Junior doctors contract row has put a third of students off studying medicine

If you want to improve weekend services, you need to hire more staff, not junior docs, who already work weekends, but pathologists, social workers, physios etc. The government would also have to be prepared to pay for that, demand is also iffy so while it sounds great, people don't want to see GP on weekends.

Docs don't get free tuition, they have to pay to work, pay to train, pay to sit exams with high rates and the gov here is asking docs to do more, for less, but somehow not actually pay them more or work them less. It's bonkers.

Posted from TSR Mobile

Free healthcare and benefits are two of the worse welfare systems to ever exist in this country. The first results in people being lazy and brings in the most useless immigrants into this country. The latter results in healthcare being inefficient, underfunded and causes low morale among health care professionals especially doctors that have to work more for less pay given this new contract.

If you want better healthcare then I'd support the doctors and support privatisation of healthcare in Britain. We need a sustainable system that isn't only reliant on the government, we need to rid ourselves of the government bureaucracy controlling our nations health. Soon hospitals are going to shut down due to budget cuts and there are going to be even more protests out there, people are delusional if they believe healthcare is free in the first place. If you don't pay directly it comes from your taxes and ultimately you would be the loser since the government ends up controlling your healthcare.

Countries like Australia, the Netherlands, the United States and Switzerland have an insurance based private healthcare system that works well. Both countries have two of the best healthcare systems on the planet, the most advanced medical technology, higher number of MRI/CAT scanners, higher cancer survival rates and the most advanced hospitals in the world.

The first step will be having the junior doctors committed a 7 day normal service NHS. You can only commit the other staff after that.

People don't want to see their GPs on the weekend? Source? At the moment most GPs don't offer weekend opening or it isn't advertised enough. I'd much rather see my GP at the weekend then have to try and take time off work every time. Anyone who works a normal job would rather that they could see their GP at the weekend.

Doctors don't get free tuition but their studies are heavily subsidies. They pay a fraction of the actual cost that is required to train a doctor.

Most of society have been asked to do more for less since the credit crunch. Why are doctors exempt?

The first step will be having the junior doctors committed a 7 day normal service NHS. You can only commit the other staff after that.

People don't want to see their GPs on the weekend? Source? At the moment most GPs don't offer weekend opening or it isn't advertised enough. I'd much rather see my GP at the weekend then have to try and take time off work every time. Anyone who works a normal job would rather that they could see their GP at the weekend.

Doctors don't get free tuition but their studies are heavily subsidies. They pay a fraction of the actual cost that is required to train a doctor.

Most of society have been asked to do more for less since the credit crunch. Why are doctors exempt?

1) Isn't accurate, junior doctors DO work over holidays, weekends, night shifts etc. To say the first step is to employ doctors is incorrect, other staff not working similar hours creates the backlog. By all means, employ more JD if wanted, but again I'm going to argue that to expect people to work longer you should pay them more for it, hardly radical.

2) You're correct in that people who have work or school tend to prefer weekends, but the vast majority of the users of GP services are people who are retired or who work limited hours, thus to the majority of users, it will change nothing. On a trial scheme, they found that there simply wasn't enough demand to outweigh the cost. In terms of cost-effectiveness it wasn't an improvement. I would have no complaints if certain practices wanted to do it, and I'm sure for some it would help, but a cross country rule won't be sensible, and yes, they should be remunerated for working it.

3) I can't control how much universities and Trusts charge for degrees, if you wanted to overall make the cost of training neutral I can understand, but it shouldn't be the junior docs who suffer, you would also see medicine become a more elite degree, maybe that isn't concerning but to some it is, medical training should be considered an investment, for that we then forcibly retrain, on our own, without funding to continue. I look at it like getting a nice phone cheap, but on a longer, more expensive contract, people forget the costs to work in our field and I argue we repay through that the cost of our initial training.

4) Because we already do, doctors already work more hours than they are paid for, demand continually goes up, stress on the job enormous, few days off, reduced social life, risk of lawsuits, all for 23k? Because of the extra demand, the docs have already been hammered, why butcher them even further?

I don't really understand people here, nor do I exactly agree with what's going on. But on one hand, it is considered the ultimate taboo to criticise the NHS and its free healthcare. Yet on the other hand, people are siding with junior doctors over wanting to reverse contracts made to sustain this free healthcare.

It does seem slightly ironic given that they're given free tuition

I do have to say that service at hospitals during the weekend is atrociously awful. I had a cousin who was born in a hospital and then put on a ventilator after they noticed problems, during the week, she got better yet urgently needed several important scans, but by the weekend, most departments had closed and we had to wait 2 days until they opened up. It's stupid because the doctor told my family that she was in 'critical condition', but they couldn't do anything until parts of the hospital reopened. In other words, the cultural tradition of a unproductive weekend had been prioritised over someone's life, that's quality healthcare?

... and then one nurse famously took my blood pressure whilst I had a cannula in my arm, the result was a yucky explosion of blood.

When I went to Canada, the facilities were fantastic.

Regarding 4), I think a lot of professions have an equally hard, if not harder, time of it than doctors do. Consider vets, pilots, certain government agents, paramedics, livestock farmers, those on the intelligence/security service, business owners, professional interpreters, firefighters and of course, anybody in the military.

Cutting doctor's wages, and thereby driving doctors out of the NHS, is a direct attack on the NHS. The NHS is not a binary thing - you can have good public healthcare where virtually no one goes private or you can have rubbish public healthcare and a big private sector. Every time you move money out you move towards the latter, every pound in is a move to the former.



Loool. Can I have my £60,000 back then please. Cash or cheque no biggie.

Doctors pay the most student fees of any degree.



But the doctors were there right?

Its the other staff that weren't. The limiting factor with getting scans at weekends is the availability of radiographers and porters. The doctor's role here is actually easy to do from home, or even outsource to overseas.



I don't want to comment on any specifics, but just to say that taking blood pressure like that is completely normal and it does not cause an 'explosion of blood'. Lots of patients have cannulas in both arms, but they get blood pressure taken just fine.

The cannula must have been going before this happened.



Well they do spend 30% more on healthcare than us. Try giving the NHS an additional £40 billion and see what happens.

And that's assuming you used the public healthcare in Canada and didn't go private.

Honestly, I agree with some of those;

1) Vets, harder to apply for but to my knowledge is less stressful than medicine and as a junior better paid. Certainly being responsible for the death of an animal is less of an issue than being responsible for the death of a human

2) Pilots have gone through a period like JDs are now, but they came out of it with far safer working hours, the right to refuse shifts and the best safety mechanisms in any profession. The health service is learning FROM pilots on how to improve the service.

3) Government agents, no, don't agree at all

4) Paramedics, in the same boat as us pretty much.

5) Farmers, granted, we heavily rely on them yet they are very undervalued, I always back measures to support them

6) Intelligence/Security service, I don't know enough about them

7) No, again, I would support people who are self-employed, because that risk is a concern, but it's not comparable

8)......no

9) Totally agree there, to my knowledge they have a very good union and they deserve alot of support as well

10) Military is a fair point, the only difference I foresee there is expertise required to go into it, junior docs earn slightly more I think that soldiers, but that is proportional to training. Military also in the same boat as us.

Well they do spend 30% more on healthcare than us. Try giving the NHS an additional £40 billion and see what happens.

And that's assuming you used the public healthcare in Canada and didn't go private.

The Canadian healthcare system is mostly public but most services are provided by private entities. For instance, the government doesn't pay for prescription medication, dental care or optometry, only the most essential basic healthcare is covered. A lot of services are paid out of pocket or employment based private insurance.

The government is responsible for ensuring that the quality of care is up to standard.. The per capita spending on health is $3,895 compared to the UK that's at $2,992. In addition to this, 30% of healthcare in Canada is funded privately. A large percentage of the healthcare system has been privatized which has reduced overall government spending. This demonstrates that even Canada needed to go private to a degree to have an effective healthcare system. Although, Switzerland, Australia and the Netherlands in my opinion have the best healthcare systems in the world, all private insurance based healthcare.

As highlighted, you're simply agreeing that the government isnt spending enough on health care, that's the problem.

Posted from TSR Mobile

Yes, the future budget cuts are going to lead to worse healthcare with a number of hospitals expected to shut down. We could have a Canadian like system where the government only provides the most essential healthcare, while services like dentistry, optometry and prescription medication is paid out of pocket or through employment based private insurance. Also, the government shouldn't fund unessential surgeries such as plastic/cosmetic surgery etc..

This is why we need to privatize the NHS because the public healthcare on its own is unsustainable. In my opinion a completely private insurance based healthcare system would be the best option for the UK, we could follow the example of Australia, New Zealand, Switzerland and the Netherlands. This type of healthcare system with government regulated standards ensure that most people would get top quality healthcare with the most advanced hospitals in the world.

This is as close as a private health care argument I'll agree with, the best policy by far would be to invest in programmes to reduce alcohol, sugar, fatty food consumption. So I would introduce taxes to ease patient pressures. I agree with Bevan who said health care could get cheaper as we advance, we just need to do more to tackle population issues.

Frankly I crave someone who at least concedes that a Cut in investment automatically brings a fall in quality. Were we to resort to a more privatised system I would lower the minimum standard and big up procedures privately, like with eyes or teeth.

My big concern is that no such regulation of private firms take place, its too easy for them to pull out of contracts and indeed there are problems with the bidding process. Why are private firms costing more providing a worse service and still winning contracts?

Posted from TSR Mobile

I think you missed the point, cheaper healthcare doesn't equal better healthcare. I doubt that a tax on alcohol, sugar or foods high in fat would reduce demand for such food since vegetables and fruit would be equally as expensive. This is an unrealistic approach at reducing obesity or cardiovascular diseases that are projected to effect most people in the future.

In order to have better healthcare we need to spend more but since the government can't cover all the costs then the NHS has to be partly privatised. I would disagree with your argument that privatisation lowers standards in fact in all cases a privatised healthcare service has the highest standards and quality of care. This can be regulated by the government as it is in other countries such as Australia, Canada, Switzerland, the Netherlands etc...

The NHS is considered by some measures to be the most efficient healthcare service because it is capable of working despite a relatively small budget. If we invest more in healthcare and the most advanced medical technology then no doubt we can have one of the best healthcare systems in the world. Privatisation is the only way the NHS could remain sustainable and most of that privatisation is non-profit therefore less of a risk of lower standards. I'm also certain the government could easily regulate standards for private care(your big private firm example doesn't apply since most privatisation would be non-profit).

I think you've missed my point. If you use public health measures to reduce instances of disease, then healhcare costs fall.

There are ways to improve on the Danish model IMO, subsidising healthier food along side taxing luxury goods is plausible, targetting luxury food items instead of staples could be more effective.

Why can't the government cover all costs?

I think measures to reduce disease can only go so far in this country unless we want complete socialism then demand for healthcare would stabilize and in fact increase over time. This isn't solving the problem it's an attempt to prevent the problem.

I wasn't referring to Denmark, I was referring to the largely privatised insurance based systems of Switzerland, the Netherlands and Australia. I don't think it is realistic to tax junk food due to the large demand it's as addictive as smoking or taking drugs. People would not stop eating junk food even if it's taxed since 'luxury' foods as you put it such as fruits and vegetables are a lot more expensive. I mean it sounds good in theory but it wouldn't really work in the real world. It's like assuming fat people would exercise if we reduce gym membership costs.

Finally, addressing your last question I believe the state is on a tight budget and can't afford to spend a higher percentage of GDP on the NHS. Privatisation is the only option left as far as I'm concerned due to projected budget cuts. Efforts to lower costs would only work to a certain extent but a funding gap would still exist that lowers the overall quality of care offered in the UK which is already not so great. With privatisation you could both lower costs to the government and provide top quality care so it's a win-win for everyone.

I'm sorry but virtually everything you are saying defies all logic and evidence.

Lets just pick up on two aspects as I don't have time to correct literally every sentence you've typed. First, you talk about how we can't increase the percentage of GDP... before advocating getting people to spend loads on a top-quality private sector. You seem to agree that the NHS is more efficient, so clearly this private sector is going to cost a lot more than the alternative (properly funding the NHS). But this money doesn't count as part of GDP because its not tax? Is that right?

Secondly, there is plenty of evidence that advertising and taxes alter behaviour. The rate of cigarette smoking has declined massively, for instance. Establishing that something is addictive means people are not making a free choice and necessitates more intervention, not less. Alternatively, if we say that its not addictive, then its a free choice and we just need to tax to internalise the externalities i.e. fund obesity-related healthcare. Either way, unhealthy food should be taxed.