England's Doctors Walk Out of Emergency Wards in First Ever All-Out Strike

Populism

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https://news.vice.com/article/englands-doctors-walk-out-of-emergency-wards-in-first-ever-all-out-strike?utm_source=vicenewstwitter&utm_medium=vicenewstwitteruk

Curious whether any English PRSI'ers have any insight.

England's Doctors Walk Out of Emergency Wards in First Ever All-Out Strike

The first ever all-out strike by doctors in the history of the UK's National Health Service (NHS) began in England on Tuesday, as junior doctors continue to protest against new contracts they say are unsafe and are being forced upon them.

Thousands of junior doctors — a term used for medical practitioners who are working while still going through their years of training — walked out of both routine and emergency care. It is the latest in a series of strikes over working hours and pay but is the first that has affected intensive care and maternity and accident and emergency wards.

The NHS said "military level" contingency planning had been carried out to protect patient safety during the 48-hour strike, including the cancellation of nearly 13,000 operations and more than 100,000 appointments, the redeployment of nurses and more senior doctors into emergency care, and the cancellation of holiday and study leave.

There are more than 55,000 junior doctors in England, around a third of all medical staff. Doctors who belong to the trade union British Medical Association (BMA) have been in a long-running dispute with the government over planned changes to their contracts, which would mean an extension of their standard working hours to include evenings and Saturdays.

At the moment, any hours worked between 7pm and 7am, or at any time over the weekend, are classed as antisocial and are consequently paid more. The contract is being changed to make basic hours (and pay) last from 7am to 10pm, and 7am to 7pm on Saturdays, as part of a government manifesto pledge to create a "seven-day National Health Service."

The Health Secretary Jeremy Hunt has offered an 13.5 percent basic pay rise but the BMA says this is offset by an overall reduction in the pay for antisocial hours, particularly Saturday pay — disputed by the government which says three quarters of doctors will take home a pay rise. While the BMA agrees with the government drive to create a seven-day NHS it says there is a dire shortage of doctors and funding.

A letter sent by the BMA to Hunt over the weekend suggested the new contract be gradually phased in, so its implications could be analyzed at a select few hospitals before being implemented more widely. However, this offer was turned down by the government.

In an interview with BBC Radio 4, BMA chairman Mark Porter accused the government of distorting research and statistics to buttress its non-existing case on this. He said the government had given junior doctors no other choice.

"The health secretary is trying to find some way to throw mud at the junior doctors of this country who have been providing weekend and night emergency cover since the NHS started," he said.

Porter said they had advised their members to take part in contingency planning and the NHS had put in a "magnificent effort," meaning that senior doctors would deliver the necessary care. Porter also denied that the BMA had refused to talk. "We have said repeatedly and always that we will call off the strike if the government will call off the imposition. By contrast the government has said... that there is nothing that will get it to call off the imposition."

Karen Smith, who had her spinal procedure cancelled for this coming Thursday, told BBC Radio 4 she was "devastated" when she heard it had been put off. "I am desperately disappointed that it hasn't gone ahead but I do support the junior doctors 100 percent," she said.

"We put our lives in their hands... and our families lives as well and [they're a] highly educated group of people and if they all say that this contract that's been imposed on them isn't safe then I believe it isn't safe."

Clare Marx, president of the Royal College of Surgeons, said: "It just shows how sorry a state we are at at the moment, I didn't ever think we'd get to this stage. The current dispute has got to a lose-lose situation," something she said was particularly impacting patients.

Speaking to parliament on Monday afternoon, Health Secretary Jeremy Hunt said he had spent three years trying to solve this issue, holding 75 meetings. Hunt blamed the "difficult" junior doctors committee for the standoff. It was "totally inappropriate" to withdraw emergency care, he argued.

"We could have had a negotiated solution a long time ago," he said, but claimed the BMA had gone for an "outright win."

"Do you move forward or do you give up?" he continued. "When it comes to patients' safety we're moving forward."

"Where health secretaries have made mistakes in the past is where they have been too willing to compromise on patients' safety."

A poll carried out for the BBC by Ipsos MORI found that public support for the junior doctors is increasing, with around 57 percent backing them against the government.
 

steve knight

macrumors 68030
Jan 28, 2009
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and in the us doctors can work 80 hour weeks 36 hour shifts. this seems to try to point our how bad it is with government run health care but compared to the US it looks like nothing.
 

VulchR

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Not English, but I do live in Scotland and a member of my family is 2 years away from being a junior doctor. Basically it boils down to this: the Conservatives in the UK do not care about anything but cutting taxes, for their appeal is to short-sighted selfishness among the voters. The Tories also claim to make public services more 'efficient', but really they starve those services of funds, thereby creating a culture of voter complaints about them, then sell them off to their top 0.1% buddies so the greedy pigs can get even more filthy rich. In this case, the Tories want the NHS to run 24/7, which is all very fine until you realise they are adding no extra money or personnel to the system to do this, and that they have not been negotiating in good faith with the doctors about the change in working conditions that would be required. Indeed, the Tories stopped negotiating and took a 'take it or leave it' attitude. It seems pretty clear that the doctors are telling the government what it can do with its contract. You know the government is wrong when 98% of junior doctors vote to strike, and 76% of them participate in that strike.

Fortunately so far here in Scotland sanity has prevailed, and the new contract is not being shoved down the junior doctors' throats. Instead, the Scottish government is negotiating in a very pragmatic way. In fact, I would not be at all surprised if Scotland picked up a few former junior doctors from England, as will Ireland, Canada, Australia, and New Zealand if the Tories continue with this.
 

Populism

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and in the us doctors can work 80 hour weeks 36 hour shifts. this seems to try to point our how bad it is with government run health care but compared to the US it looks like nothing.
Leave it to Steve Knight to derail a thread - in Post No. 3, no less - and make it another epistle on Why Steve Knight Hates The US.

Quality response, SK. Outstanding quality.
 

A.Goldberg

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Wow. That's pretty ballsy for doctors (or residents as we'd call them here I believe) to walk out of the doors. Despite the "contingency plan" putting off 100,000 appointments and 13,000 operations undoubtably will have negative consequences for the healthcare of their patients.

Residents lives are hell. My GF is in her residency and works 12+ hours a day, generally 10-12 days on, 1 day off. And work is not exactly stress free. I just (within the past 48hrs) completed a post-grad pharmacy specialty residency which was pretty rigorous, especially in the beginning.

I can't comment on the working conditions in England, but in the US residents are overworked and underpaid. It's really a hospitals way of hiring cheap but skilled labor. I'm just a PharmD but my salary literally will more than double from my residency to after completing it. Doctors see an even bigger jump.
 

Peterkro

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Hunt is a complete prat.Junior doctors have huge public support plus the support of nearly all consultants,this is a no win for the tories.Worse case scenario junior doctors resign en masse.
The irony of course is that because consultants will be covering the two days (and it is only days not nights) treatment for A&E and for other patients in real trouble will be better than when the juniors are working.The putting off of non urgent operations and appointments is neither here nor there in the grand scheme of things,in spite of the tories claims that bodies will be piling up in the streets.

E2a: Meanwhile in NZ they are looking for a rural GP the salary is $400,000 (nearly £200,000),three months holiday,50% share in the practice and no night or weekend work.These rural practices are normally staffed by overseas doctors and this case is by no means the only vacancy like this:

http://www.theguardian.com/world/2016/feb/23/400000-year-job-new-zealand-three-months-holiday

E2a2: pic of Consultants supporting junior doctors.
 
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juanm

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Wow. That's pretty ballsy for doctors (or residents as we'd call them here I believe) to walk out of the doors. Despite the "contingency plan" putting off 100,000 appointments and 13,000 operations undoubtably will have negative consequences for the healthcare of their patients.
They are making demands for a better funded NHS. In the long run, it'll be better for their patients.

Other than that, nothing to add to what @VulchR said.
 

FieldingMellish

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They need a Ronald Reagan to say, "you're not showing up for work? Well, then stay out of work." And then go about a major hiring process.
 

VulchR

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They need a Ronald Reagan to say, "you're not showing up for work? Well, then stay out of work." And then go about a major hiring process.
There is literally nobody else qualified in the UK to hire. Indeed there is talk about mass resignation junior doctors, followed by their joining the profit-making services that provide temporary staff for the NHS. The costs of that to the UK society would be astronomical - rather like the healthcare costs in the US.

But, hey, if you are qualified, knock yourself out and join the NHS.

[doublepost=1461753567][/doublepost]
what happened to the Hippocratic oath?
There is nothing in the oath about working more for less pay, and specifically the 'do no harm' that people believe is part of the oath rather precludes the doctors working past the point of safety for their patients. Part of this is that the junior doctors feel so overworked that they fear they will make mistakes due to exhaustion and sleep deprivation.

That was the point of Steve Knight above, who alluded to the working conditions of US doctors as being even more extreme in regard to the work schedule. As a neuroscientist and psychologist I can tell you that it is impossible to sustain high levels accuracy and efficiency under the typical US schedule and the proposed UK schedule. It's called 'vigilance decrement', and it has been well documented in a variety of contexts since the 1940's.
 
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0007776

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what happened to the Hippocratic oath?
They are preventing future harm, and more senior doctors are working some of their shifts so the emergencies can be handled. But doctors or nurses who work too many hours are at a higher risk of making errors that will harm the patients. Stopping these kinds of stupid cost cutting schemes before they get out of hand and start hurting patient outcomes.
http://www.bcmj.org/article/impact-sleep-deprivation-resident-physicians-physician-and-patient-safety-it-time-wake-call
 

VulchR

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They are preventing future harm, and more senior doctors are working some of their shifts so the emergencies can be handled. But doctors or nurses who work too many hours are at a higher risk of making errors that will harm the patients...
I suppose the Tories could hand out amphetamines to doctors like the armed forces did for soldiers in WWII. :cool:
 

Limey77

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Apr 22, 2010
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While I wholeheartedly support the doctors, they do need to be careful. At the moment they have public support, however, the longer strikes go on and as soon a one death can be attributed to the strike then they will very quickly lose support.

Now if they could get the 76% of doctors who went on strike to all resign - then they'd be in a very powerful position.
 

0007776

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While I wholeheartedly support the doctors, they do need to be careful. At the moment they have public support, however, the longer strikes go on and as soon a one death can be attributed to the strike then they will very quickly lose support.

Now if they could get the 76% of doctors who went on strike to all resign - then they'd be in a very powerful position.
Agreed, the smart thing to do would be to have a short strike, and then if they don't get what they want periodically repeat with more short strikes. That way the procedures that are being disrupted by other doctors filling in on emergencies can still go ahead and they don't lose public support.
 

Limey77

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Apr 22, 2010
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Agreed, the smart thing to do would be to have a short strike, and then if they don't get what they want periodically repeat with more short strikes. That way the procedures that are being disrupted by other doctors filling in on emergencies can still go ahead and they don't lose public support.
My wife had a hospital appointment yesterday, and while she got a consultant instead of a junior doctor (great result), she said there were four or five pensioners who were very unstable on their feet whose appointments had been cancelled but they never received notification. So thes 80+ year olds had left home, taken a taxi or bus to get to Charing Cross and simply had to go back home and then have to come back at a later date.
 

Renzatic

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To boil it down to its bare basics, and throw around some blanket terms, conservatives want to support austerity funding standards, which leads to skeleton crews working around the clocks with very little compensation. Liberals are all about dumping as much money as they can on all social programs, which leads to an overspending on pointless thing.

While you could say that one is better than the other depending on your political leanings, the truth is, neither of these scenarios are preferable. It isn't an issue of more or less, it's an issue of good management.
 
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sim667

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To boil it down to its bare basics, and throw around some blanket terms, conservatives want to support austerity funding standards, which leads to skeleton crews working around the clocks with very little compensation. Liberals are all about dumping as much money as they can on all social programs, which leads to an overspending on pointless thing.

While you could say that one is better than the other depending on your political leanings, the truth is, neither of these scenarios are preferable. It isn't an issue of more or less, it's an issue of good management.
Not quite, conservatives want to make the NHS look bad in order to continue a sell off to private companies. Same goes for education, and I believe even other public services would have gone that way (Policing being another I'd be particularly worried about).

Enforcing new contracts and austerity undeniably drives down standards, giving excuses for the Tories to justify sell of to private companies.

If we're honest about it now though, the NHS by all definitions is essentially in the hands of private companies already.
 

AFEPPL

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Sep 30, 2014
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It's the unions causing problems yet again..
We saw it with the miners - result no more mines as it simply wasn't economically viable
We see it with steel - they have now priced themselves out of a job as no one will buy the steel

And now the doctors don't want to give up their massive overtime kicks for working additional shifts even though they are getting a large basic increase of 19%. Its also argued more people are dying over the weekend when cover is not as good, so the shift pattern changes is meant to address that. All that will happen is the privatisation of the NHS, which in itself is probably a good thing as this monster will consume any amount of cash any government throws at it. Funding right now is more than its every been in history. Root of this problem is the previous government and its PFI crap that has now stripped NHS of huge amounts of money for the next 25years..
 

Peterkro

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It's the unions causing problems yet again..
We saw it with the miners - result no more mines as it simply wasn't economically viable
We see it with steel - they have now priced themselves out of a job as no one will buy the steel

And now the doctors don't want to give up their massive overtime kicks for working additional shifts even though they are getting a large basic increase of 19%. Its also argued more people are dying over the weekend when cover is not as good, so the shift pattern changes is meant to address that. All that will happen is the privatisation of the NHS, which in itself is probably a good thing as this monster will consume any amount of cash any government throws at it. Funding right now is more than its every been in history. Root of this problem is the previous government and its PFI crap that has now stripped NHS of huge amounts of money for the next 25years..
The more people dying at weekends bollocks is wrong first off their definition of the weekend is Friday to Monday inclusive,second the day with the most deaths is actually Wednesday.
 
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sim667

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It's the unions causing problems yet again..
We saw it with the miners - result no more mines as it simply wasn't economically viable
We see it with steel - they have now priced themselves out of a job as no one will buy the steel

And now the doctors don't want to give up their massive overtime kicks for working additional shifts even though they are getting a large basic increase of 19%. Its also argued more people are dying over the weekend when cover is not as good, so the shift pattern changes is meant to address that. All that will happen is the privatisation of the NHS, which in itself is probably a good thing as this monster will consume any amount of cash any government throws at it. Funding right now is more than its every been in history. Root of this problem is the previous government and its PFI crap that has now stripped NHS of huge amounts of money for the next 25years..
More hours for less pay is nothing to do with the previous government, nor is it a fair contract.

Lets no forget these changes are being implemented by a man who wrote a book about dissolving the NHS. He has one final goal, which is to privatise it entirely.
 
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