours in between, I, and every colleague I have ever worked with, stays for their sick patient. Because, one day, somewhere, for someone else, that patient will be their mum, or dad, wife or husband, son or daughter.

We have had, and always have had, the extraordinary privilege of one the greatest healthcare systems, pound-for-pound, in the world. The reasons for it’s great outcomes and low cost are debatable. But there are some reasons we never mention. This country has a medical school system of international renown, whose doctors, for the most part, qualify and stay exclusively working within the NHS. The staff of the NHS gives untold free hours to the profession; when I was a first-year junior doctor, I calculated I worked one day at work for £4.10 an hour. I used to get paid more at Tescos. But a very sick patient needed a lot of complex care, and so I stayed, and helped, and he survived: as millions of patients have since 1948. [4]

The moves of the current government against the medical profession are calculated: to deride working conditions, salaries, hours and deplete hospital resources, until a normal person, like myself, buckles under the social, financial and emotional cost. At that point, a sea-change of new, private hospitals will open, and we will go and work there. And our lives will be pretty much the same- different bosses, the same bureaucracy and probably better pay. But our lives, as normal people, will not. You will still pay taxes, a stripped-down NHS will persist, for no frills, emergency care only, but not for all the other healthcare needs of a 21st century population: you will need private healthcare. And that healthcare insurance will cost you hundreds of pounds a year, if not a month. And if you don’t have insurance, you will spend thousands of pounds on the simplest, quickest procedure [5]. And the NHS won’t be there for my family, or the families of normal people across the country.

So, I want this to reach as many normal people as it can. If you don’t act now, it will be too late. It might already be too late.

We care deeply because we can see the great good the NHS does, every single day. And I care because, like you, I care about the ones I love.

Where can you start?

June the 8th, 2017

At the polling booth,

Yours sincerely,

juniordoctorblog.com

[PART 2: A Factual Appendix]

-What normal people appreciate, are hard, solid, unflinching, facts. So here they are.

[2] Medical students studying now can now expect to pay £9000 pay a year as of 2015 for six years for most courses: that is £54,000. Most will require a student loan to pay living expenses for a full time course, at a further £5000 a year that totals £79,000 for six years study. Maintenance grants for the poorest students have been scrapped, adding an additional £10,000 debt as a minimum.

[3] Starting pay for any consultant in the UK : £75, 249. In the US: £111,799.80 for internal medicine, £183,152.91 for a radiologist. ($/GBP rate correct at time of writing). In Australia: a basic salary of £78,000 for internal medicine consultants, BUT this is for a 38 hour working week. Average overtime and up-scale pay between £92,526.97- £244,366.10.  Same with New Zealand for a 40-hour week, after average overtime and up-scale up to £128,039.69.

UK data: http://bma.org.uk/practical-support-at-work/pay-fees-allowances/pay-scales/consultants-england
US data: http://www.payscale.com/research/US/People_with_Jobs_as_Physicians_%2F_Doctors/Salary.
Australian data: http://www.imrmedical.com/australia-salaries-tax
New Zealand data: http://www.imrmedical.com/new-zealand-salaries-tax

[4] The NHS opened it’s doors, metaphorically, July 5th 1948. It’s first patient was a 12-year old girl with a liver condition. http://www.legislation.gov.uk/ukpga/Geo6/11-12/29

[5] This is incredibly interesting reading, although it is for claims, it is still very reflective of the actual cost. https://www.freedomhealthinsurance.co.uk/downloads/your-choice-procedure-payment-guide

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51 thoughts on “Dear Other Normal Human Beings

  1. I’ve worked fir the NHS for over 35 years. I’m a registered nurse. I’ve also spent a lot of my working life as a midwife. I’m so proud to read your blog, you are the future and you are fighting the same fight that a great many of your colleagues are. I drive people nuts because I try to explain that we need to fight to keep our glorious NHS. I explain that there are many private health firms who use the umbrella logo of the NHS even though they are privately commissioned and are profit driven. Not many people understand, they think I am obsessed. (Of course they’re right, I am!) I’ve lost friends,mainly Tory supporters and albeit on Facebook, they block my posts even though I do intersperse them with the odd photograph of a kitten! I don’t blame them entirely but I do wish they’d see beyond the economy which would be best managed without giving all the tax benefits to the seriously wealthy. Brilliantly and sensitively written, a joy to read, thank you. All petitions signed!

  2. THANK YOU for taking the time to write this brilliant article to share your thoughts, and ALL the hard work and sacrifices that you and other health professions have contributed to the health system.

    I sincerely hope that this article would allow ‘the other normal human beings’ that did’t understand the impact of a private health system would have on them (and their loved ones) if the NHS finally buckled under poor management.

    Warm wishes to you and your families and friends that have supported you, which in return, supported the rest of us in the society!

  3. What a great letter. Thank you for taking the trouble to write it. I doubt you get much free time. It is so good when people like you speak out for what is right.

  4. And as a doctor you earn a lot more than the average member of the armed forces who protects the freedom that allows you to be a doctor. They are on duty 24/7/365 and don’t winge and moan. I myself have missed numerous weddings, christening, far to many Christmases, Easters, Bank Holidays but I was lucky enough to be able to attend my mothers funeral as I was not away. However she died in absolute agony screaming in pain due to the incompetent Doctors looking after her. Many of my colleagues have become divorced due to their sacrifice, so please stop moaning and do your bit.

    1. I think you’ve slightly missed the point here. It’s about saving the NHS that we’re proud to be part of at the moment, not ‘moaning’ about our own working conditions or pay. The working conditions of the armed forces are also not ideal but like all these professions, we went into them out of choice. We didn’t go into them for the money or perks! It’s a shame that as a fellow doctor you can’t see that.

      1. Considering this post (and many others like it) are about saving the NHS, it’s funny how much moaning about pay and hours it contains! Yes, doctors work hard, and they have to work hard to become a doctor, but this post, along with others like it, do betray a common opinion among doctors that they think they are more hard done by than others. I feel much more sympathy for those on minimum wage (cleaners/security guards etc), who work through the night every night, have zero control over which shifts they take (also missing weddings etc), and do not have the respect doctors receive. And the crap about working out your wage based on overtime to be less than minimum wage…come off it…the take home pay of a doctor is well over the average, including many of those who work over time or work multiple jobs to make ends meet.

        There is a huge degree of hyperbole in this letter. To say that those people would have died in a system other than the NHS is a little far-fetched. Other countries have very different health systems, but comparable (or better) patient outcomes.

        Further, the NHS is pretty much the only Government led department/programme that has seen (and will see) a significant real-terms increase in its budget between 2010 and 2020. If you think the NHS is hard done by, look at pretty much anything else in the country at this moment…

        The very fact that all of these “save the NHS/anti-Hunt” posts are being shared during contract negotiations between the BMA and the NHS Employers tells the real story. It’s about doctors wanting to negotiate the best deal for themselves, dressed up as a “save the NHS” story. Fair play to the BMA for stoking the flames, it’s a great negotiating tactic, but I for one see through it.

      2. Anon1, I can only assume you are a paid Tory worker, spinning such nonsense. I see no moaning, just a factual counterbalance to the extraordinary undermining the medical staff have had at the hands of this government.
        You say other countries have very different systems but comparable (or better) outcomes. They (arguably) might, in some cases, but the cost is always higher. They pay more as a percentage of GDP, but we are always being told we can’t afford more. There is a peculiar blind spot in the accounting for such things that reckons if people pay out of their own pickets it doesn’t count as more expensive. Mindless tosh. If the country pays, the country pays, regardless of whose pocket it comes from.
        The NHS has not seen a significant increase in its budget. That is another accounting sleight of hand. Whilst its budget appears to be being maintained it had to make £20bn of cuts in the last 5 years and will have to make £22bn more in the next 5. What’s given with one hand is taken away 5 fold on the other.
        And you don’t address the elephant in the room. Privatisation. The NHS is being privatised. That’s the point of the attack on the doctors and other staff. The 24/7 working contract is designed to drive away the doctors who have just about had enough and to remove payment enhancements for anti social hours. Anyone who is paying attention can see that. It’s a cost saving for the private sector who are pretty pissed off that they aren’t yet recouping the kind of profits the H&SCA promised them.

    2. Sorry to hear about your mother, although you don’t mention exactly what happened.

      In response to what you say about the armed forces: I’ve heard a lot of them moan (and with good reason). I’ve also seen a lot of them have subsidised housing, which doctors don’t get. And in response to your comment about it being the armed forces that allow doctors the freedom to be doctors: it’s doctors that help the armed forces to be able to continue their work, and sometimes to continue living.

      Once again I am sorry to hear about your mother- I have had similar experiences myself. However. Maybe the “incompetence” you talk about was partly due to being exhausted. Exhausted for working hours that are not documented. Not having enough time to eat for over ten hours. Going “home” to a house share (because a lot of them can’t afford to rent flats) filled with damp, mice, and people who keep them up at night partying. Perhaps they didn’t have the luxury to go home at all.

      Just think about it because for many doctors this is an everyday occurance that they don’t moan about.

    3. I am sorry that your mother died in a dreadful way. I’m not sure of the circumstances and you are right to feel angry. I do have to say there are far more who get incredible life changing and life saving treatment. However it doesn’t make it any better for you but crucially I think you’ve missed the point. The NHS is being dismantled and so that the government can get away with it Hunt and Cameron use inappropriate, inaccurate and inflammatory comments to set the general public against the health service and its staff who are in the majority dedicated to patients. They use scewed data to prove their point which by and large is wholly inaccurate in its interpretation. The NHS logo is used by many privatised commissioners so actually you will not know whether your mother for example was treated by a profit led commissioned service such as Care UK or the NHS. Both of whome provide community and hospital services. Also investment in the service of palliative care etc may have contributed to a better outcome for her. I don’t know. Sadly if people, such as yourself continue to feel that the NHS is not providing a good enough service then the government’s privatised service bill will succeed and this will make treatment more difficult to obtain for those who cannot pay. If you look at the USA ( the model used by the gov) then you will see only the rich can afford good treatment and the poorest will have a basic service if any at all. Palliative care and treatments are more expensive so many more people will die in agony. The NHS is better than the USA by a mile and at a cost of £2500 per head capita compared with £7000 per head Capita USA it is a far better service compared to all developed countries (2011) . Read the article, the doctor is not complaining about his lot, he loves his job but hates the lack of government support. Why compare it to the armed forces who have utmost respect of the citizens in the UK? We need to work together on this as the problem will become out of control and we will lose it despite all our NI contributions it will be a pay for privatised health service. Be very careful what you wish for.

    4. Soldiers don’t whinge and moan?!? I should introduce you to some of my soldier friends. They hardly seem to do anything else.

      1. Ha ha! Having served 19yrs in the Army (both as a soldier & an officer) I can assure you that soldiers do whinge & moan, about everything! Regardless of the operational tours & long exercises, we had it good for years in terms of pay & leave entitlement, now not so much, but that’s another story. This is a good straight-from-the-heart blog about a service that over the recent years has been badly managed by bureaucrats. I for one am grateful for our NHS & what it has provided to my family & friends. Long may it continue.

    5. A lot of people from the armed forces are too thick to be able to get jobs anywhere else. That in addition to PTSD is why there are so many homeless unemployed veterans. That does not apply to doctors who as the blogger indicated, could easily leave the NHS for more lucrative employment. We should thank our lucky stars they haven’t.

      Very few people die due to incompetent doctors. We die of natural causes and doctors delay that. We’d be dying a lot sooner without them.

      Soldiers kill for a living at the whim of unscrupulous dishonest politicians. You’re fighting for oil; not freedom, so wind your pompous neck in and stop moaning yourself!

    6. I agree with you. My own mother died in absolute agony with stomach cancer because of an incompetent doctor too. He kept insisting that she only had indigestion and fed her bottles of Gaviscon, she was too trusting at over 80 years of age to insist on tests. It was discovered too late to do anything for her and then all she was given was boxes of paracetamol to cope with her pain. In hospital after she collapsed one night she was kept on morphine which did nothing for her and she was screaming while she was unconcious until she died a few hours later. My brother called me in the early hours in tears after they took her away, the ambulance men were rough with her and ignored my brother. They expected her to walk to the ambulance! She was upstairs collapsed on the floor!!! How the hell could she walk???
      I had a mad dash driving up there for hours so that I could be there.

      I will NEVER forgive that bloody doctor!

      Thankfully I could sit by her for one last time but I cannot forgive what happened to her and how she wasn’t treated properly.

    7. This is not a “doctors versus soldiers” debate and never intended to be. The government should protect and support all its workers.

  5. Very true words. As a nurse myself I can totally understand and empathise with every word of this. Although now after being s nurse for 23 yes I technically work Monday to Friday 9-5. Due to the dedication and love of my job I probably work a minimum of 10hrs overtime s week. My phone us never off and I answer work text, calls and email in the evenings, weekends and if I am off sick. Although inflation has been going up as well as travel costs this year I did not get s raise at all and for the past several yes it has been 1%. What do politicians and bankers get? I didn’t become s nurse for its pay I did it because I love it and love helping people. But the NHS has changed and I don’t like it the government are treating it like a business and cut pay and positions to save money and this is reflected in the service you get. Save our NHS by treating the workforce properly and then the good decent hard working staff won’t look to go work elsewhere.

  6. I have nursed in the nhs for 23 years now having the great privilege to train in one of the best healthcare systems in the world.
    Yes in it’s current form the nhs is unsustainable I agree.
    I would like to point out that the centralisation of care in hospitals was a government led move. We used to have cottage hospitals , integrated care in the community with local GPs and nursing and midwifery teams serving their local population and hospital was only for specialist care.
    We are moving back to that model now but it was the internal market and the development of specialist centres competing for patients that caused us to try and provide every service at every hospital at the expense of local general care near to where patients all live.
    At my local hospital consultant physicians and paediatricians are on site 7 days a week until 10pm and surgeons are on site during the day sat and Sunday .
    Jeremy hunt needs to understand that most hospitals already run a 7 day service for core services .
    Consultants and senior nurses like myself as with all staff work well above our hours and provide on call via quite punishing Rota’s . My last 3 nights and days continuously on call were so busy I hardly slept but patients need care and senior staff go out of their way to support junior staff in providing that care.
    Mr hunt should join me on my next on call being rung every few hours through the night and working a ten hour day for 3 days and nights and then he can reassess his assertion we are being paid too much and don’t provide a senior cover at weekends.
    And Mr hunt while you are at it i haven’t had a pay rise to meet the increased cost of living for 2 years and now you are saying it will be 1% for next 4 years.
    If Mr Cairney at the Bank of England puts up interest rates as predicted I will have a monthly pay decrease of £288 .
    I have already lost out on my pension rights .

    1. No idea when this golden age of cottage hospitals occurred – not during the 35 years of my nursing career. I remember excellent district general hospitals which trained nurses & midwives, & which focused on treating all the commonplace medical & surgical conditions. That’s how we learned good general nursing. Now what remains of those hospitals is made as inaccessible as possible to frail elderly people & people with learning difficulties. And don’t forget to supply your own medications on admission. We have to acknowledge the poor standards of care as well: weight loss, pressure ulcers, mandatory urinary catheters, long-term medications discontinued ill-advisedly & with no rationale or consultation with the specialist who initiated the treatment.

      As for the standards of community care… Sounds a wonderful idea, but it is supplied by district nurses who, like GPs, think it unreasonable for them to be expected to work unsocial hours. Community care is increasingly being provided free of charge by families, or with dismal ‘care packages’, all overseen by social workers with no insight into, or interest in, what we understand as good care. As long as it’s cheap.

      I cannot comment on the financial lure of the independent sector for doctors, but can for nurses, so let me dispel a few myths. We are not raking in huge salaries (substantially less than NHS staff, with no extras), and experience salary cuts during lean economic times, such as now. Our salaries depend on our skills in marketing, to fill the beds & provide the income, something we were never trained to do. We also work excessive hours as senior staff, spend perhaps months at a time on-call, with responsibility not just for clinical management but everything & anything else – the chef’s gone sick, the lift’s stuck, tonight’s agency nurse has cancelled with an hour’s notice etc. And it’s worth noting how isolated we are as practitioners, with not much more than a suction machine in case of emergency, and the option of calling 999 for help. Other than that we are alone with our core nursing skills, so they need to be impeccable.

      But I’d never return to the NHS, even if it were not moribund. The pressures, the targets, the constant upheavals, are simply not worth the extra money & pension. The independent sector is at least honest – it’s a business, but it’s one in which we nurses can exert perhaps surprising influence, so we all learn the techniques for making sure business imperatives do not hamper the purchasing of equipment we need for our residents.

      Not even the dreaded CQC would tempt me back. This bunch of inadequates is ideologically hostile to the independent sector, & takes great delight in making life as difficult as possible for as many providers as possible. But we learn resilience to their hatred. By contrast CQC tells NHS services when they will be inspecting, affording them every opportunity to make sure everything is perfect, & deflects suspicion of their methodology & integrity by making an example of a few hapless victims. Mid Staffs? Try Royal United Bath, Yeovil District, Southampton General, Royal Bournemouth, Dorset County, & spot the difference.

      Honesty again, or a lack of it.

      Plenty of NHS staff do, and have always, voted Tory – it’s always baffled me. They have therefore got what they wanted, so perhaps time for a rethink, assuming it’s not too late?

  7. Anyone who cannot see what is happening to the NHS under this government needs a reality check. I no longer live in the UK, but did for 60 years and was grateful for the Health Care Service. Reality check- in 1989 my mother had open heart surgery whilst holidaying in the USA – cost $1.2 million dollars.
    I had a pulmonary embolism in the USA and I cannot remember the total cost of my 8 day stay in hospital, but I do know that everything was itemised, every blood check sometimes as many as 8 a day, X-rays, scans ultrasounds,meals, general care and believe me it is scary.
    I recently had a second embolism this time in the UK- cost to myself-0, although I have always paid my National Insurance contributions.
    I also had an opportunity to stand behind an elderly man in a U.S. Pharmacy who couldn’t get the hospital prescribed drug because he didn’t have insurance.

    God forbid that the Healthcare of the future emulates the above.

  8. Hello colleague!
    I’m about to start as a junior doctor and I can only echo your thoughts. I was offered lucrative pay in another sector before I embarked on a medical degree and I don’t regret that decision one bit. Despite the tuition fees and living costs, I want a job that I can spend my life making a difference and enjoying, and I, along with my family, made sacrifices to make that happen. I won’t detail them here (don’t want to be accused of complaining before I’ve even started!).

    Like you, I see the future if privatisation takes off – my husband and I will be fine, I’ll earn more for fewer hours and get more time to support my family. However, like you, I’ve had family members who’ve relied on, and died during NHS care (which has been the best possible) and I believe that if we are to have a community (country) bound by common values, the NHS represents the best of those values and we need to fight tooth and nail for it.

    Private healthcare systems work fine, and “Anon1” is right when they state they have comparable outcomes. BUT we need to ask what values those outcomes represent – if the people of the UK decide NOT to fight for the NHS by writing to their MPs and signing petitions…. If they believe that healthcare quality should be based on ability to pay rather than need (unless an emergency, when a payment plan is worked out afterwards), then that’s their democratic choice. And it will be THE most depressing and unfulfilling “I told you so” in the history of our nation. It’s happening right now. Hunt’s book reads like a 12 step plan for privatisation and thanks to him and his predecessor Lansley, the government is up to (approximately) step 4 – it makes my blood boil that The Last Leg, a comedy show, are the only journalists who are reporting this!!

    Anyway. I’m going to continue to bend the ear of everyone I meet regarding Mr Hunt and the government’s drive towards privatisation (which is why he’s linked mortality to consultant contracts). Everyone is now sick of my soapbox, as I suspect your non-healthcare friends are sick of yours. But this is too important an issue to be silent on. I believe healthcare should be based on need and I stand with you. Thank you for your article. Keep up the good work.

  9. I agree with everything that you have said about the NHS.
    But isn’t there another side to the story ?
    Does the NHS really need the number of administrators that it seems to employ ? Maybe it does, I am certainly not an expert and sometimes I do listen to politicians – maybe not a wise thing to do ?
    As well as that, doesn’t having a system like the NHS discourage people from taking responsibility for their own health ? There seem to be an awful lot of fat people in the UK.
    Just a couple of thoughts

    1. I can only speak from primary care, but the administrators employed there take away all the tasks that can be taken to allow the doctors to treat patients, this includes administering letters from hospitals , it is they that ensure the latest results, treatment updates are put into the patients medical records, so that when patient sees doctors they can be assured that doctor is fully aware of latest results. They also handle something in the region of 900 calls a day into the practice. These calls can include: making appointments; request for repeat medication; passing on requests for advice to the doctors; not to mention calling patients on behalf of the doctors, when results are not as they should be or for calling patients back to manage the multiple health problems they may have I.e. Asthma, diabetes so that the patients do not become sicker they do a fantastic job with often no thanks. If the general practitioners had to do this themselves, they would have little time left to see you when needed. I can assure you we do not employ more than we absolutely have to because the doctors in the practice have to pay these administrators. They are the unsung heroes in my mind

    2. That’s an excellent comment, I worked in the NHS for 40 years, now retired, as a Biomedical scientist. When I first started, if we wanted to purchase any new equipment we asked the hospital board, they we given the faacts and made a decision. When I left, if we wanted new equipment it had to be discussed by a heads of department, then to the hospital board, then, if it got past that hurdle to the regional board, if it still got through then it had to be advertised Europe wide for firms to qote, once that had happened it came back down to more local committees to dreate a shortlist, and to decide just what the key criteris were, this was then sent to the firms. They then had to reply, and management people had to go and see it working. They then reported back, there were then a number of meetings before a final decision was made. The equipment was then ordered. Time scale here was around 3 years from start to finish. Due to inprovements in technology etc, this equipment had a working life of about 4 years, and so the whole cycle started again. The cost of the exercise would be around £15,000, and the number of different admin people involved was about 30 at 4 different levels.

  10. HI – a comment from the United States. If our government is moving towards a US style health care system that should be opposed with every fiber of your being. Anyone who thinks tax payments to fund your NHS are too high should try paying 400-700 dollars per month for health insurance knowing that if you get really sick you can end up liable for another $5,000+ and have certain uncovered expenses you have to pay yourself.

    Also, as someone who does computers for medical practices, let me tell you your NHS red tape is nothing compared to having to deal with private insurers. Large multi-hospital medical groups in the USA have crowded rooms packed with staff filling out insurance claims. The large number of employees is explained needing separate full time staff for each insurer the medical group accepts. Private practices and small clinics generally have one or two full time employees who do the preliminary data entry for filing claims. Then the claims are forwarded to large companies who specialize in submitting claims to insurance companies. These have staff similar to large multi-hospital groups and take the raw information and code it to submit to the insurance company Like the multi-hospital groups they have one large set of full time staff for each insurer they submit claims to.

    If your government is moving to a US style health care system, I can tell you as a 55 year old US citizen who has live in the USA all his life and who works specifically in the medical IT field that if your government moves to a US style health care system it is insane.

    1. My hospital trust treats 750,000 patients a year. That requires a lot of clinical, support and administration staff. The NHS is an amazing institution and should be valued as such. The major problem is that negative ores is released to a largely Tory press, the Health Secretary fuels the negativity by crass, inflammatory, inaccurate and bizarre statement aimed at his particular cunning plan of privatisation and everyone paying into a Health Insurance policy and therefore free treatment at the point of delivery will be a thing of the past.
      We pay National Insurance for our healthcare already. They have sold off the profitable bits which are failing under private providers. Who actually thinks that private providers care? Stupid people that’s who!
      Wake up. You are all being robbed blind by a government who frankly don’t give a damn. Stop bashing the lack of care. Start rallying your MP tosspot the NHS. Stop using it as your drop in centre for a bit if a cold or a headache or your false nail has broken before your night out (true story!)
      We need to get tough with those who abuse the system and a stop treating it as a right to roll up with any lame excuse, to stop abusing the transport system so that money can be invested for those who really need it and start attending your appointments.
      Most of all stop moaning unless you want to pay through the nose for your treatment. Good luck everyone!!

      1. Strangely spell check has attacked my post!!
        It should read ” negative PRESS is released” line 3
        Line 11
        Start rallying your MP to support the NHS ….. Not your MP TOSSPOT !!! Although that one made me laugh, how ironic!! Thanks spellcheck 😊😂😉

  11. All students are paying £9k a year and unlike medical students most don’t have guaranteed job security for life. Most professions work on a pyramidal basis where you have to strive to climb the ladder. Whereas most doctors become consultants around 10 years after med school which is roughly aged 35. Only £75k starting salary for a consultant – my heart bleeds for you pal.

    It’s time you started earning that money – any other profession that pays that kind of money works a hell of a lot more hours than doctors believe me. If you don’t like it then I suggest that you go part time.

    For those interested – doctors were fiercly opposed to creation of the NHS as they thought it would result in a pay cut.

    If the government want a 7 day NHS which is safer for patients and a service that gets better value for money by making doctors earn their enormous pay packets then I say fair play to them.

    1. If you really want to make a comment please ensure you know what you are talking about. The NHS is already a 365 24/7 service. Who do you think treats you if you have a pile up on the motorway at 2 am in the morning or have a Stroke on Sunday at 3am. God help us all if we move to the American system of only those who can afford to be treated are able to access care – wake up and smell the coffee. The conservatives have their buddies to take over lucrative parts of NHS. But what about the elderly, or those with mental health needs, where there is no money to be made. Who do you suppose will Care for them?

      In terms of them earning high salaries you need to see the hours of unpaid overtime they work because they stay to treat or cover un-filled vacancies.
      they are dedicated as to are allied staff ie nurses, physio, radiotherapists, administrators etc

      It is Jeremy Hunt that are portraying them as money hungry, the doctors are not. The doctors want to treat patients to get best outcomes for them. Remember politicians come and go but the doctors you are knocking in the main stay – some are so demoralised they leave to go to a country where they can work without political whims or self serving political dictates who can blame them! If you want to knock any one look higher up the chain of NH S but they too have their strings pulled by J Hunt

    2. Consultants DO earn that money- do not believe the Tory spin. They work 56 hours standard per week plus on call and lots of unpaid overtime. They have no breaks and no food or drink provided so often have to go without. The Government forget that there IS a 7 day NHS and that the studies they based their assertions on were only saying that patients admitted on a Sunday were 16% more likely to die IN THE NEXT 30 DAYS. They did not die at the weekend. And consultants and there teams were there to look after them at all times. They wondered if patients admitted on Sundays happened to be iller than those admitted on other days. Do not believe their lies or soon our beloved and very cost effective NHS will be destroyed.

      1. Going to have to correct your facts here love because I actually know what I am talking about:

        Standard contract for consultants is a 40 hour week (or 10PAs).
        They DO get paid for working over these hours and when taking on extra responsibilities (called additional PAs). So most consultants at my place are paid for about 12 PAs – roughly 120k.

        Let’s not forget to mention clinical excellence award which is essentially a bonus for life. Once you’ve got it, you’ve got it, you don’t have to re-earn it. CEAs can be as much as £76k but realistically most are around the 20-30k mark. Any other profession your bonus is reviewed at least once a year and you have to earn it but with doctors once you’ve got it you’ve invariably got it for the rest of your career – which to me seems wrong.

        And then there’s the WLI payments (waiting list initiative payments) for working weekends. That’s £540 for 4 hours work on a Saturday at my place.

        And then there’s the private practice- Most of the consultants where I work do at least some private work which I am told is very lucrative.

        In summary – yes junior doctors work hard but once you become a consultant (around 35 years old) you can ride that gravy train all the way to early retirement.

        😀

  12. It seems true that the government manipulates the press to create headlines which put professionals in a poor light. We all suspect that failure in the governmental policies has led to an increase in the load borne by the NHS with little additional funding. In the same way I have seen the education profession pilloried through the press via inexcusable governmental interference.
    The government set ridiculous targets for health and education front lines whilst not setting similar targets for its own MPs. They have proved this by accepting a pay rise for their members before they have proved their worth!

  13. To all of you who think you’re the only one with bad conditions, low pay and long hours, don’t forget that in most cases YOU CHOSE to be there. Many people don’t have the option and have to accept such conditions etc. Everyone deserves a decent wage, working hours that don’t tire them out so much that they can’t enjoy their time off, and to be treated fairly and decently in work and by those workers who serve or protect them for whatever reason.
    Stop arguing about who is worst off, start working together to put the Great back in Great Britain and make this a nation to be proud of.

  14. You make it sound like being a doctor is the only profession that requires hard work and sacrifice, but you say that you have never wanted to do anything else and never known anything else.

    Maybe if you had experienced work elsewhere you would appreciate that doctors really aren’t that hard done by. Yes doctors work hard, but so do the people who are out in the M6 laying Tarmac at 1am on a Saturday morning and I dare say they are far less well rewarded.

    Have a read of “The status syndrome” by Michael Marmot.

  15. Dr,

    Thank you for your excellent blog and for all the work you and your colleagues put into making sure all of us have access to at least one of the very best healthcare systems in the world.

    You don’t actually say, but I do hope that our government do not speak for the vast majority of us on this issue. I have had asthma since a child and now experience poor mental health, so have been at the receiving end of our very
    excellent NHS.

    What successive governments have been trying to do to our NHS for a long time now is fundamentally wrong. Over an extended period of time they have made some success towards they ultimate goal of shifting us to a pay for system of healthcare, but I believe that it is never too late.

    That is one of the many reasons I have setup a new grassroots group for the people called Redesigning Democracy UK. The purpose of this group is to provide a platform for people to come together to discuss, debate design & build a better, fairer, more democratic UK society that will include a NHS that is built upon it’s founding principles.

    Group meetings are held online as webinars and our first meeting has in fact just taken place this evening. The next meeting will be during the first week in September, on a date and time to be confirmed. Anyone who is UK resident and wants to be a part of designing and building something better can join the group
    by sending an email to redesigndemocracy@yahoo.co.uk

    Thank you for the continued dedication and commitment of you and your colleagues, to whom we will always be indebted.

    Damien Quigg

    Redesigning Democracy founder

  16. Was all going ok until we got to the quantum leap at the end. More is being spent on the NHS than ever before. And just because everything doesn’t stay exactly the same as it was in 1948 doesn’t automatically mean we go to an American system. there are plenty of other systems that work very well.
    This ‘NHS or back to using leeches’ argument is pretty puerile, especially from someone who has spent so long being educated.

  17. Jeremy Hunt Needs 2 Go. he hasn’t got a Clue what the Hell Hes Doing . what does he Know about Our NHS. The Tories Just want 2 Sell it. putting Profits Before Lives. well the Tories have Shown us They have no Compassion 4 our Lives . look How Many Disabled People They Have Killed Its 120.000 Or Maybe Even More. they will not Reveal The True Numbers. put The NHS In The Doctors Hands. then it will b More Profitable & Start 2 Work Properly.

  18. Having to miss a christmas to pay for your rent? That’s exceptionally bad financial planning for someone who will have had to do numerate subjects at A-level

    Whining on about your student debt –
    You’re not the only one in that situation and you chose to take the longest course possible

  19. The government is accused of manipulating the public with its weekend death stats, which I would agree with (you need to allow for the fact that those admitted at the weekend are more ill) but this letter is just as bad.

    The sense of entitlement that comes across is terrible. There are lots of people with student debt and lots of people that work hard. Many professions in the private sector would expect overtime without pay.

    When the average consultant salary is £118,000 (top 2% of earners in the country) plus £1m pension pots they can hardly claim to be hard up. From what I can tell the main change being proposed is just to add a requirement to work some nights and weekends. Hardly radical and certainly not the privatisation of the NHS. It also looks to me like higher salaries in earlier years are being proposed which would seem fairer given how hard junior doctors do have it….

    Surely much better to put some actual facts about what is being proposed on the table and why this is a problem?

    It’s now almost 25 years since Thatcher but everything is still couched in language from a bygone era. Nobody wants an American System of health insurance. All parties are behind a free healthcare system. There isn’t some crazy agenda to fully privatise the NHS from the Tories or anyone else. And even if there was it would be in the table because there was a belief it could provide a better service, not because of random ideology. Profit is not a dirty word. It is often people’s salary. Or money paid into the nation’s pension pots. Can we all start being grown up and respecting people’s views rather than throwing insults around just because someone has a different view to you.

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