NHS problems etc

13567

Comments

  • webboo said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    Lots! In my wife's case, her immediate line manager is an absolutley wonderful person but a pretty mediocre manager.

    Is the line manager also a healthcare professional?

    This isn't an argument for fewer managers, it is for good management, who can effectively make it so that the front line can concentrate on doing what they are good at, and for the right people at the right time. There's no point in having lots of front line staff and terrible organisation and coordination meaning they are wasting their time.
    I think she is a healthcare professional (i.e a midwife) who has been elevated to "manager"
    Exactly - this isn't the way to find the best performing managers. Probably now doesn't do the thing she is actually good at, because becoming a manager was the only way to get more status and remuneration.
    I was elevated to become an NHS manager, grade wise I stayed the same. The trust I worked for decided that all band 7 nurses should be either clinical leads or team leaders. So from being responsible for 5 or 6 nurses, you were suddenly running a team of thirty staff of all professions such Consultant psychiatrists, clinical psychologists, social workers, occupational therapists and admin staff as well as managing the budget. If you didn’t agree to this you would become a band 6 nurse.
    This was all to achieve budget savings, it’s never about better care
    Doesn't make sense, does it? Get good managers in and let clinical staff do their thing. Also they will never be distracted from their job because there's important clinical work to be done.
    That's the theory. How is it working out?
    Doesn't sound like it's happening, does it?
    Well in a lot of professions the higher up you get the less of the original professional work you do. The best scientists in industry end up managing scientists and not doing science, Lawers run the company and manage lawyers, but don't do the actual layering so much. Etc.

    What are you proposing, lift the glass ceiling for actual clinical work, and get admin and managers in for cheaper?

    Problem there is you get managers without an understanding of all of the implications of their decisions, don't you?
    If they are no good, yes.

    And of course the best manager could come from a clinical background.

    I don't agree that because you don't want to manage people that should represent a glass ceiling. You could still be a subject expert.
  • webboo
    webboo Posts: 6,087

    webboo said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    Lots! In my wife's case, her immediate line manager is an absolutley wonderful person but a pretty mediocre manager.

    Is the line manager also a healthcare professional?

    This isn't an argument for fewer managers, it is for good management, who can effectively make it so that the front line can concentrate on doing what they are good at, and for the right people at the right time. There's no point in having lots of front line staff and terrible organisation and coordination meaning they are wasting their time.
    I think she is a healthcare professional (i.e a midwife) who has been elevated to "manager"
    Exactly - this isn't the way to find the best performing managers. Probably now doesn't do the thing she is actually good at, because becoming a manager was the only way to get more status and remuneration.
    I was elevated to become an NHS manager, grade wise I stayed the same. The trust I worked for decided that all band 7 nurses should be either clinical leads or team leaders. So from being responsible for 5 or 6 nurses, you were suddenly running a team of thirty staff of all professions such Consultant psychiatrists, clinical psychologists, social workers, occupational therapists and admin staff as well as managing the budget. If you didn’t agree to this you would become a band 6 nurse.
    This was all to achieve budget savings, it’s never about better care
    Doesn't make sense, does it? Get good managers in and let clinical staff do their thing. Also they will never be distracted from their job because there's important clinical work to be done.
    That's the theory. How is it working out?
    Doesn't sound like it's happening, does it?
    Well in a lot of professions the higher up you get the less of the original professional work you do. The best scientists in industry end up managing scientists and not doing science, Lawers run the company and manage lawyers, but don't do the actual layering so much. Etc.

    What are you proposing, lift the glass ceiling for actual clinical work, and get admin and managers in for cheaper?

    Problem there is you get managers without an understanding of all of the implications of their decisions, don't you?
    When I was working salaries in the private sector were fairly similar but the private sector generally had better working conditions. However in my field community mental health services there was no private sector.
    The private sector doesn’t want to try provide for services where there is no control. For example they don’t want A and E because no matter how vast a service you provide there will still be more demand. It is similar for community mental health services.
    In mental health the private sector likes to provide secure beds ie. People referred by the courts who are detained under MH act. So they now how long they got them for.
    I personally would not have worked outside the NHS as unfortunately it’s something I believe in, despite how sh!t it is.
    So then they’ve got you over a barrel.
  • First.Aspect
    First.Aspect Posts: 14,290
    Yes care sector the same. Even the "private" agencies have only one customer effectively, the local authorities. So this normalises salaries and conditions.

    Surprised any private sector t&Cs would be more generous than NHS in terms of leave, pension contributions, extra leave for people with young children, maternity/paternity etc.
  • webboo
    webboo Posts: 6,087
    The problem is that private health couldn’t exist without the NHS. They don’t train staff and if the case of a lot of medical staff their pensions are going to be provided by the NHS.
    Interestingly some of the nurses who I trained with who were a bit crap ended up working in the private sector. This may might not be a general theme. ;)
  • TheBigBean
    TheBigBean Posts: 20,277

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I don't have the answer. I just know when I did some work where there was a requirement to hire GPs, the pay, without the NHS pension, was much lower than I expected to lure them out of practice.

    There was widespread dissatisfaction amongsts the salaried GPs at conditions.

    Apparently a compelling feature of the proposed work was that no one was going to die. The inevitability of killing people clearly weighs on minds.

    So to encourage more people to become GPs requires better conditions or better pay to compensate for the responsibility and conditions.

    And I think some of the partner GPs are responsible for this

    Something that was pointed out to me as a way to measure the enthusiasm of the partnered GPs for patients was to look at the parking they allocate themselves. Is it closer than the disabled parking? Almost always is.
  • webboo
    webboo Posts: 6,087
    One should not forget Doctors actually voted against the founding of NHS that’s why GP’s are really still in private practice.
  • First.Aspect
    First.Aspect Posts: 14,290
    edited January 2023
    Seems like GPs are outliers here and that the salaried ones are similarly disgruntled for similar reasons to salaried lawyers looking at the golfers running the firm. At least there's a loft hatch in the glass ceiling for GPs, unlike nursing or A&E specialists.

    Fwiw the base salaries of all NHS doctors isn't that high in the grand scheme of things. Consultants top out at 120 for 40hrs. But again there's a loft ladder through the glass ceiling to a whole other floor of the building for them.
  • Pross
    Pross Posts: 39,827

    There are too many non-front line staff employed by the NHS - it is the largest employer in Europe and comfortably in the top 10 employers globally. There are inefficiencies throughout the system.
    There are clearly far too few front line staff (and that's not just doctors and nurses, but I'd include roles like porters).
    Some aspects need to be centralised - eg procurement of drugs and negotiating prices thereof, but other things need to done at a local level - eg cleaning, without 2 or 3 middlemen taking a cut.
    Being able to return things like crutches for reuse in the system, another simple and logical fix.
    There also needs to be a discussion around what services it should provide - IVF being an example of that.
    Should we pay a nominal amount for a GP appointment which could then be offset against a prescription charge - might stop a load of the hypercondriac timewasters?
    There needs to be more preventative stuff going on - eg proper health checks at various ages.
    And then the social care side needs to be addressed. We need to get away from the idea that people shouldn't have to sell their homes to help pay for their care. Part of the social care side might include the need to build half way houses so hospital beds aren't blocked, but the hwh is used before people are fully fit to return home.

    The problem with this and other suggestions mentioned by Laurentian and others is that if the Tories try to make any major shake up they will be accused of trying to privatise the NHS and I’m not sure how much it would suit Labour either.

    It really needs a proper cross-party approach and for everyone to stop using the NHS as a political football. Nothing should be off the table when discussing options.
  • photonic69
    photonic69 Posts: 2,347
    Health, transport, education, utilities should all be outside of the political arena. It should be a set level of service that is voted democratically by the tax payer. We need to stop all this being a political, point-scoring football.
    Basically we need to be more Swiss.


    Sometimes. Maybe. Possibly.

  • rjsterry
    rjsterry Posts: 27,248
    edited January 2023

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    🤨

    I mean that plus the pension really doesn't seem to bad given the overall national income distribution.
    1985 Mercian King of Mercia - work in progress (Hah! Who am I kidding?)
    Pinnacle Monzonite

    Part of the anti-growth coalition
  • rjsterry
    rjsterry Posts: 27,248

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    1985 Mercian King of Mercia - work in progress (Hah! Who am I kidding?)
    Pinnacle Monzonite

    Part of the anti-growth coalition
  • rick_chasey
    rick_chasey Posts: 71,577
    rjsterry said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    Scarcity innit
  • ddraver
    ddraver Posts: 26,318
    Another from the irony thread is that the party all about "the free market" are currently desperately trying to ignore the plain fact that the free market has decided that nurse or carer pay is much too low
    We're in danger of confusing passion with incompetence
    - @ddraver
  • First.Aspect
    First.Aspect Posts: 14,290
    rjsterry said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    Dont really agree, but the long training period is often wheeled out for doctors. Reality is that its at least 3-4 years for most people by the same measure.
  • briantrumpet
    briantrumpet Posts: 17,324
    ddraver said:

    Another from the irony thread is that the party all about "the free market" are currently desperately trying to ignore the plain fact that the free market has decided that nurse or carer pay is much too low

    Well, especially if you put in barriers to people getting on their bikes or boats and filling the vacancies.
  • rjsterry
    rjsterry Posts: 27,248

    rjsterry said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    Dont really agree, but the long training period is often wheeled out for doctors. Reality is that its at least 3-4 years for most people by the same measure.
    The knowledge and skills and how much you can sell that expertise for are what is useful. It doesn't really make any difference whether you acquire those in 3, 5 or 10 years. I mean, you were moaning yourself about how even after a degree and PhD, your new trainees were not very productive.
    1985 Mercian King of Mercia - work in progress (Hah! Who am I kidding?)
    Pinnacle Monzonite

    Part of the anti-growth coalition
  • ddraver
    ddraver Posts: 26,318
    God damn it Tories you've made me agree with Ash Sarkar! 🤢

    https://vm.tiktok.com/ZMFoP6xCX/
    We're in danger of confusing passion with incompetence
    - @ddraver
  • First.Aspect
    First.Aspect Posts: 14,290
    rjsterry said:

    rjsterry said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    Dont really agree, but the long training period is often wheeled out for doctors. Reality is that its at least 3-4 years for most people by the same measure.
    The knowledge and skills and how much you can sell that expertise for are what is useful. It doesn't really make any difference whether you acquire those in 3, 5 or 10 years. I mean, you were moaning yourself about how even after a degree and PhD, your new trainees were not very productive.
    Different issue entirely. I was comparing generations then, and professions now.

    Quite apart from which, all I am questioning is whether GPs earn surprisingly little given how much training they do. Suspect BB would find the salaries modest, but for most of the workforce, me included, they seem about par. Or, if you are on an average UK salary, pretty damn good.

    I have some sympathy with the argument that the starting salary and overall career progression opportunities need to be attractive to make up for not earning for a decade. Because why else would people do it without a carrot at the end of the stick?

    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.
  • pblakeney
    pblakeney Posts: 25,222



    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.

    Just a stab in the dark, but not everything is about money.
    That said, a vocation doesn't pay the mortgage.
    The above may be fact, or fiction, I may be serious, I may be jesting.
    I am not sure. You have no chance.
    Veronese68 wrote:
    PB is the most sensible person on here.
  • rjsterry
    rjsterry Posts: 27,248

    rjsterry said:

    rjsterry said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    Dont really agree, but the long training period is often wheeled out for doctors. Reality is that its at least 3-4 years for most people by the same measure.
    The knowledge and skills and how much you can sell that expertise for are what is useful. It doesn't really make any difference whether you acquire those in 3, 5 or 10 years. I mean, you were moaning yourself about how even after a degree and PhD, your new trainees were not very productive.
    Different issue entirely. I was comparing generations then, and professions now.

    Quite apart from which, all I am questioning is whether GPs earn surprisingly little given how much training they do. Suspect BB would find the salaries modest, but for most of the workforce, me included, they seem about par. Or, if you are on an average UK salary, pretty damn good.

    I have some sympathy with the argument that the starting salary and overall career progression opportunities need to be attractive to make up for not earning for a decade. Because why else would people do it without a carrot at the end of the stick?

    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.
    Looking at this, nobody is going ten years without earning.
    https://www.bmj.com/careers/article/how-much-do-doctors-really-earn-#:~:text=Foundation year doctors earn between,earn £41,158-£76,751
    I'm sure a lot of graduates would be very pleased to start at that level while they completed their vocational training. As a side note, fixed pay scales rightly went out in the early 80s in other professions. Notwithstanding the perversities of the tax system, I suspect conditions rather than pay is what is turning people away from medicine.
    1985 Mercian King of Mercia - work in progress (Hah! Who am I kidding?)
    Pinnacle Monzonite

    Part of the anti-growth coalition
  • Jezyboy
    Jezyboy Posts: 2,784
    In the case of med students, there's certainly no shortage of applicants at the bottom level.

  • First.Aspect
    First.Aspect Posts: 14,290
    pblakeney said:



    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.

    Just a stab in the dark, but not everything is about money.
    That said, a vocation doesn't pay the mortgage.
    Agree, and doctors aren't striking so this is a diversion.

    However nursing, another "vocation", is on strike and I've never heard of a large scale strike that is about conditions, or a strike that's about conditions and pay. They are all about pay, fundamentally, or pay and conditions.

    Btw I find categorising some jobs as a vocation difficult. It means, tacitly, teaching, nursing, etc. More worthy? We are more noble somehow? I know the true meaning is just that you are very specifically trained - and so would include me, architects, lawyers, barristers, many engineers, scientists, soldiers etc., but it doesn't seem to be used like that.
  • rick_chasey
    rick_chasey Posts: 71,577
    edited January 2023
    Worthiness, despite Webboo's moralising, is pretty much irrelevant.

    It's supply and demand, and with nursing the it's not a well functioning market because there's only one employer. Hence sub-optimal wages and vacancies.

    Inevitably, we all know, consciously or otherwise, that the conditions nurses have to work in, because of the above, is pretty grim, so we treat them like angels and clap and all the rest of it to compensate for that fact.
  • pblakeney
    pblakeney Posts: 25,222
    edited January 2023

    pblakeney said:



    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.

    Just a stab in the dark, but not everything is about money.
    That said, a vocation doesn't pay the mortgage.
    Agree, and doctors aren't striking so this is a diversion.

    However nursing, another "vocation", is on strike and I've never heard of a large scale strike that is about conditions, or a strike that's about conditions and pay. They are all about pay, fundamentally, or pay and conditions.

    Btw I find categorising some jobs as a vocation difficult. It means, tacitly, teaching, nursing, etc. More worthy? We are more noble somehow? I know the true meaning is just that you are very specifically trained - and so would include me, architects, lawyers, barristers, many engineers, scientists, soldiers etc., but it doesn't seem to be used like that.
    "Vocation" - used by those outside of the industry in the vain hope that people do the job for the love of it and will accept sub-par pay. My wife hates the word along with angel.
    The above may be fact, or fiction, I may be serious, I may be jesting.
    I am not sure. You have no chance.
    Veronese68 wrote:
    PB is the most sensible person on here.
  • rick_chasey
    rick_chasey Posts: 71,577
    pblakeney said:

    pblakeney said:



    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.

    Just a stab in the dark, but not everything is about money.
    That said, a vocation doesn't pay the mortgage.
    Agree, and doctors aren't striking so this is a diversion.

    However nursing, another "vocation", is on strike and I've never heard of a large scale strike that is about conditions, or a strike that's about conditions and pay. They are all about pay, fundamentally, or pay and conditions.

    Btw I find categorising some jobs as a vocation difficult. It means, tacitly, teaching, nursing, etc. More worthy? We are more noble somehow? I know the true meaning is just that you are very specifically trained - and so would include me, architects, lawyers, barristers, many engineers, scientists, soldiers etc., but it doesn't seem to be used like that.
    "Vocation" - used by those outside of the industry in the vain hope that people do the job for the love of it and will accept sub-par pay. My wife hates the word along with angel.
    There you go, see above.

    If everyone thought you were well paid they wouldn't be in the streets clapping for you.
  • First.Aspect
    First.Aspect Posts: 14,290
    pblakeney said:

    pblakeney said:



    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.

    Just a stab in the dark, but not everything is about money.
    That said, a vocation doesn't pay the mortgage.
    Agree, and doctors aren't striking so this is a diversion.

    However nursing, another "vocation", is on strike and I've never heard of a large scale strike that is about conditions, or a strike that's about conditions and pay. They are all about pay, fundamentally, or pay and conditions.

    Btw I find categorising some jobs as a vocation difficult. It means, tacitly, teaching, nursing, etc. More worthy? We are more noble somehow? I know the true meaning is just that you are very specifically trained - and so would include me, architects, lawyers, barristers, many engineers, scientists, soldiers etc., but it doesn't seem to be used like that.
    "Vocation" - used by those outside of the industry in the vain hope that people do the job for the love of it and will accept sub-par pay. My wife hates the word along with angel.
    It is also leveraged by those inside the industry during a dispute.
  • DeVlaeminck
    DeVlaeminck Posts: 8,707
    Re doctors salaries this may be controversial but there are a disproportionate number from private schools and affluent backgrounds in general. That is going to feed into their expectations about salaries - they may feel £60-100k is insufficient because daddy was on several times that.

    Maybe if we accepted kids from less advantaged backgrounds are just as able but that it's hard to get straight A*s if you went to some shite comprehensive - and find a way to get more of those kids into the profession - then we'd have a medical profession less demanding of excessive pay. Ideally of course we'd have the same kind of investment in state education nationwide that London had some time ago (and ban private schools) so we don't have to look at exam results through a prism of where they were achieved.

    At the same time if doctors really are over worked then that needs tackling - no point in just paying them more if that just allows them to cut down their hours because the real issue wasn't pay but conditions.
    [Castle Donington Ladies FC - going up in '22]
  • pblakeney
    pblakeney Posts: 25,222
    ...oh, and junior doctors are currently voting on whether to go on strike or not.
    The above may be fact, or fiction, I may be serious, I may be jesting.
    I am not sure. You have no chance.
    Veronese68 wrote:
    PB is the most sensible person on here.
  • TheBigBean
    TheBigBean Posts: 20,277
    rjsterry said:

    rjsterry said:

    rjsterry said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    Dont really agree, but the long training period is often wheeled out for doctors. Reality is that its at least 3-4 years for most people by the same measure.
    The knowledge and skills and how much you can sell that expertise for are what is useful. It doesn't really make any difference whether you acquire those in 3, 5 or 10 years. I mean, you were moaning yourself about how even after a degree and PhD, your new trainees were not very productive.
    Different issue entirely. I was comparing generations then, and professions now.

    Quite apart from which, all I am questioning is whether GPs earn surprisingly little given how much training they do. Suspect BB would find the salaries modest, but for most of the workforce, me included, they seem about par. Or, if you are on an average UK salary, pretty damn good.

    I have some sympathy with the argument that the starting salary and overall career progression opportunities need to be attractive to make up for not earning for a decade. Because why else would people do it without a carrot at the end of the stick?

    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.
    Looking at this, nobody is going ten years without earning.
    https://www.bmj.com/careers/article/how-much-do-doctors-really-earn-#:~:text=Foundation year doctors earn between,earn £41,158-£76,751
    I'm sure a lot of graduates would be very pleased to start at that level while they completed their vocational training. As a side note, fixed pay scales rightly went out in the early 80s in other professions. Notwithstanding the perversities of the tax system, I suspect conditions rather than pay is what is turning people away from medicine.
    And yet there is a big shortage of GPs, so either the pay or conditions need to improve (or the perception of them).
  • pblakeney
    pblakeney Posts: 25,222

    rjsterry said:

    rjsterry said:

    rjsterry said:

    I wonder how much stress and workload is caused by the army of administrators making decisions to help nurses, over their heads. One of the biggest contributors to any workplace stress is a lack of control, right?

    GPs are independently run and the NHS contracts them.
    Wasn't really discussing them to be honest. But GPs are an interesting case of bleeting incessantly but apparently having complete control over their situation.

    I find it impossibly hard to assess from the outside.
    GP surgeries are paid per patient on their books plus bonuses for other stuff. From this they pay the salaried GPs' wages. What's left over goes to the partners.

    The partnered GPs could argue that the amount per patient is insufficient, but even then they do need to accept their role in making the salaried GP job unattractive.
    My difficulty is pinning down whether or not, or why, the GP salaried role is unattractive.

    Or any more so than other professional services with a market rate. Clearly the salaried GPs earning in the 100k range are generating income that pays for much higher salaries for the partners, but join the club.

    For them, is it really the salary?
    "From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194". This is lower than most people think based on the 10 years of study/training. On top of that, it can be a stressful job without that much support. This has been the case of a long time.

    I suspect to attract more people, it either needs more money or better conditions, but that is probably stating the obvious.




    Degree 3-4 years
    PhD 4-5 years
    Patent exams 3-5 years.

    NQ salary ca. £60-70k, after 10-14 years training.

    You can say similar things about lots of other professions, including solicitors (with the exception of the meat grinder that is NQ solicitor for magic circle firms).

    So given the pension provision is so good as well, is it salary or conditions that's the problem?

    If it is salary, how much should a GP be paid? And how much would they need to be paid for the conditions to be worthwhile?
    I do find the academic duration p***ing contest a bit tedious. The idea that you should be able to demand a £60k+ salary because you have been at school for a really long time is also pretty weird. That is only tangentially what is of value to the employer.
    Dont really agree, but the long training period is often wheeled out for doctors. Reality is that its at least 3-4 years for most people by the same measure.
    The knowledge and skills and how much you can sell that expertise for are what is useful. It doesn't really make any difference whether you acquire those in 3, 5 or 10 years. I mean, you were moaning yourself about how even after a degree and PhD, your new trainees were not very productive.
    Different issue entirely. I was comparing generations then, and professions now.

    Quite apart from which, all I am questioning is whether GPs earn surprisingly little given how much training they do. Suspect BB would find the salaries modest, but for most of the workforce, me included, they seem about par. Or, if you are on an average UK salary, pretty damn good.

    I have some sympathy with the argument that the starting salary and overall career progression opportunities need to be attractive to make up for not earning for a decade. Because why else would people do it without a carrot at the end of the stick?

    Even for what I do, we are competing with other professions so there has to be a reason to take all those exams and earn less than all your mates in the meantime.
    Looking at this, nobody is going ten years without earning.
    https://www.bmj.com/careers/article/how-much-do-doctors-really-earn-#:~:text=Foundation year doctors earn between,earn £41,158-£76,751
    I'm sure a lot of graduates would be very pleased to start at that level while they completed their vocational training. As a side note, fixed pay scales rightly went out in the early 80s in other professions. Notwithstanding the perversities of the tax system, I suspect conditions rather than pay is what is turning people away from medicine.
    And yet there is a big shortage of GPs, so either the pay or conditions need to improve (or the perception of them).
    You could say that the market has decided. 😉
    The above may be fact, or fiction, I may be serious, I may be jesting.
    I am not sure. You have no chance.
    Veronese68 wrote:
    PB is the most sensible person on here.