This week the death of Nigel Lawson was announced. Readers may be aware that Margaret Thatcher’s prominent Chancellor famously compared the NHS to a “national religion”. The second part of his observation is more rarely quoted – to the effect that those who work within the NHS system regard themselves as a kind of priesthood.
Lawson’s remarks were rarely so appropriate. The week following his death will see four days of consecutive strike action by junior doctors, accompanied by familiar incantations about how they are withdrawing their labour to save the NHS. The demand for a 35% pay rise is of course necessary to protect the system from the evil Tory Government and the privatisation agenda. Should readers wish to access any more of this propagandised pap, they are welcome to read the mainstream media. Here at the Daily Sceptic, we aim to provide more substantial analysis and to discuss the real issues behind the news – commentary which in polite society would certainly be characterised as ‘wrongthink’.
Many professional groups gripe about pay and conditions – disagreements between doctors and the state are by no means new. Doctors have taken industrial action of varying intensity on several occasions before, most recently in the junior doctors strike of 2016. The British Medical Association (the doctors trade union) has a longstanding tradition of opposing virtually every government policy, often in the interests of enhancing professional remuneration. So far, so normal.
On this occasion, however, I do think the current militancy represents something of a sea change in medical behaviour. This is a consequence of various structural changes in medical workforce matters over the past decade. It is important for readers to appreciate that the term ‘junior doctor’ covers a wide spectrum of practitioner, ranging from very recent medical graduates in their early twenties to senior trainees in their mid-thirties. In fact, the term itself is outdated and a better descriptor would probably be ‘doctors in training’ or similar. More senior trainees often have a different perspective than their younger colleagues. It is striking (excuse the pun) that the current junior doctor leadership seems to be drawn from the more inexperienced section of the junior doctor community.
The strike next week is the second round of the dispute. The first strike in March was unprecedented, in that junior doctors absented themselves from emergency cover for an entire 72-hour period. Readers may not appreciate what a big deal that is – to spell it out, the striking doctors refused to staff emergency rotas. This action left patients arriving to A&E departments with acute heart attacks, diabetic crises, strokes, car crash injuries and the like, with zero medical care. They also withdrew ward cover, so patients in hospital unfortunate enough to develop post-operative complications had no doctors to look after them. That’s apparently what it takes to save the NHS.
In actual fact, the first strike turned out to be a bit of a damp squib. Hospitals managed quite effectively to reallocate consultant level doctors to cover emergency and ward work. Paradoxically, emergency care pathways were more efficient than usual, as senior decision makers processed patients much faster than trainee doctors. This of course came at the cost of cancelling the vast majority of routine outpatient appointments and operative procedures – adding still further to the legacy of lockdown.
Managing the second round of strikes might not be so easy. The second round has been deliberately timed for after the Easter weekend, when a lot of consultants will be away on leave. In effect, the strike leadership is ensuring that there will be no routine work carried out in the NHS for a 10-day period. Major operations can’t be undertaken if there is doubt about the provision of 24/7 medical care, so no significant procedures can be done safely in the days leading up to the strike action. It is notable that senior hospital managers have been encouraging consultants to engage with the press emphasising the risk to patients – normally managers hate doctors talking to the press, but in this case there seems to be an intention to undermine the strike. It is unlikely that round two will be the end of this dispute and further escalation is quite possible. It is inconceivable that these young doctors are unaware of the effect their action will have on patient care. It is highly likely that some patients will be harmed as a result of this strike and some may well die as a direct consequence of industrial action – this is several orders of magnitude more significant than not being able to get on a train for a few days.
Readers may very well be wondering how it has come to this. Until recent times, a doctors strike would have been inconceivable. Of course, the charge is often levelled that older clinicians tediously harp on about how much better things were in the ‘olden days’. For clarity I should state that things were not better, but they were certainly different. As this dispute is ostensibly about money and conditions, readers may be interested in a comparison of junior doctors’ pay rates in the late 1980s with the modern-day equivalent.
Until a decade ago, hospital-level care was delivered by small teams of doctors, called ‘firms’. A typical firm comprised one or two consultants, a senior trainee and two or three other juniors. Being on a good firm was hard work but great fun. Patients got an excellent deal from the ‘firm’ structure, because it provided continuity of care – the same doctors looking after the patient throughout their time in hospital and afterwards in outpatients. Payment for medical time was split into four-hour blocks known as a UMT (unit of medical time) – so the standard 40 hour week comprised 10 UMT’s, paid at a basic rate. Junior doctors then had compulsory ‘on call’ UMTs – the standard for a one-in-three on call rota was 13 additional UMT’s. These were paid at 30% of the standard rate – please note, that is 30% of standard, not 130%. Junior doctors on call were the lowest paid workers in the hospital, with an hourly rate of pay less than that of the cleaners – far lower than the current remuneration. On the upside, the work was so intense and the hours so long that junior doctors were provided with hospital accommodation free of charge. Work life balance was perfect, because work and life were the same thing.
The reason I point this out is that low hourly pay rates for junior doctors is not news. Nor is it a secret. It cannot come as a surprise to any newly qualified doctor that the pay in the early years of medical practice is not great. About 15 years ago, the structure of junior doctor terms and conditions changed substantially. The ‘firm’ structure was abolished and on-call rotas were changed to shift patterns. The driving force behind this change was the assertion that long hours were dangerous for patients and damaging to doctors. There was some truth in this view – mistakes were made by tired junior doctors, myself included. Unfortunately, the cure turned out to be worse than the problem.
Loss of the firm structure demolished continuity of care and made the whole process of looking after patients very inefficient. The complicated shift systems proved unwieldy, inflexible and very unpopular with juniors. Not surprisingly, junior doctors remained unhappy with their pay and conditions – they were doing far fewer hours work than their predecessors and therefore lost free accommodation. Total pay reduced (because of a lower on-call commitment) and workforce surveys revealed far lower levels of job satisfaction than under the old regime. The numbers of doctors in training increased substantially, but their pay fell in real terms, because each individual was doing less work. Needless to say, this was entirely predictable and indeed was predicted at the time the changes were proposed.
Discontent with shift-working and its remuneration formed the basis of the 2016 strike, which ended in a comprehensive defeat for the doctors. A face-saving, window-dressing compromise was agreed which failed to address any of the real grievances. The current dispute in many ways is continuity 2016, driven by a more militant and explicitly Left-wing cadre of political activists.
It is often trumpeted by the BMA that as a consequence of poor remuneration, U.K.-trained doctors are leaving for jobs in Australia. Ironically, the doctors union fails to ask why Australian doctors have a much better deal than their British counterparts working in the socialist utopia of the NHS. Might it be because the Australians have a mixed health economy, where hospital systems are competing for a finite medical workforce and therefore provide better terms and conditions? Isn’t this the same mixed economy model that the BMA regards as unsuitable for the U.K.? There must be a fair amount of cognitive dissonance going on in BMA House – but then the doctors’ union is adept at that and the wilful blindness that goes with it.
I think the real cause of the juniors strike actually lies in disappointed aspirations. Indoctrinated medical graduates have been led to believe that possession of a medical degree guarantees membership of the NHS ‘nomenklatura’. The reality is that doctors are simply part of the lumpen proletariat, with little influence or bargaining power. The likely resolution of this dispute is hard to predict at the moment. A lot will depend on how cohesive the strike is as the dispute escalates. The BMA junior committee has started with a very intense and prolonged industrial action. The Government will not give in easily, so the expectation must be that the strike committee will raise the ante. As walkouts become more prolonged, it is quite possible that their members may return to work, concerned about loss of pay and the effect on patients. More senior trainee doctors may worry about the effect on their training and future career prospects. It is not inconceivable that the vanguard of the proletariat could yet end up marching on its own.
The author, the Daily Sceptic‘s in-house doctor, is a former NHS consultant now in private practice.
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JSO vs Pride. The lefty wamminz worst nightmare – who to support??
I’m looking forward to the battle of hurty words – because the gods know that there isn’t enough muscle power in either group for an actual battle – and who the police will give greater protection to….
“Huge Nebraska Solar Park Completely Smashed to Pieces by One Single Hailstorm!”
Yeah! Dance on nature!
best news I’ve heard for ages!
I’ve got news for you Dinger.. that wasn’t nature that did that. It was a consequence of massive geoengineering. Weather modification/warfare. A rather nice irony in it though just the same..
Take a look at this..
https://www.geoengineeringwatch.org/aftermath-of-chemical-ice-nucleation/
Wow! I really don’t know how to take that? Is it real? are we meddling that much? surely not, please tell me its just a conspiracy theory!
It is not a conspiracy theory Dinger. Its frighteningly real, and if you start to do some research on the subject there’s a good chance your jaw will drop to the floor.
I’ll say something I’m 100% confident is true.. there is NO natural weather any more, and the methods they are using to control it are mind boggling. Want some forest fires – easy, want to wreck the autumn harvest – easy, want to cause havoc by flooding – easy, want an earthquake – easy, and every MET office in the world knows its going on but they say nothing..
Absolutely….it’s true..and not new…
..there is a UN treaty on the ‘Convention of the prohibition of military or any other hostile use of environmental modification techniques’ 1976…
https://en.wikipedia.org/wiki/Environmental_Modification_Convention
This is a long article from the US National Science Foundation…’A report on the Special Commission on Weather Modification’
..from 1965
https://www.nsf.gov/nsb/publications/1965/nsb1265.pdf
Both are worth a look just for some background….
Don’t know about you , but I detect an air of brewing, deepening anger taking over the general demeanour of the headlines and posts today! I wonder why?
Just more athletes in prime physical condition dropping dead and/or being rushed to hospital. Rugby players in this instance, and two from the same club. Just par for the course that people in the prime of their lives and who have superior health and fitness to the general population should experience these unforeseen tragedies. Mere white noise nowadays….
”Two promising players from Auckland’s Suburbs Rugby Football Club have been rushed to hospital in a critical condition after suffering separate on-field medical events in the space of a week.
One of the players was seen collapsing on the field before being rushed to hospital and undergoing surgery to remove a blood clot from his brain.
In the other incident, Auckland Rugby has praised spectators who rushed to the aid of a player over the weekend who is believed to have suffered a seizure and stopped breathing. The spectators performed CPR on the stricken man until paramedics arrived.
The events come after a Bay of Plenty rugby league player and a rugby union player from Ruatoria both died after on-field incidents.”
https://www.nzherald.co.nz/nz/two-auckland-suburbs-rugby-club-players-suffer-critical-life-threatening-injuries-in-consecutive-weeks/RKKTBRLSCNAXLCFFI4UIZTSLRE/
“Safe and effective” in action!
Yep..spotted this one to add to the growing numbers…
https://sandrarose.com/2023/06/tv-doctor-and-vaccination-expert-dr-alfredo-victoria-dies-suddenly-at-42/
A popular Mexican TV doctor who regularly appeared on “Mexico Today” as a “vaccination expert” died suddenly from a myocardial infarction, according to reports.
Dr. Alfredo Victoria Moreno was only 42 years old when he died in his sleep early Monday. He was a vocal advocate of COVID mRNA vaccines.
Dr. Alfredo’s massive global fanbase took to social media to mourn his untimely death. They referred to his passing as a “tragedy.”
Watch: Not a single Question Time audience member shows support for Rwanda policy
The constant propaganda on issues like immigration, climate change, affirmative action, gender transitioning, etc mean that people are reluctant to indicate publicly what they actually believe. To hold out that this QT audience poll proves that the Government is way out of line with the public is massively disingenuous, and is simply another propaganda tool.
“Yorkshire Building Society ‘closed vicar’s account after trans protest’”
This is getting more and more alarming. Is anyone out there compiling a list of banks and building societies which will summarily close customer accounts for not complying with The Narrative™, and are there any recommendations for banks that have stricter rules on this sort of ideological persecution?
The best thing about the Rwanda policy is that it shows so clearly how all the lefty do-gooders are really a bunch of racists at heart, over compensating for their feelings of guilt.
If the policy were to ship immigrants to Switzerland or Norway or Canada you wouldn’t hear a peep.
The problem is that it’s Rwanda which they assume without having been there that there is something fundamentally wrong with the place.
I agree except for one picky point – they are racists by their definition of racism, which is to notice differences based on race. My definition of racism is to have a blanket belief about an entire race that disregards individuals, which just seems a bit weird to me.
“Huge Nebraska solar park completely smashed…”
Probable MSM reporting: “Extreme destructive weather events are getting worse! Build more solar parks.”
,to save the solar parks from extreme weather events,.. Shish!
There is absolutely no way that any of this money is even ‘real’..is there?
https://www.dossier.today/p/new-york-quietly-shuts-down-its-250?utm_source=post-email-title&publication_id=69009&post_id=132199406&isFreemail=true&utm_medium=email
New York State officials announced on Friday afternoon that they are discontinuing their controversial mobile phone vaccine passport program, known as “Excelsior Pass,” citing “reduced demand for access to digital COVID-19 test and vaccine records.”
The Excelsior Pass program began in early 2021 with an estimated cost burden of $2.5 million. It later balooned to a sum approaching one hundred times over the original budget, with an approximate amount of $250 million dollars being handed out to IBM, Deloitte and Boston Consulting Group.
Deloitte and Boston Consulting Group have billed New York taxpayers approximately $200 million for “marketing” and “buildout” costs associated with the program since 2021, while IBM has billed around $40 million plus $200,000 a month since 2021 in “data storage” fees, according to state records…..
You don’t have to green with him, but this is a very calm and collected speech from Max Blumenthal’s as he addresses the UN about the Ukraine/Russia conflict
https://www.youtube.com/watch?v=Eq4643bsH8w
……it links to the study and report on where the money for Ukraine has and hasn’t gone….! These questions need to be asked and answered….
All aboard the gravy train: an independent audit of US funding for Ukrainehttps://thegrayzone.com/2023/06/27/gravy-train-independent-audit-ukraine/
Edward Dowd
@DowdEdward
Hey Doctors out there…is 25 sigma above trend too high for Haematological System disorders? ¯\_(ツ)_/¯
We are going to need your help on our next report.
The so called governmental health authorities won’t be able to run from this data.
Stay tuned.
(Apparently he and Dr Kelly Victory will be giving out more information soon….I will keep us updated..along with fellow Twitter watchers, I’m sure!)
https://maryannedemasi.substack.com/p/no-more-moderna-jab-for-children
No more Moderna jab for children under 12 in AustraliaThe Australian government has quietly pulled Moderna’s (Spikevax) covid-19 vaccine for children under 12 years and won’t explain why.
It’s now not possible to look at Twitter at all without a twitter account. Could you post the Martina Pastorelli interview on a publicly accessible platform please
I think Twitter is down..I can’t see anything..and the Daily Mail have said it’s crashed!!?
..according to the Mail..the lack of access to non-subscribers is only temporary….so you might be able to access once it’s back up..