It’s been a busy couple of weeks on the healthcare news front. Industrial action continues apace, with junior doctors declaring a further five-day strike in mid-July and hospital consultants voting for strike action shortly thereafter. In the Guardian on Thursday, Professor Philip Banfield of the BMA exults that all English doctors could be taking strike action before the next election. Banfield states this is precisely the BMA’s intention.
That the BMA is inciting politically motivated strikes is no surprise – the union has been run by Left-wing agitators for many years. The main bone of contention is ostensibly financial – the BMA demand a 35% increase in basic pay across the board for all grades of hospital doctor. The cost to the taxpayer of such a demand is hotly debated. Estimates for full settlement of the junior doctors’ pay claim range from between £1 billion per year (BMA) to double that amount (HMG). The cost of the consultant pay demand would be substantially more expensive. Assuming a reasonable mid-point estimate, the BMA is probably demanding an extra £4 billion per year in taxpayer’s money.
Closer inspection suggests all may not quite be what it seems on the barricades. For example, the nursing union failed to secure a mandate for further strikes, and the junior doctors’ action may also be wavering. During the last juniors strike, some hospitals reported 70% of their trainees turned up for work. It is important to remind readers that the term ‘junior doctor’ covers a wide spectrum of medical practitioner – from the newly minted F1 houseman fresh out of medical school in his or her early 20s, to the senior registrar in his or her mid- to early 30s, with 10 or more years of hard work invested in their careers. Many older trainees with family commitments can’t afford to strike, nor have their valuable training time reduced by industrial action.
My understanding of the current situation is that more experienced medical trainees are either reporting for work as normal on strike days or making money by doing extra shifts to cover absences of their younger colleagues – at pay rates of up to £269 per hour.
The strike is still disruptive as a lot of routine work has to be cancelled. On the other hand, it is a manageable situation as the die-hard militants are mostly drawn from the younger group of juniors – the equivalent of medical toddlers. This cohort are easily replaceable by more mature practitioners for short periods of time.
A consultant strike could be a different beast. Consultants are fully trained and accredited specialists – in short, no clinical work can happen without a consultant assigned to supervise it. Yet again, there is more to this action than meets the eye.
The union publicly exhorted members to vote for strike action, even if the individual had no intention of striking, in order to ‘send a message to the Government’. The proposed consultants action involves providing ‘Christmas day’ cover – in other words a full emergency service but no elective work. This is a strike deliberately intended to disrupt efforts to reduce waiting times for patients. It remains to be seen how many consultants will actually turn up for work as usual, despite the strike vote. That said, even if a surgeon arrives for a planned operating list on a strike day, the list still can’t proceed if the anaesthetist is on strike.
I think it helpful at this point to explain just how consultant specialists are paid. There has been a good deal of argument in the deadwood press as to the precise amount consultants earn, with every claim and counterclaim subject to traditional accusations of ‘misinformation’ and subject to contentious ‘fact checks’ by BMA agitators. Having spent 20 years as a consultant, I can shed light on this byzantine system for readers with the stamina to stick with the detail – you certainly won’t read this information anywhere in the mainstream media. The remuneration system goes some way to explaining the productivity conundrum – why NHS productivity continues to fall, and the system continues to underperform despite more money being spent and more doctors recruited.
Consultant time is remunerated per ‘programmed activity’ of four hours – abbreviated to PA. Hence a 40-hour working week constitutes a 10 PA job plan. The basic salary rates quoted by the BMA are on a sliding scale from £88,000 for a newly qualified consultant to £128,000 at the top of the scale. There are several important points to note when interpreting what the BMA says. The first is that not all new consultants start on the lowest salary point – those with post-fellowship qualifications may start several points up the scale. The second point is that this is an upwards-only increment – in other words, progression up the scale is related purely to time in the job. There is no requirement to achieve certain milestones, or hit productivity targets – simply keeping breathing and not getting fired is sufficient to get a pensionable salary increment, before any nationally agreed pay increase is added. Given that it is virtually impossible to be fired as a doctor, pay progression is assured.
The figures quoted do not include various add-on supplements. For example, there is an extra pay award for intensity of on-call, for London weighting and for extra duties such as managerial roles. Consultants can also apply for ‘clinical excellence points’ which accumulate and can make a substantial contribution to take-home pay. Doctors taking on extra work can be awarded extra PAs – in my time working for the NHS it was not unusual for some colleagues to be on 13 PAs, effectively enhancing their base salary by 30%.
The definition of a programmed activity is open to negotiation in the yearly job planning process. About 25% of a doctor’s time is allotted to ‘supporting activities’ – teaching, audit, participation in mandatory training and various other administrative tasks. Even PAs for direct clinical care of patients can be modified to include time taken on writing letters, travelling between hospital sites and a multitude of other tasks not involving patient contact time.
Annual leave allowances are generous. The BMA states that consultants are entitled to six weeks paid annual leave per year. Again, in fact the allowance is more than stated. Once bank holidays and various other entitlements are considered, most hospital consultants get between seven and eight paid weeks of holiday per year. In addition there are 10 days per year of paid study leave or professional leave to attend courses and conferences. Doctors involved in national bodies such as the many Royal Colleges, professional associations or in academic practice can negotiate much more paid leave than this. It is not uncommon for some NHS consultants to be absent on paid leave for nine or 10 weeks of the year.
Contrast this system with remuneration in private practice. In the private sector a doctor is only paid for directly relevant clinical services. Doctors are not paid for all the necessary administrative tasks involved in running a practice. There is no paid leave of any kind – no holiday pay, no sick pay and no study leave. Nor are there any pension entitlements. Financial incentives in private practice are aligned to encourage direct clinical contact. In the NHS it is the other way around.
NHS consultants can also be remunerated (in addition to their base salaries) by taking on extracurricular activities for NHS England or other national bodies. Consulting work for the pharmaceutical industry or medical device companies is commonplace. Some consultants earn significant extra money by writing medical reports for the legal system.
And then there is private practice. It is important to state that a minority of NHS consultants do a large amount of private work. Nevertheless, the nature of job planning usually leaves at least a whole day a week free for private practice, plus evenings and weekends. A moderately industrious doctor in a reasonably affluent part of the country should be able to clear £80,000-£100,000 per year net of expenses from private practice without too much extra effort.
The NHS itself also provides opportunities for additional income by laying on extra clinical sessions outside agreed job plans to reduce waiting lists – simply put, if patients cannot be treated during normal paid working hours, the NHS will pay consultants extra to treat them in the evenings and at weekends to meet political targets. Several enterprising companies have started highly lucrative ‘insourcing’ ventures – where NHS staff use NHS facilities outside normal working hours to treat NHS long waiters. NHS managers look kindly on these companies, because the ‘optics’ are preferable to passing over large numbers of long waiting patients to private hospitals for treatment – if patients are being treated in NHS facilities, it looks like the NHS is managing the process by itself, even if a private company is actually involved.
And then there is the pension. It is certainly the case that NHS pension entitlements reduced when the 1995 final salary scheme was changed to the 2015 career average scheme, but benefits are far better than anything available in the private sector. For example, higher earning consultants pay 13.5% of their pay into a pension (with tax relief), but the employer pays in an additional 20.5%. This is the reason why there was such squealing about the pension lifetime allowance and reduction in tax relief on contributions. But pensions are just a mechanism for deferred payment and need to be considered when assessing overall remuneration levels.
Many consultants approaching retirement have substantial benefits in the 1995 scheme – inflation linked to final salary with a normal pension age of 60. Such schemes are no longer available in private industry, for a very good reason – they are too expensive to run. But, if one’s employer is the British taxpayer, no scheme is too expensive for the BMA.
Finally, consider this. A high proportion of NHS consultants are married to other NHS consultants or to GPs. I can’t find any statistics on this point, but in my own social network I estimate that over 50% of my peers are married to other medical professionals. That’s two sets of taxpayer funded salaries and pensions per household. I’m not claiming such couples don’t deserve their financial compensation – medicine is a highly demanding and stressful occupation which carries a significant personal cost for many practitioners and doctors work hard for their money. Even allowing for my obvious bias, I doubt many people would push back too strongly on that point. However, a demand for a 35% increase in salary by the BMA is surely unjustifiable when taxes are already at a 70-year high and many working people are struggling to make ends meet. I entirely agree with Banfield that many senior doctors are highly stressed and angry. My perception, however, is that discontent about pay is secondary to dissatisfaction with the coercive NHS system, intimidatory professional regulation and intense organisational friction. I may examine those points in more detail in future.
The British Medical Association would do the nation a service if it focused its effort on enhancing NHS productivity. Unfortunately, the union prefers politically-motivated industrial action intended to facilitate the election of a malleable socialist Government. Prepare for more boondoggles masquerading as patient care in our wonderful NHS, which remains of course, the envy of the world.
The author, the Daily Sceptic’s in-house doctor, is a former NHS consultant now in private practice.
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Never about the science though, was it? Otherwise that man and his many collaborators in parliament and the media would have mentioned nutritional medicine, and spoken to the Orthomolecular Medicine News Service (OMNS), and we wouldn’t have had those rigged vitamin D trials where vitamin D deficient people were excluded, and which were completely different to what the OMNS recommended (and by the way we wouldn’t have had lockdowns, the Diamond Princess proving that this virus was far below the lethality envisioned in the previous pandemic preparedness plans that were so casually cast aside). Never forget what was done to us, the distortions and outright lies we were fed (thankyou, Devi “100% safe” Sridhar). Where was ruddy Ofcom when we needed them?
They turned their own science into a god and all other science was considered as pagan, the preserve of heretics. They said they were following the science. Trust the science they said. That sorry excuse for a human being, Fauci, even said ‘I am the science’! What self-deluded, arrogant, evil little twerps they all are, cowards every man jack of them and we, WE, let them govern US. They don’t deserve to be in positions of such power. We will have our day in court. Hancock must never, ever be allowed near any type of power unless it’s a bare live wire from an electric plug.
Hancock is a patsy – culpable yes – but only in the same way that big moronic giant is in Steinbeck’s ‘Of Mice & Me’. Fauci, Daszak, Farrar would be a good place to start…
Not of course the narcissistic ‘Of Mice and Me’ by Matt Hancock, subtitled ‘How I got the Bivalent Covid Boosters Trialled and Approved As Safe and Effective’
Ofcom were of course enforcing the narrative.
We don’t have to follow “the science”. Science is a method and the knowledge derived from that method. That doesn’t mean it can provide the answer to important questions like: do we lock people in their homes, or do we force vax passports on people.
Those are not scientific questions, they are political and moral questions for which the scientific method has nothing to offer.
Few phrases get my back up more these days than “follow the science”. It is the mantra of people who think themselves too rational to follow a religion but in fact crave one.
Ah, the Times muppets who have muzzled their reporter (sorry, policy editor) Oliver Wright so he doesn’t repeat articles like these from 2014…
Big Pharma lobbyists exploit patients and doctors | The Independent | The Independent
Revealed: Big Pharma’s hidden links to NHS policy, with senior MPs saying medical industry uses ‘wealth to influence government’ | The Independent | The Independent
(Refresh page to reveal full articles?).
For those who haven’t seen, the Mark Steyn show is always worth a watch.
Suffer the Little Children… :: SteynOnline
Naomi Wolf on Covid and Control :: SteynOnline
Mark’s firing on all cylinders as usual. So good to have him back.
https://www.dailymail.co.uk/news/article-11848913/Dont-call-girls-princess-tell-theyre-pretty-nursery-tells-parents-woke-handbook.html
Tomboy – shock, horror, swoon – how could the term be so wrongly used. It should be tomthey, surely? What a load of spherical in plural!
“Sadiq Khan blames Boris Johnson for Ulez extension:”
So, someone else has an idea, you nick it and use it, then when it goes wrong, you blame them for it! What an absolute priceless tit Khan is!
Like kids in a play ground pointing and blaming every one else!
Well, that’s it, Dings, they ARE little kids. Mature people take responsibility for their actions and stand by them and if they are proved wrong, they admit they are wrong and learn from their mistakes. Here, we have a psychotherapist’s full waiting room of political fools to deal with. In fact, Anyone seeking the reins of power should have a full psychiatric evaluation before they are ever allowed to participate.
Oh you are so right!
“The five times Hancock didn’t follow the science” – Ex-Health Secretary Matt Hancock …… the Mail reports.
He never followed any science. Follow the science or Follow the Money?
Stand in the Park Make friends & keep sane
Sundays 10.30am to 11.30am
Elms Field
near Everyman Cinema & play area
Wokingham RG40 2FE
I’d describe Jeremy Farrar as corrupt rather than supine.
Supine is a curious choice of word. Agreed.
Farrar is way beyond supine, he is the European equivalent of Fraudci at least but has kept himself under the radar for thirty years. A deeply evil specimen who is up to his neck in all the Reset shyte. Extremely dangerous.
A decade plus in Vietnam , bagging the coveted Order of Ho Chi Minh. I wonder if Farrar and Hunt both hail from the Manchester area, as then they could rightly be described as Mancunian Candidates as well.
WHO knows?
The top article from UnHerd article about ‘Sir’ Jeremy Farrar is excellent.
This MiniMe Fauci is exposed here quite comprehensively. HIs actions of stifling the truth, to misdirect and deceive the world about the lab leak origins, along with Daszak and a dodgy crew of Deep State Military Bioweapon players represent the very antithesis of science and most certainly anything representing itself as medicine.
And now he’s going to be the Chief Scientific Officer of the WHO, which can be reasonably described as a demonic subsidiary cartel of the pharmafia technocratic beast. Who here doubts it?
It occurs to me that this Farrar/WHO/FAUCI/bioweapon swamp is in some unfathomable way the actual origin story for the Daleks and that of their leader Davros who is interestingly named.
It’s all dark and the people running it are dark. There is no truth here.
Can right thinking people have anything more than contempt and distrust for the WHO and its equivocating minions?
Five times Hancock didn’t follow the science:
Time 1) All the time
Times 2-5) See above
Lineker , Let’s talk – MOTD is surely nearing the end of its shelf life , i fast forward the ponderous Shearer input & banal quips from other diverse contributors! So GL has been in my opinion carefully groomed into a lefty activist , I doubt he will return to punditry as he’s off & running in his new career with I guess a complete back room staff to cover the ground & kill the Tories ( with their help ) right off upto the next election in which Starmer will be in no 10 !
Mr Gum was watching some ‘highlights’ this morning …(Barnsley 3-0 against Portsmouth..come on you Red’s…..)….and said there was no commentating at all and it was heaven……then switched to Ch4 where the commentators were happily taking the pi*s about the fact that at least they had some!! LOL!
I watch URC matches on S4C – my Welsh is pants so I can just follow the match & what the ref’s saying without distraction.
Edward Dowd: “There’s a Smoking Gun in the UK Data” Among Children Aged 0 to 14
• Once the C19 shots were introduced, excess deaths across all age cohorts increased — except the 0 to 14 age group, which didn’t have vaccines available to them at the time.
• Excess mortality for the 0 to 14 group was coming down during the lockdowns because the largest single cause of death in that age cohort is accidental.
• It wasn’t until November 2021, when the injections rolled out to 5 to 11-year-olds, that the 0 to 14 age group saw a rise in excess deaths.
https://twitter.com/VigilantFox/status/16336232250232
Nothing to see though ! We’ve got to soak up Linekers exploits which are far more important
Hope not Hate really hates TCW – we wonder why?
“A READER has alerted us to the fact that TCW features in a newly published Hope Not Hate report, Entitled ‘State of Hate 2023’, it is framed as a piece of academic research, but is more of a 132-page common-room harangue where we are lumped in with terrorist organisations.
According to this bastion of love and toleration, we, ‘the misleadingly-titled Conservative Woman’ are ‘an online conspiracy theory-oriented website with predominantly male contributors’ that ‘attracts around one million monthly views of its anti-immigration, anti-vaccine and general conspiracy theory content’. Among ‘the lowlights’ of our 2022 content are James Delingpole ‘claiming that Aids and HIV were a scam effectively concocted by Big Pharma […] to push unnecessary, expensive and dangerous medical treatments’ and an article describing Drag Queen Story Hour events as having a ‘sinister Marxist agenda’.
We are expecting a visit from Prevent next.”
Just one piece from TCW’s excellent weekly roundup series – “In case you missed it…”
https://www.conservativewoman.co.uk/our-weekly-round-up-of-news-the-mainstream-media-has-ignored-or-misreported/
Abi Roberts posted a substack article back in December 2022 about Isabel Oakeshott & Hancock. It deserves a read, lest we continue to propagate the myth that Oakeshott is on the side of truth.
https://abiroberts.substack.com/p/the-truth-about-isabel-oakeshott
Great article….and where have I been, she’s Richard Tice’s girlfriend?
I think it’s because I’ve stopped reading a lot of stuff in detail, I’m getting a bit drowned with it…that’ll teach me!!
She’s controlled opposition.
I think that coming up for air & finding a life raft occasionally is vital to our individual survival. Enough of us here to collectively have the knowledge.
It’s exhausting taking in all of the information. That’s why the cabal are rushing through change on so many fronts, to wear us out.
But she’s been on Triggernometry !!??
Hiding in plain sight.
I know I have read this Abi stack previously but it certainly deserves re-reading.
Good morning all……
I wonder which it is…LOL!
“The USA, with 4.25% of the global population, currently accounts for 44% of all covid deaths reported worldwide.
Which is more believable: covid has ended everywhere but the USA or that the USA is currently (and always has been) overcounting due to monetary/political incentives?”
https://twitter.com/Humble_Analysis/status/1633968446559096832
Conversely, China currently accounts for 0% of all COVID deaths reported worldwide.
…..in fairness this isn’t really surprising as nearly all of Asia, Africa and South America are currently in the 0 or less than 1 per 100.000 deaths…including several countries in Europe….
700 climate activists were arrested at yesterday’s demo at The Hague vs 2 from the farmers’ protest. At least the police take action in removing these divvies over here, but that’s a lot of arrests.
https://nltimes.nl/2023/03/12/700-climate-activists-arrested-xr-demonstration-a12-hague-4-activists-became-unwell
700? Something’s not right here Mogs.
https://off-guardian.org/2023/03/11/hand-picked/
A short, thought provoking piece from Todd Hayen over at Off-G asking
“Why us?”
Are we the chosen ones?
I have to be honest, I’m not really bothered whether Lineker stays or goes..it’s very much a storm in a teacup as far as I am concerned..but I find myself agreeing with Peter Hitchens here….
https://www.dailymail.co.uk/debate/article-11848611/PETER-HITCHENS-End-crude-smear-against-conservatives.html
PETER HITCHENS: End this crude smear against conservatives – Hitler’s Nazis were in fact left-wing racists… Gary Lineker knows as much about politics as I know about football
Can you say hypocrite??
https://www.independent.co.uk/sport/football/news/ian-wright-matt-le-tissier-sky-sports-sacked-soccer-saturday-phil-thompson-charlie-nicholas-a9690971.html
Ian Wight’s decision to stand by Lineker, should at least be consistent shouldn’t it?
Forgive me if this is old news but I haven’t come across it on DS so far. The update on ongoing Brooke Jackson V Pfizer whistleblowing case led by Robert Barnes reveals some interesting facts on the contracts.
https://rumble.com/v2c0cqc-brook-jackson-v.-pfizer-the-biggest-whistleblower-case-in-american-history-.html
..excellent update thanks, I have been following it, but hadn’t seen this…..I could listen to Robert Barnes all day..a brilliant bloke….and if they can get to call Fauci and Co…it would be fantastic!
“How the Left-wing elite used Britain’s museums to distort history” – From ‘racist’ plants at Kew Gardens….
Racist plants? Horticultural decolonisation?? Oh FFS. What about all the native slaves the Romans used to cultivate their imports including such delights as apple, cherry, almond & walnut trees plus other goodies like cucumbers, celery and of course grapes? Gonna slap a colonialist label on your next Cox’ Orange Pippin or bottle of English Sparkling are you? I agree wholeheartedly with Sir John Hayes MP:
‘Tory MP Sir John Hayes responded to the announcement by saying he would look into public funding of Kew Gardens.
“This is preposterous posturing by people who are so out of touch with the sentiment of patriotic Britain,” said Hayes.
“This is typically bourgeois liberal arrogance which is ill-fitting of people that get public funding,” he added.’
https://summit.news/2021/03/12/kew-gardens-to-inform-visitors-of-how-racist-its-plants-are/
2 really great ones by HART.
The real story of Covid/excess deaths. https://www.hartgroup.org/a-autopsy-on-covid-deaths/?swcfpc=1
Their take in the cockup Vs conspiracy issue. Much more of the latter.
https://www.hartgroup.org/it-was-a-vaccine-strategy-from-the-start/?swcfpc=1