UKC

Obviously this is a real issue close to my heart, but what does the Collective Hive mind think of practically everybody within the NHS going on strike at some point this year?

And before anybody asks my views, I'm in a union and I will do what ever that union advises me to do.

A dreadful idea if they were to strike - yes, the NHS needs more investment, more staff, better facilities and training - taking it out on patients by striking is not the way though.

(how you go about achieving the investment goal though is another question)

I'll have a go at answering your question with a question: are you happy to accept a pay cut?

Reality dictates the question is usually, if that's the pay, do you want the job ?

I wholeheartedly support the strikes.

How on one hand can the government be moaning about lack of medical staff while also having given them years of pay cuts is laughable.

The 'reality' question for the rest of us is do we want doctors, nurses and paramedics. 

If so we really have a pretty pressing need to attract more people into all of those professions ASAP, not make life even more difficult for people already doing the job.  The last thing in the world they want to do is hurt patients, but you can't pay the rent or feed your kids with a round of applause.

What kind of society do you want to live in, where you boil it down to that question?

We should be increasing the pay of all medical staff, fire fighters, teachers etc. in line with inflation without fail. Every year. They have such immense value, why should they be treated any differently?

Yeah, "they can leave" if they don't like a crappy payrise: https://nursingnotes.co.uk/news/nurses-can-leave-if-they-want-to-they-have-...

Good thinking when there's a massive staff shortage, let's fill the vacancies with massively expensive agency staff ... if there any available?

Do you think that is an acceptable attitude from 'our' Health minister?

Might be better in "The Pub" forum as anyone with skin in the game may be put off contributing. 

I think pay is the wrong reason to be banding the "S" word about, at least in the ambulance world, (I can't speak for other NHS staff), as I don't think we're poorly paid.

NHS band 5/6/7 depending on your job. look this up and the basic salary will seem okay but add in unsocial hours and it's really not bad. Plus a decent 12 hour shift pattern is effing awesome.

I'm not going to go into detail but there are many other reasons for staff to be striking.

If workers are balloted and decide to go on strike they absolutely have my support. The freedom to withdraw your labour if you are unhappy with your working conditions is a fundamental right and not one that people exercise lightly. 

The NHS workers that I know, are very compassionate people, and letting down patients is the last things they'd want to do. It's a mark of how bad the situation is that they have been driven to this.   

Before going no strike itself it would be better to work to tile, absolutely and utterly to the letter of contracts.

No one looses pay etc and it highlights how much is done "above & beyond" for free in the broken system. 

It also leaves the door open to escalating to full blown walk out

Yes, in simple terms.

The problem is if inflation isn't held down quickly, interest rates on mortgages will easily take all that inflation linked pay rise. There is no win position anymore, there's only pain in every direction. Labour knows this too, that's why they are already talking about when they inherit the current state of government finances it'll be really grim etc.. 

Perhaps it's better to focus on conditions, recruitment, training, annual leave, pensions etc.. to improve their lot long term, instead of pushing inflation now.

I have skin in the game, and I'm not ashamed to ask the question and have it die when interest goes off the heat.

And I can say that many years ago ambulance service staff, including me went on strike. Not a single member of the ambulance service refused to attend an emergency. We were on strike yet I worked just as hard as I did no my normal days.

For somebody like me the idea of going on "Strike" is an concept, because we will never refuse to attend any emergencies. The government knows this and they will play on emotional heart strings but we will never refuse to attend emergencies even though we are on strike.

In my opinion the front line NHS staff get shat on from a great height on a daily basis, strike away and hopefully improve things a bit.

Unfortunately I don't think it will, they might pay you a bit more and / or improve working conditions but the underlying problem of bad management and massive wastage will never get sorted. 

Reality is 10% of posts unfilled and experienced staff leaving in droves, so reality is answering your question for you.

I don't mind 

A band 6 paramedic is looking at around a 20% real terms pay cut since 2011 and it's a bit like the reverse of overpaying your mortgage in that it's cumulative. Say you get an inflation matching pay award every year from now on (LOL) until you retire at the statutory frontline paramedic age of 67 or 68  (LOL), that 20% cut will still be there, year in year out, and will be reflected in your pension until the day you die.

Yes there's lots of other reasons for industrial action but NHS pay is certainly one of them.

How does that compare to average inflation adjusted pay over that time? I can't see from a quick Google but I'd guess it's typical or not much worse - pay fell in absolute terms in 2021.

I'll translate that for you if you like:

"I can't find any figures supporting my argument but I'll make it anyway"

Seems a fairly key piece of information to me in judging whether a 20% loss of earnings is bad, typical or even good. The fact is the UK isn't as rich as it was.

I could just as much say you haven't provided figures justifying your argument for more pay

Real race to the bottom stuff there. Some people in this country have been getting very much richer in recent year but most of us have been getting poorer. Time for a re-adjustment!

Not all, just looking for the context 

Absolutely. It's your contention that 20% is average so a source would be nice.

Here's a source: https://www.gmb.org.uk/news/nhs-workers-lose-9000-year-decade-pay-cuts

A paramedic is on the same banding as a midwife and the quoted real terms cut equates to over 20% of basic salary.

Found it now. Cumulative inflation since 2011 to September is 32%. Average pay has increased about 18% to 2021 So a 20%  effective reduction is a little worse than average.

I support your right to strike: it should be every paid worker’s right without question.

 I support your claim for a pay settlement that isn’t a real-terms cut: it’s hard to believe anyone thinks this is debatable.

And yes, I’m content to pay the tax it takes for that to happen.

Good luck in your dispute!

And are WE/YOU prepared to pay for it?

We can any have whatever NHS WE/YOU want...but it costs....and that cost comes from US/YOU.

This is the grown up conversation that needs to be had....

Barbeg 

No. Everyone else should strike on their behalf.

I pointed out you’d made an argument based on a guess, you then asked me for a source, which I provided. You’ve still not provided a source for your figures. 
Here’s the FT stating that average real terms wage growth has been flat for the last 12 years, not negative.

https://www.ftadviser.com/your-industry/2020/10/13/real-term-wages-gone-now...

Inflation from BoE 

https://www.bankofengland.co.uk/monetary-policy/inflation/inflation-calcula... 

Pay from 

https://www.statista.com/statistics/1002964/average-full-time-annual-earnin...

Edit to say the FT article is from 2020, before COVID and recent inflation.

Absolutely. We already pay very low tax, this should increase. And increase even more for the higher tax bands. I'd gladly pay it.

Even more so if we taxed tech giants in a meaningful way.

Yes definitely and I think the wider civil service/government employees are going in that direction.

The more pay cuts start hurting the people you want to keep will move in to the private sector for higher pay.

If these people don't have competitive salaries then it's the public who will suffer with poor service 

ahh, I see where we've differed. I've quoted average total wage growth and you've quoted median wage growth. Total wage growth has been flat in real terms while the median has shown a decline (but not nearly as big a decline as seen in band 6 NHS pay).

The discrepancy in the two figures is entirely down to a decade of Tory policy driving down the wages of those on normal salaries while hugely boosting the incomes of the very rich. Yay Tories.

As a self confessed "centre right conservative" your position seems to amount to thinking the NHS should swallow repeated real terms pay cuts cos we're only doing a bit worse than the rest of the proles. Stuff that.

Can't remember the exact year - 2017 or so? Paramedics got re-banded from Band 5 to Band 6. I joined before that, so like a lot of the workforce, started work with the expectation that my Tech salary would be Band 4 and my subsequent Para salary would be Band 5. So I'm now paid a Band 6 wage, still with unsocial hours on top.

I haven't done the maths, no doubt someone will be along to correct me if I'm wrong, but in general I would have thought moving to a higher pay band equated to a pay increase above the rate of inflation that year (I'm guessing!!). None of us complained about that!

So yes, I would love an inflation-matching pay rise, but if everyone gets that, inflation just runs away. It's a tough time all round just now. I'm paid a good salary, and will be happy with a 5% pay rise and knowing I've got a secure job. I don't want to strike. 

(My comment is specific to me as a paramedic, not other NHS roles. And it's nothing related to politics, I'm certainly no Tory or SNP apologist.)

Would rather pay for that than run away dividends and bonuses, which we seem to have zero choice over

You are imagining things.

I've not said anything like that either.

"There are plenty of centre rightish conservatives (in some ways that includes me)."

Did somebody hack your account on Thursday evening? 

So you'd agree a pay cut of 20% in an understaffed and overwhelmed service would represent another disastrous Tory policy outcome.

No. But you jumping from me holding some views in common to "confessing" it defining me is quite something.

I'd certainly agree the NHS is in a mess. I don't know regarding pay, hence trying to get some context 

This discussion seems to have input from paramedics, but no-one else in the NHS (Does this mean that few medics and nurses climb? Or...)

The question about different groups striking about pay always gets asked without some of the objectivity which would help. Key amongst this would be how much, in sterling terms are the people in question actually being paid currently(?), and how much are others in society in general, with specific roles paid at this time? Thus, comparisons might be drawn.

Another problem with the NHS is increasing numbers of techniques with newer technologies. Many governments have not insignificantly increased the NHS budget (they have increased input considerably), but these modalities of newer treatments always soak the extra monies up. We did not live as long in the past due to this, and there will come a time when treatment vs age and other factors such as mental cognition, and general physical health are balanced up, and evaluated, leading to some sense of more directed treatments, and restriction of treatments to those who will benefit less, if at all, other than to merely stay alive. Health care around the world has this problem.  So it is not just a matter of finding more funding for the NHS. The whole matter of the NHS needs a sensibly run commission to examine the things which I hint at, and to aim for a structural plan for how to approach the increasing problems of funding in the future. Unfortunately, such a commission will take a long time.

Yes I understand all of that, I would say my view aligns with gld73 so I won't repeat their post, though they've been a paramedic much longer than me so will have seen the big jump in bandings they mentioned a few years ago.

Then again I will admit my views will be skewed by spending my entire adult life as self employed before making switch so still getting my head around having paid holidays, overtime for finishing a shift late (most shifts.....) and employer pension contributions so would likely be the worst union rep ever ;p

That time already came, surely. I'm sure there will need to be ongoing debate, and maybe even some big shifts in the future, but decisions about what should be available on the NHS already include a significant degree of cost-benefit analysis.

No

I've given an alternative insider view (to the general "our wonderful NHS is beyond criticism") previously.  And got roundly (and generally, ignorantly) flamed for introducing facts (doctor and nurses pay for example).

But no. Would not support.

Would hugely support increases in floor pay for care workers.

The problem is not in those earning above national median.

They do...for new things. There's the majority of stuff that's always been done but never received the same scrutiny.  There's also divergence between national assessment (NICE) and local affordability and implementation (cataracts being the biggest scandal that never gets discussed)

Is it not more of a joint process, with the Union doing what the members say, so it is important that you do have a view, after listening to the opinion of the Union, so that the Union can represent that view?

You need to catch up with 21st century management responses to legal union ballots on any seriously impactful working to rule. The norm is no pay for days with any such action. In such circumstances working to rule effectively becomes a 'lock-out'.

Of course it is: members debate in their union what they want and then the union negotiate to try and achieve that. If negotiations fail a legal strike vote is difficult to achieve under current legislation and within that a big majority of members must support it. A strike vote requires the union following a very tight and expensive (paper balloting is a deliberately costly and complex choice in the legislation) process which can be legally challenged by the employer.

The answer would depend on the reasons for a strike.

I whole heartedly agree that Care Workers should be paid more for what they do. I personally found the job far more mentally challenging than my current job.

But then again, nobody is willing to pay, or even able to afford, for a good standard of service for their relatives and will look for the cheapest "Provider" which invariably gives a woefully inadequate level service. That's not strictly true, because if you pay as little as possible then you get the standard of service for the amount of money you are willing to pay.

Possibly, a price many of us will have to pay for a longer lifespan, is that we will have to accept that we have to care for our own parents when they get older.

Other cultures, seem to accept that at some point that they will have to accept this.

It is something that has long intrigued me about many who take up climbing, that they seem to espouse a more social conception of society, but are resolutely individualistic. These always seem to me to be incompatible approaches.

Interesting post with an interesting slant. Personally, I've never seen anyone write anything on here along the lines of "our wonderful NHS is beyond criticism". Perhaps you could enlighten me as to your position on nurses pay?

Presumably you're in favour of below inflation pay cuts.

as would I

The problem, as I see it, is that the goalposts are shifting. The wealthy get richer, the middle gets increasingly squeezed and the national median wage falls further and further behind inflation. This is not sustainable unless you're happy to live in a society where increasing economic inequality is embedded in the system.

Addressing the health and social care sector more directly, the ONS provides some interesting data.

"Annual growth in median pay for employees in September 2022 was highest in the health and social work sector (an increase of 11.3%), and lowest in the arts, entertainment and recreation sector (an increase of 2.5%)."

Now look at that- median pay in the health and social sector up 11.3% this September. NHS England have been offered 4% (NHS Scotland 5%) and since they're by far the largest employer in the sector, private must be increasing the pay of their employees way above that 11.3% figure. My interpretation is that the government is starving the public sector of funds with a resultant increase in cash funnelled into the private sector. As wage disparity increases, more and more NHS workers jump ship cos they like stuff like food and warm houses... and the waiting lists get longer and the NHS sinks further in public opinion.

The NHS is being deliberately dismantled on ideological grounds and degrading NHS pay in comparison to private healthcare is a deliberate part of that strategy. Taking industrial action is part of the battle to preserve the NHS.

https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandwo...

What about the people who clean the toilets and clean up all the other mess ?

It's all very well looking after a group with a high profile, but they don't live (and work) in isolation. Not only that, the ones who do the dirty jobs are on less to start with, so will end up suffering even more.

It seems to be generally trotted out by those who are trying to claim that the NHS hasnt been under almost constant "improvements" since it was formed.

Its convenient because it allows people to double down on bad decisions by pretending the same bad ideas havent been tried in the past.

Plenty of evidence (ONS etc) that private sector pay has risen on average about 1% a year greater than public sector, so over the last decade the benefit has obviously been around 10%.

The only thing that would add to that though, is that distribution maybe more even in the public sector.

You're concerned that the reasons might be frivolous? 

Perhaps the Royal College of Nursing have seen the RMT and the posties on the picket lines and are moving towards calling a strike for the first time in their history (over a century) because it looks like a bit of a laugh.

I think the Pub may have eaten the nurse thread, here are a couple of others.  Broadly I'd say that 

a.  Some nurses are not paid enough for the job that they (individually) do

b. Some nurses are overpaid for the job that they (individually) do

c. Overall discussion tends to be disingenuous - no mention of in band progression, band mix, area weighting, on call and antisocial hours payments, true value of pension.  The figures used are often bare band minima, applicable to almost nobody

d. When you look at actual nurse pay, it's not terrible.

https://www.ukclimbing.com/forums/politics/the_nhs_is_broken-750572?v=1#x96...

https://www.ukclimbing.com/forums/off_belay/can_anybody_see_this_helping_th...

And this is the sort of hyperbole that is unhelpful.  I'm mostly in favour of reducing inequality by raising the floor of the most poorly paid - and that's care workers and HCAs, not nurses and doctors.  I'm also in favour of not baking in inflation.  And if I could make one change it would be to distinguish between "the same job" done brilliantly and barely adequately.

I'm not - see above.  Inequality is a huge issue.  But train drivers and nurses are not the front line of it!

I think you have misinterpreted the data - pay inflation in the NHS is significantly higher than the last pay award.  Banding increases (see comments above about this getting ignored), use of bank, agency and locum staff and changes in variable payments have all driven it.

I don't agree.  See previous comments about "privatisation" - it's been 90% private since inception!

"Battle to preserve" is more hyperbole and fuels a belief that the status quo is as good as it can be ... which is nonsense.

To another poster, speaking about impact of technology advances: Free at point of care.  Universal.  Up to date. Pick 2 if you want it affordable

Reorganisations, for sure.  Misguided and painful largely (although we are at last seeing the demise of the silly internal market ideas).  Genuine process, quality and productivity improvement not so much.  You only have to use it as a patient to understand that!

Preciously few ambulance staff make it to pensionable age to enjoy even one penny of it. We are worked that hard with such a challenging job that we either get broken and are sacked from our jobs because we can no longer fulfil our job descriptions, or we die before pensionable age because the job is so physically demanding for somebody aged 67.

Do you see many Police officers on the road or members of the Fire Service working on a Fire Engine aged 67?

We are worked into the ground well before we win the lottery of making it to pensionable age.

Why do you think it is silly to say that I might think differently about strikes depending on the reason for striking?

I don't think there will ever be a strike in the traditional sense.....and it's worth noting that the issues affect other clinical staff equally....physios, OT's, dieticians, psychologists, speech therapists plus many others.

To me the pay for qualified staff is generally ok but progression is a real issue.....an example being a band 5 nurse I was speaking to last week with her nursing BSc and an MSc in intensive care nursing....she was very switched on, impressive and doing a very tough job but can't progress where she is as there are not likely to be any band 6 vacancies coming up for a long time.

I'd be in favour of increasing pay for care staff for sure but the NHS is so varied I'm not sure there is a wide understanding of the variety of clinical areas and jobs. There is a real issue with recruitment and retention....in my area we have a 25 percent vacancy rate and we can't recruit......

Pensions are a bigger issue.....the newest scheme within NHS pensions is ridiculous with severe penalty clauses for anyone wishing to leave early....there is no way a lot of staff will be able to do their jobs aged mid 60's before their pensions....

Not just NHS but all public sector should come out on a general strike. 10 years of wage stagnation is now crystallised very sharply when inflation is 10% and interest rates are on the rise, and we're being told by the richest MP/ PM we've ever had that more austerity is on the way. I got a 1.8% pay 'award' this year so effectively an 8% pay cut. I am f**king sick of being rinsed. And before anyone says go and get another job then - I am looking. 

Davie

I think we’ll be alright now with the new PM. He is magic remember and produced billions of magic money pounds during the pandemic. Millions of folk got free magic money for months on end and even all the fraud didn’t matter as it was after all, magic money.

railway staff, post office, nurses, ambulance technicians, uni staff, pensioners, benefit claimants etc etc will not have to suffer for much longer as the PM will produce enough magic money to keep everyone happy and by Christmas we’ll all be wondering what all the fuss was about.  

Up to the extent of my knowledge and where I work (nurse) we don't want to strike, there is pressure enough,  short staffed, lack of recruitment,  use of agency staff every day ( I'm not saying they don't work well, they do, but time taking inducting different agency staff each shift is time away from patients and a lack of consistency, which is pretty much vital in the area I work. A lot is based on establishing interpersonal relationships with patients which is impossible if there are different staff on each shift)  , agency and goodwill does not create an effective service. When I qualified we were told and it's in our professional code of conduct that nurses don't strike, with the rcn balloting members the time they are a changing!

If your going to make definitive statements about the value of some nurses over others it might help if you stated what your own NHS role is.

None of which have any bearing on annual pay rises. They're all part and parcel of the contracts we signed up for.

So that's the standard we're aiming for, better than terrible? How many more years of below inflation increase before you'd judge it to be terrible?

I'm also in favour of raising floor level pay but if you keep reducing the differential between HCA (no qualifications required) and nurse (degree required) at what point do you think people will start thinking "bugger taking on 60k of debt and 3 years loss of earnings"? How many HCAs do you think will be encouraged to take that on and retrain for marginally better money?

How would you do that exactly?

Train drivers?

Band increases are part of the contract we signed up for. They're there to recognise the value of experience and help retain staff with that experience. They also top out at 5 years service.

Those staff aren't employed directly by the NHS and aren't taking industrial action.

The people we're talking about, the roles discussed in the OP aren't private sector, they're working directly for the public sector!

I didn't say anything about preserving the status quo. I stated that the NHS is being degraded and dismantled on ideological grounds.

I note with interest that you've ignored the ONS data showing an 11.3% increase in wages for health and social care. What do you think is driving that data, and no, it isn't band increases as they're a baked in cost that've existed for decades.

It's down to the government's woeful underinvestment in the NHS vying against the considerable weight of moral responsibility that is endemic in the medical professions and people's health. The latter retains people in work against incredible odds, effectively meaning the government can do what the bloody hell they like - which is exactly what they are doing.

It is nearing breaking point however, at which even the moral rectitude and professional ethics in the medical professions will inevitably snap, in an attempt to oppose and correct the moral barrenness of tory politics. In the absence of a long list of Health Secretary's willingness to negotiate, strike action is the only lever there is to redress that balance.

I support strike action.

A good old fashioned work to rule/overtime ban would also be pretty effective.

In a period of escalating  cost of living when every penny counts , how does that benefit striking members in respect of lost pay. 

No strike involved.

 No pay for overtime etc. The loser is the member. 

I don’t think paramedics stuck in an hours long queue outside of a backed up A&E can turn down overtime - they need to hand over the patient and drive back to base I assume. 
 

Perhaps other staff groups could though. 

Everyone loses when industrial action is involved, that's why it's a last resort. Just how much of a last resort is reinforced by the fact that the Royal college of nursing is balloting its members to strike for the first time in it's 106 year history

You’re right that we cannot ‘turn down’ enforced overtime caused by delayed handovers and other causes that result in a late finish. However, a large proportion of operational ambulance crews regularly do voluntary overtime, picking up vacant shifts where other staff members are off sick/on leave or there simply aren’t enough staff to fill the rota. 

On the topic of late finishes though, ambulance services seem particularly prone to this. I’ve worked 14 12 hour shifts this month (Another 3 to go) and so far have clocked up 13.5 hours of ‘enforced overtime’ - i.e. late finishes.

Doctors and nurses should count themselves lucky they have had a fully paid job throughout the pandemic.  Many people in the music industry I work in have been left high and dry without any support when our government shut down our industry.  The financial stress of it all has absolutely ruined some people I know.  Other have lost businesses built up with toil and effort over years.  The industry still has not fully recovered to pre-covid levels.

So to see ungrateful medical staff demanding a pay increase or strike feels like a kick in the teeth.  I mean how insensitive are these people?  Most people I know would have given their back teeth to have worked throughout the pandemic.  Seriously guys, get a job out in the real world.  I bet most of you wouldn't last two minutes.  Count yourselves lucky and be grateful for what you have got.

Shift overruns no we can't but Techs and Paramedics can stop applying for extra shifts on rest days, which on a mostly 3x12 pattern actually isn't that bad to do, which I think is what Neil is getting at. Band 6 at whatever o/t rate the employer pays can be a hefty top up.

I take it you're not aware of how many ambulance staff have had one or even two careers before joining?

One think I am sure of though, as a frontline Paramedic, is that I certainly would not last two minutes as a nurse in most A&E departments. 

 > I mean how insensitive are these people?

In the middle of that post, jeez.

I see he’s now restricted from posting (I was waiting for his reply on another thread) Although his post may have been provocative I don’t see the need for a “No platform” approach by UKC in  an environment where open counter argument can be much more effective and productive 

My guess is they were identified as one of the trolls for whom  it has been demonstrated that open discussion is wasted on.

Yeah agreed. 

The poster wasn't wrong, their industry was screwed over, businesses ruined etc. and NHS staff were in a better position than many during the pandemic, despite all we've had to deal with.

It's the second paragraph that was completely ignorant to the skillset and backgrounds of NHS staff combined with undertones of Victorian mill owner and I was rather looking forward to the poster getting ripped into.

That’s clearly not the case in the other discussion I referred to

Made me laugh out loud. I had an image of Harry styles haranguing David Nott:

"You think your job's stressful mate, you wanna get out in the real world like what us music industry types inhabit..."

UKC doesn't have a 'no platform' policy and nobody gets banned for making a provocative post within the forum rules.  If this person has been restricted from posting it'll have been for some other reason, best not to speculate what but if you really want to know you could try emailing the mods and asking them.

If a close relative died as a consequence of a strike, what would your thoughts be, how benevolent towards the clinicians would you be?

(Between my wife and I, we've clocked up 80 years of NHS primary and secondary care provision, for context, so, torn...)

https://www.bbc.co.uk/news/55089900.amp

https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandwo...

https://moneyweek.com/economy/uk-economy/602141/private-vs-public-sector-pa...

The evidence suggests that public sector workers (including the NHS) are now paid broadly in line with the private sector after adjusting for skills and experience.

The decrease in real wages witnessed over the past 10 years is the correction of the previous labour government inflating public sector wages ahead of private sector wages. This is just a required normalisation.

As another poster pointed out, the private sector isn’t all roses at the moment. Pay rises over the past few years have been non-existent (during Covid) and are sub-inflationary in most sectors (now).

In the context of an upcoming recession and the redundancies that it will bring, it feels a bit tone deaf.

Words fail me. Some of my work colleagues lost their lives before a vaccine was discovered. They had a fully paid job. Were they lucky?
 

And because the government cut you high and dry, gives you the moral high ground over other industries that did not have the safety net of being confronted by a virus that killed quite a lot of people who had to go to work so that shops could provide food?

Sorry, my bad. I did not read this paragraph before I started replying.

you are completely correct, I just dream of having a job in the real world.

Meh. It's debatable but the pandemic is history (for most of us - certainly as far as the music industry is concerned), this thread is about the future.

Fwiw though Brexit has already had a vastly more damaging effect on the British music industry and will probably continue to do so far into the future.  Something tells me this poster is a 'blaming the effects of Brexit on the pandemic' kind of a guy.

There's a deal, a kind of covenant, with professions where it's unthinkable to strike that conveniently gets forgotten by a lot of commentators lately. Employers also have a moral obligation not to force such people into a position where they have no choice.

In spite of the right wing press pivoting from weekly rounds of applause to "Nurses: they're all greedy bastards" I think a lot of us will remember that it takes two to tango.

12 years of austerity have inflicted a death toll arguably bigger than the pandemic. And have led to some startlingly short sighted decisions as all sorts of relatively cheap interventions that can prevent a lifetime of expensive health problems have been axed. Some of those are only just beginning to bite now, as people who were toddlers and babies as the Sure Start centres were being closed begin to approach adolescence and early adulthood.

While individual clinicians will agonise over the possibility that a strike might lead to a poorer outcome, even maybe hasten the demise of poor old Mrs Miggins the government couldn't be more obvious about not giving the merest hint of a shit about her, and those of us not blinded by the Daily Mail can plainly see that.

There's an increasingly desperate shortage of nurses, GPs, paramedics, you name it. And in spite of loads of promises from the Tories to increase their numbers it only seems to be getting worse.

Funny how the sort of people who invariably invoke 'market forces' to justify the unjustifiable when it comes to bankers bonuses, 'executive' salaries and big fat pay rises for CEOs as their gravy train rumbles on don't seem to be talking about "supply and demand" in this thread innit.

This is the main reason I won't be striking. I couldn't deal with the thought that any cancer treatment delays would be down to me being on strike. 

But thinking longer term I do feel that the erosion of wages and working conditions (I.e constant staff shortages meaning we have to work more stressful, and longer shifts) is only going to make fewer people want to enter the profession, which will inevitably lead to poorer care. So I am also torn.

Agreed. Although you and your colleagues will take a substantial hit in your income if you do an overtime ban. At this point in the cost of living crises that is a big one to ask. 
 

Your negotiating strength will come from your vacancy rate etc. it’s pretty simple in private sector salaries go up where there is shortages of skilled and valued employees  . That’s your ace and winning card in the fraught negotiations to come. Not your arguments on other issues. You know this and I hope that is what wins it for you and your colleagues. 
 

And sadly they won't take the obvious simple solution.....scrap the fees for training or write them off following a defined period of service to the NHS! I recall my daughter as a second year trainee nurse being really traumatised whilst working in paediatric A&E....she was literally having to remove skull bone fragments from her scrubs etc after a child had died in a terrible RTA. The consultant medic talked to her afterwards and told her how she had been really helpful and done a good job.....she had flashbacks and other PTSD symptoms for a while afterwards........and she was paying fees for what she went through, it's appalling and outrageous.

Absolutely.......market forces for some and not others!!!

I’d rather our hospitals were devoid of staff for the period of a strike than devoid of them for years to come because shit conditions have made  many realise they are better off elsewhere.

To be fair depending on which section of the music industry they may well get through more drugs a night than the local hospital.

The shit, as the yoof say, has hit the rubber already on that one without the need for strike action.

https://www.rcm.org.uk/media-releases/2021/september/rcm-warns-of-midwife-e...

Unfortunately it isn't. Public sector workers don't donate vast sums of money to the Conservative Party. The public sector isn't going to provide a series of well paid executive directorships for 2 days work to government ministers when they retire. Government ministers aren't mates with paramedics and nurses and know they can do each other mutually financially beneficial 'favours'.

The current government don't give a flying f*** about public sector workers, they see them as a commodity to be worked to the absolute maximum for the absolute minimum pay possible, then blamed for the resulting collapse in public services.

Private Eye had an article this week on how nicely the private hospitals are doing from the NHS being stretched to breaking point. Especially after the government handed them a ton of cash for them doing not a lot during lockdown.

Especially stupid as it seems unlikely that the fees will ever get paid off in full by most nurses - why not make that explicit by not having them?

Morons.

In reply to that post about the music industry earlier, my response would be that the medics perform a useful, nay, essential service rather than a luxury dependant on whims. Great by all means but hardly in the same ball park is it?

This has to be irony!

And the irony is that given that the rate limiting step for the NHS is that there is a finite supply of staff private provision actually does nothing really regards capacity. But private institutions almost always do not contribute to training / research, but do benefit from this as provided by NHS institutions. (There are some exceptions).

'but the underlying problem of bad management and massive wastage will never get sorted. '

I often see this bandied around , but I have absolutely no idea how true this is.  I would point out that what you can achieve in efficiency in a company of less than 20 people is one thing, once you move onto larger organisations, or more complex tasks, this gets an awful lot harder, and any gains become a lot smaller, and more difficult to achieve, and what might be good for the overall picture sucks on an individual case.

I'd also note that in a lot of discussions about more efficient working, a starting assumption is that to achieve an efficient result from the viewpoint of the patient you need not to be constrained by lack of staff, resources, staff error etc.... and clearly that's not the case in the NHS.  Sp imagining that some wonder reorg is going to achieve miracles is likely to be disapointing...

As a taxpayer I absolutely want to see the public sector do the maximum amount of work for the lowest cost possible.

Surely this is a given?

When it comes to public sector pay it’s just a case of robbing Peter to pay Paul, and I (as a private sector Peter) don’t like being robbed.

You mean "if I'm very indirectly paying someone I'm reassured if I think they're being flogged to death for as little money as possible."

No. I tip well largely because I recognise the people I'm tipping aren't getting paid a huge salary. I don't begrudge this in the slightest, same with charity donations.

Robbery is when someone steals your money. Tax is when you pay your share back into society. Perhaps you'd be a lot less bitter about it if you got those basic facts straight in your head.

You could do this for one month by just not paying us at the end. The following month may be slightly low on productivity though. 

Might need some longer term thinking though 

It's often bandied about....in my experience by people who know nothing of NHS management.

In the NHS Trust where I work there are very few managers and they work extremely hard juggling multiple demands every day. I am a clinician and lead a small specialist team of 6 people. My manager is the overall service manager for this and about 10 other teams, all much bigger. His boss is an Associate Director who reports to the Trust Board......these are the people who worked in the 'ops room' throughout the worst of covid and made sure the service still ran and looked out for the staff.

Where there is poor leadership I have found this to be in the politically created 'internal market' within the NHS. Political ideology has created this (politicians).....not the NHS.!

Yes, some of my colleagues are being trained in private, but I think this is because one of the teaching staff worked in private. Seems quite rare though, as you say. 

You're the person saying 50 percent of all non clinical staff should be got rid of the other day....it illustrates your ignorance.

A bit like your comment the other week about the people who create growth.....and the rest of us being described as 'plebs'! 

Big talk is easy...

Well done you for adding that you don't know if it is true or not! NHS management costs are actually very low compared to those in other Western systems. But so are per capital: spending on health, medical staff, nursing staff, bed numbers, ITU bed numbers etc etc.

There are obviously loads of inefficiencies and my life is plagued with bureaucracy . But there is a bigger picture about health spending which is obscured by this sort of twaddle.

Unfortunately what there is in the UK as a whole (we have multiple health systems, they are all devolved, theer is no 'NHS' there is NHS England, NHS Wales, NHS Scotland, NI etc) is massive politicisation and interference with health and ever changing policies from above.

I also , as a private sector manager, see lumps of inefficient spending, and failure, quite often.  In the private sector that's the cost if expanding your business, and it's ok to fail sometimes, but in the public sector..... a different story

Workers have a right to strike if they feel they are being shat on. Doesn't matter what area they work in.

It is unfortunate that members of the public get caught up in the effect of 'service' strikes. But maybe their employers need to recognise the impact of not reaching a settlement themselves. There are always two sides to an industrial dispute.

A few points.

Firstly NHS productivity increases are higher than average in the UK economy

https://www.england.nhs.uk/2019/04/staff-praised-as-nhs-productivity-grows/

Secondly NHS management costs for a health system are on the lower end for Western nations, way below US costs where private health policy rules (with some provisos below where the UK does have identifiable problems).

https://www.commonwealthfund.org/publications/journal-article/2014/sep/comp...

Finally, please just ignore VS. He clearly knows better than some of the crap he spouts but feeds on the attention.

Now the provisos, as there are clearly identified problems in how the NHS works, that if fixed could save tens of billions and lead separately to major service improvements. These problems are well known by those paying attention and are clearly interrelated.

The biggest issue is probably the ludicrous level of political interference and lies about under-funding that leaves parts of the system hitting capacity limits....here things have got much worse in recent years, leading to increases in bed blocking, long waits for treatment, a total joke of workforce planning (especially a massive need in extra funded training places given NHS demographics) and various disastrous scandals ( including: the shameful maternity unit failures, appalling mental health services for the young and unacceptable ambulance response times for serious emergencies). In all this NHS trusts are heavily pressured to avoid bad news and as a result a 'manage-up bully-down' management culture too often thrives, that is highly aggressive to whistleblowing. The voting public need to recognise this malign influence on the NHS and campaign for it to stop. Independant transparency on funding and governance quality need to be returned to the NHS.

Next, a specific...the pressures in the NHS lead to more and more medical mistakes and the legal process that seeks recompense to victims  has spiralling costs. We need to shift to a no blame process such as that which operates well in Sweden, at much lower cost per mistake.

Next structures. Care has to be better integrated with the NHS to stop unnecessary admissions and bed blocking. Various initiatives with improved links have demonstrated improvements and cost saving through this. On a seperate issue, the government are at last dumping the incredibly expensive (for no gain whatsoever) purchaser provider system of commissioning (but too slowly) but someone needs to have a hard look at the commissioning replacement organisations (called ICBs) that did seem like an improvement but seem to me to have rather drifted: shifting the expensive bureaucracy across without looking at the more important gaps that need resolving to meet their new aims.

https://digital.nhs.uk/services/organisation-data-service/integrated-care-b...

Then Public Health....we had an excellent system in the UK under Labour but Cameron's government defenestrated it by sticking the main local functions in cash strapped councils. Public Health investment always saves on health intervention costs decades later.

Every single working woman and man in the UK should not go to work tomorrow. See how quick things change.

You're being robbed every single day. If a burglar came into your house every day and took stuff from you and you knew where they lived would you accept it?

Sunak is going to give 4m households £300 towards their energy bills. That's about 1.2bn. It's estimated that the UK energy companies could make 170bn profit over the next two years.

E

Your numbers are a bit out of date.

The projected cost for UK Gov is closer to £100 billion  for domestic support. Plus £40 billion for business support.

The £400 subsidy you are referring to ( not £300) was before the new current subsidy.

I have no idea where you got the  £170 bn over the next 2 years from for profits.

Out of interest how much is it costing the French Gov...probably similar numbers.... usually its about broadly the same.

Either way its not good.

Haven't looked at exact numbers but I saw 65bn mentioned. Difference is over here that no matter what happens the citizens are the priority. Compared to the UK where it's subjects are last in line for anything way behind shareholders etc etc

E

Possibly. Out of interest where do Total's profits go?

Neilh and Enty

Respectfully, please keep on track.

This is an interesting discussion as it is with out you two naval gazing.

The cost of that subsidy is going to have a big impact on your pay discussions...!

A big chunk now going to the workers - 7% pay rise and up to €6000 bonus. Two refineries still on strike for 10% though last I heard. Shame the other unions agreed the 7%.
Got to keep on holding on for that windfall tax. Effing Macron

E