Thursday, 31 May 2012

Dear Joe Public - the doctor strike facts

There will be a lot of disingenuous and dishonest information spread by the government and various biased sections of the media in the forthcoming weeks ahead, and it is vital that you, the public, are informed of the facts so that they can make up their own minds as to whether a strike is justified.  Just remember that this is the same media that is being shown to be rather free of honesty and morals in the Leveson inquiry.

First and foremost a strike is completely safe and ethical, any strike will not involve emergency services, it will only affect anything that is non-emergency, in fact ironically emergency patients may well get better care than normal during a strike as all elective work will be cancelled.

Secondly there are several key facts that you will not hear in certain sections of the media, certain journalists and newspapers have massive vested interests, they cannot be trusted with their propaganda.  The facts that no one from the government can deny are as follows:

1. Our pension fund is in surplus of about 2 BILLION pounds per year.  It is sustainable and it is simply being raided by government to subsidise losses and deficits elsewhere.

2. Doctors have had numerous pay cuts and freezes over the last 20 years or so, compared to their peers from equivalent backgrounds and levels of education, doctors earn significantly less money over their careers.

3. Doctors agreed a new pension deal in 2008 which the government wants to tear up, this already increased contributions hugely, the new proposals which have already been enacted involve doubling the current contributions.

4.  Strangely the pension contributions of politicians and civil servants are not being plundered in the same manner, I wonder why this could be?  Surely the whole public sector should be treated in the same manner and doctors, who already pay a good chunk of their salaries, should not be selectively robbed.

I am biased, I will not deny this but a line in the sand needs to be drawn now and a strike is utterly essential for numerous very solid reasons.  The government is privatising the NHS as we speak and they have no democratic mandate for this.  They now want to steal money from the pension funds of doctors to pay for their errors, of note from pension funds that are accruing about 2 billion pounds of surplus cash per year.

We, doctors, need the public's support and we need you to ignore the dishonest bile that will be thrown in your direction from the likes of the Daily Mail and the BBC.  The vast majority of doctors feel this way.  I love being a doctor, however I am relatively poorly paid in comparison to most of my peer group who did not go into medicine, and all I ask is that our reasonable pensions are not plundered by the incompetent and dishonest fools in government who will tell you numerous porkies in order to make you think that I am greedy or selfish.  This is not the case, I just don't want the government to steal from my pension fund to pay for their negligence and incompetence.  Thanks for listening.


Anonymous said...

Speaking as a layman, the trouble is that it's easy for us to see only a narrow picture. Government published figures show the GPs in my PCT area getting between £125,000 (about half of them) and £475,000 (one of them), but when I go on doctors' blogs, they speak of getting much less in general practice, so where are the figures for them? You need better PR as a profession.

Old Codger said...

Your claim that your pension fund has an enormous surplus I find surprising. If it is a proper actuarial figure it would suggest that someone has been putting very large amounts into the fund. Most private sector funds are in significant actuarial deficit.

Doctors are not being specially selected. Much, if not all, the NHS is having their pensions adjusted adversely. I thought it was being applied throughout the civil service, certainly the police and fire services are objecting to similar proposals for their pensions. I do agree though that there is little indication of MPs suffering.

I don't think there will be much public support. You are seen as being relatively highly paid and, if anything like around here, few of you work a full week, some as little as two days per week. The previous government gave you a significant rise whilst at the same time removing the requirement to provide 24 hour care.

What you, and the rest of the public sector, have to realise is that private sector pensions have already been slashed. Some companies have gone into administration because they could not continue to pay pensions let alone also support a continuing pension for current employees. Few companies now operate a defined benefit scheme so their employees are entirely dependent on the performance of the stock market and annuity rates. Those defined benefit schemes that still exist pay considerably less than they used to. The one I know of has an accrual rate of 100ths, so a 40% final salary pension after 40 years in the scheme instead of the 2/3rds pension it used to be.

I am not too worked up about privatising the health service in principle, although I do see many problems. The biggest concern is the incompetence of the shower that is currently pretending to govern us. It is inevitable that they will mess it up.

Sam said...

This bit is interesting:

"The NHS pension scheme is not compulsory. If it's really a bad deal, then we might better consider leaving. Such a move would create a need for talks on contract terms – or a chance to create a new institution to look after doctors' interests."

I think the juniors need a new contract. Specially now that they have fallen way behind in comparison to other graduates age for age, let alone the exceptional hard work doctors put in to gain their multiple qualifications.

With a fair contract, doctors can also negotiate opting in or out of a government's pensions.

But a new contract is a must and long overdue too.

"I don't think there will be much public support."

Sometimes in life one needs to take a stand because of 'principle' whether others support him or not. That said, I do not support a strike because I'm hoping that in these difficult times, we need to draw nearer to our leaders and trust each other more if we are to work 'together' to get this country up again. In which case, Andrew Lansley is not just Health Secretary, but is Boss, and boss should always strive for best deal for his staff, like the civil servants do, and they got a much better deal too.

Time we ditch that horrible 'them and us' culture and replace with 'stronger together' culture! Very cost effective too!

Anonymous said...

anonymous 1- I agree, our PR machinery needs to be better, GP pay is nowhere near that reported in the media on the whole

old codger - so many strange points that I will comment on the main ones

- the pension fund is in surplus, like it or not, that's the way it is!

- it is being selectively applied to doctors, we agreed a new deal in 2008 and the new 14.5% contributions are way higher than virtually all others in public sector

- you are well wide of the mark on 'significant rise' and no 24 hour care, this is for GPs, there are many tens of thousands of junior doctors and hospital staff who have had incessant pay freezes/cuts and who have still to work long hours with long on calls

-GPs are not the only fish in the sea and it is extremely misguided to talk solely about GPs in all this

-the private sector? this is a nonsense argument and an unfair one

if I had gone into the private sector when I graduated I could have earnt massively more over my career and I would be aware that the pension would be poor

part of the public sector deal is relatively lower pay and a better pension

the logic of your private sector pension argument stinks, as if doctors simply said I want to be paid an equivalent private sector salary then would that be fair, of course not, it is equally ludicrous

it is unfair to shift the goal posts like this and it is unfair to selectively nail doctors


Joe everybody said...
This comment has been removed by a blog administrator.
Anonymous said...
This comment has been removed by a blog administrator.
drphilyerboots said...

Dear Gareth,

The doctors are at present in surplus to the treasury of £2 billion, making a net contribution to the exchequer at present, but this is projected to substantially reverse over the next few years. There will be a wave of retirements soon brought about by a combination of medical demographics (see bad medicine passim), desire to get out under the old pension terms and dislike of the Lansley reforms and revalidation. The scheme will not be in surplus long.

I will not be striking, and did note vote to do so as I have left the BMA. My union the HCSA has not published its ballot yet. I voted for industrial action short of striking. I think a "work to rule, work to contract" or a ban on meetings for non clinical purposes would be more effective.

Ultimately we have to accept the fact that UK doctors are better paid than in all other OECD countries apart from the USA, and their figures are very skewed by a few mega-earners.

The Hutton Deal is not a bad one, my main concern is that will be reneged on in a few more years next time a government runs out of money. Sound government finances are the key to secure pensions in the future, public or private sector.

Dr Phil

Sam said...

Well the figures for all the Russell group graduates are out there to compare starting salaries, and salaries, plus bonuses, three years on, or by the time a medic graduates after 6 years in college. Even try to compare to other health professionals pay, not forgetting the high academic requirements of medicine and the double length of study too. Of course, everybody whether private or private sector get their their professional development exams and the like paid for by their bosses, but doctors.

As for other countries, some doctors as well as most other professionals are paid near to naught while the corrupt few keep all the wealth for themselves and that's why revolutions happen around many parts of the world! :-)

So let's compare our young doctors to other professionals graduating from the Russell group here in 'Britain' because that's where our doctors live and need to make ends meet according to the 'here' economics! Not forgetting that young doctors have now had a pay freeze for the past three years too. That's despite their terribly unfair wages and the fact that they can not start a lucrative practice on the side as some seniors do because they are in training for a minimum of 9 years following graduation for hospital consultants or 5 set now to rise to 6 years for GP. Of course the majority of hospital seniors do not have a side Harley Street niches either, but good luck to those who do, nothing wrong with striving and reaping the reward of hard work. The juniors do not have the luxury though.

Lord Darzi when he was minister commissioned a pay review for the juniors, but the results of that was shelved and were never made public;

Garth Marenghi said...

well said

I will delete comments that spout factual inaccuracies and accuse doctors of being no more intelligent than nurses, as they are so foolish they will not be tolerated

drphilyerboots said...

Dear Sam and Garth,

The figure for comparing doctors salaries across countries can be found here( admittedly a little old as the consultants are calculated on the basis of the old contract, compared with the more lucrative new contract)

These figures are corrected for purchase price parity to adjust for each countries cost of living. UK doctors are second in income by this measure, and in many of these countries have to fund their own pensions. We all want more money, but it is undeniable that British doctors are well paid, and that includes junior doctors. The starting payscales ignore banding payments which are substantial, indeed many doctors take a pay cut when they become consultants as these posts do not include banding payments.

There are real issues about the shifting sands of government policy on pensions for all citizens. Much government policy penalises thrifty savers as these are the people who have money when assessed for means tested benefits. Many take the rational approach of not saving as a response. We need cross party long term pensions policies for all sectors if people are to plan for their old age.

Sorry to call you Gareth, Garth, this was unintentional memory failure.

Dr Phil

Old Codger said...


Seems you have a post size limit so I am having to post in stages

You might consider them strange points but:

I wondered why I could find nothing on the doctors pension fund. I found out, there is no such thing it is the NHS pension scheme and the proposals apply to the scheme, not just to doctors.

There is no fund, the scheme is "pay as you go". This makes it difficult to compare to real funds except by looking at the level of contributions of both the employer and the employee.

Since there is no fund there cannot be a surplus. The scheme did make a £2.11bn in 2008-9 but the employer's (NHS - taxpayer) contribution to the scheme was £5.01bn so the taxpayer's net contribution was £2.9bn, about in line with other large public sector organisations. Not so much a surplus as a refund of part of the taxpayer's contribution. In contrast in 99-2000 the treasury had to stump up an additional £1.11bn.

Since these changes are to the NHS pension scheme it must be obvious that it is not being "selectively applied to doctors". Additionally, I believe similar changes are being proposed right across the public sector and, in the areas of which I am aware, many of the arguments are not dissimilar to yours. Again, this demonstrates that it is not "being selectively applied to doctors, or even to just the NHS".

There were changes to the NHS pension scheme in 2008 but they were to take account of the 2006 age discrimination legislation, and the change of the normal pension age for new members of public sector schemes. It seems this is only part way to making the scheme self supporting into the future.

Old Codger said...


part 2

I can't comment on the level of contributions across the public sector and you may well be correct at the moment.

I admit I was thing primarily of GPs and do apologise. It may well be that junior doctors have suffered as you describe but they cannot be too far out of line with more senior doctors and GPs.

I do not believe comparison with the private sector is a "nonsense argument" and it certainly is not unfair. If there was no private sector there would be no public sector.

If you had gone into the private sector when you graduated you might have earnt massively more over your career, or you might not. It would depend on where you went and how successful you were. Very few receive the income of an investment banker. That poor pension that you would have been aware of would by now be significantly poorer.

Public sector pay has not been significantly lower for at least 30 years to my personal knowledge and I doubt doctors ever had significantly lower pay. I believe doctors had to be "bribed" to join the NHS in 1948. Whilst this will undoubtedly have been whittled away over the years I doubt if it took doctors significantly below equivalent professionals in other large organisations. Doctors in private practice do have higher earnings, and some do extremely well, but they also have to fund their business and their pensions.

30 years ago I was employed within the defence industry and worked regularly with civil servants. Those at roughly the equivalent level as myself were noticeably better paid and had better pensions. Their jobs were also much more secure.

In, I think, 2010, the average public sector salary was over £2000 higher than the average private sector salary (£23660/£21528).

Pay freezes and pay cuts were happening in large parts of the private sector long before they were being reported within the NHS. In a not insignificant number of instances it was either that of the firm going broke. Pay cut or no jobs.

I don't think comparing private and public sector pension stinks. If the public sector pension scheme has to be topped up by the taxpayer the private sector pensioner, on a much lower pension, has to contribute. Where is the fairness in that?

I do agree, it would be ludicrous for doctors to say they would want to be paid an equivalent private sector salary. It would be lower so they would not even consider it.

I think I have shown that neither doctors not the NHS are being "selectively nailed".

It may be unfair to "shift the goal posts" but unfortunately it is a fact of life. It has happened throughout the private sector with many losing all links with salary and going onto defined contribution schemes and these are the people who will have to contribute to your pension if it is not sustainable. Incidentally, I suspect that the NHS pension scheme has changed a number of times over the years, as most schemes have, usually for the better, until the last 15 to 20 years. I never heard complaints about shifting goal posts then.

Old Codger said...


everybody does not get their professional development exams and the like paid for by their bosses. This is long ago but I doubt it has changed for the better. As an apprentice, the company did pay for my continuing education and exams, as long as I was successful. If I had failed I would have had to pay my own way until a pass was achieved. Once my apprenticeship was complete, further education and exams, to achieve Chartered Engineer, had to be paid for by myself. There was not even a pay rise for the qualification. This was, general in industry and I suspect it is worse today.

Anonymous said...

Superficially english doctors appear well paid but we have less than half the number of doctors that other countries have per thousand of population.

In other words we are paid well because we do much more. Personally I would rather have a better work life balance. I am no longer full time because it is enough work for two doctors. I am half time and only earn half that of my partners but I still put in about 30 hours a week. I do not feel part time and at the end of the day I am emotionally drained due to the rigours of the job.

Sam said...

Dr Phil "We all want more money"

No 'we' don't Dr Philyerboots, by that I mean you and myself, you being happy with what you have achieved, as you always say, and myself being only a parent of young doctors who is happy for you, and wants to see her children and all their generation of young doctors have the opportunity you had, then it is up to them what to do with it themselves, and that's why I am here since MTAS. Parenting is unpaid work as you know.

Re your comments, to be honest, I do not understand what is the purpose of your last comment and the one before it. In one you say that the 2 billion excess is going to dry out in a few years time because many of your generation intend to retire early to protect their pensions. So, are you suggesting that the young doctors or those seniors a bit younger than yourself should therefore 'accept' to suffer and pay as a result?! Is that what you mean?

And then you're posting a link to 'historical data' compiled from 1999 for a few years then published in 2004, that is usually used for statistical comparisons between past and present and is mainly a government tool for comparisons with other countries, not Britain with Britain over, say, a decade or something - and it does not even include the juniors in all the 'estimates', so what good is that for our situation here, where is the relevence?! Nonetheless, you still state that doctors, 'including the juniors' are well paid! Where did that assumption come from?! You already know of plan 2000 and posted on MTAS yourself, does that still not say why did a large majority decide for such drastic action as a strike then?! All greedy?! I don't think you mean that, but it does sound so, or please explain if I missed your point, and does that justify that civil servants have a better deal for example?

Then you also say;

" I voted for industrial action short of striking. I think a "work to rule, work to contract",

... and again I can't understand why you voted this way at all, ie for and not against?! If you are happy, and if as you say, other docs 'including the juniors' should be happy too?!

As for 'banding', and just for the sake of readers who don't know what this is, it is overtime paid when doctors are required to do on call duties. It is not of their choosing, hence, sometimes you get that and sometimes you don't according to your rotation. This of course means a sudden drop in income if you don't get a rotation with banding, so if you have financial commitments like a mortgage, family and the like, a young doctor will have a sudden drop in income and will suffer as a result. It doesn't happen to the seniors, or those with more generous arrangements or outside incomes though, but those are a small minority.

I'm going to leave the part about our shared attempts to befriend the government for now Dr Philyerboots, after all neither MTAS nor the resulting mess we suffer from to date is their doing - but that is just to acknowledge that at least we both share something.

BTW, a friend of one of the boys phoned today, her I-phone disappeared from her bag which was in the staff room, she says the lockers are for the nurses and my son says his hospital is the same, no lockers for the docs, so he leaves his stuff at the back of his cars ... last year a friend of my eldest had the back of his car and his laptop disappeared. Is this no lockers for docs universal?

Sam said...

Old Codger "As an apprentice, the company did pay for my continuing education and exams, as long as I was successful. If I had failed I would have had to pay my own way until a pass was achieved."

It still happens Old Codger, in good companies who spend to retain good staff :-)

As for docs would have been worse off in the private sector, I beg to differ, they are, like yourself, an intelligent and hard working lot, so the chances are more positive.

And I don't know much about the seniors but the juniors have had it rough since 2007, or since MTAS, or the Big Bang event of British Medicine. Things do not want to clear since then despite lots of efforts ... and I am against doctors striking by the way, I do not like confrontations, and firmly believe dialogue is way better, always.

JoeEverybody said...

Any particular reason why you deleted my post rather than argue/debate with it?

Old Codger said...

Hi Sam,

Thanks for your comments. I don't think we are that far apart.

All the best.

Sam said...

And the very best for you too, thank you

Garth Marenghi said...

I am sorry

but judges/teachers/MPs/policeman/civil servants are not being asked to pay anything like doctors

this is simple and a fact

Old Codger said...

As I understand it, the maximum proposed pension contribution to the NHS scheme is 10.9% for those earning over £110,273 per annum. Lower increases apply below this.

Police officers on salaries of over £60,000 already pay 12.5% and their proposals take this up to 15%.

It does seem that, in regard to the police, your statement that they "are not being asked to pay anything like doctors" is incorrect. It seems to me that they are being asked to pay even more than doctors, on a lower salary.

Anonymous said...

Two wrongs don't make a right