The new junior doctors imposed contract. “Free will”, and “strike or leave”… The result of abandoning the health services over a long term..

NHSreality commented 20th July 2014: Lets sell the family silver: abandon the health services to covert rationing and market forces. As empires fell in the past (Roman, Aztec) they had little insight into why. It seems our politicians remain blinkered and in denial, and will do until the inevitable knee jerk response

Two letters in The Times 28th April 2016 emphasises this:

Sir, The disaster of the junior doctors’ strike, whichever side wins, is the long-term effect it may have on the medical workforce. Foundation year applications to Scotland and Wales are up and to England are down. It is strongly rumoured that many specialty training places in hard- pressed specialties are for the first time unfilled. Many health trusts have difficulties filling rotas for various reasons and services can function only with the help of locum doctors.

The locum pay cap (a co-incidental and badly timed intervention), as well as rota staffing problems, mean that services are under real threat; some have reconfigured already. Locum pay rates are in the main not excessive, but now, at £20 per hour for mid-level trainees, when tax, national insurance and travel costs are deducted, what is left barely covers childcare.

It is bizarre for a government that espouses the free market and inflated salaries to captains of industry to exercise Soviet-style wage restraint through a monopoly employer. However, these talented and motivated young professionals have one thing that Soviet doctors didn’t have: a free will. It is to their sadness and our detriment that many will exercise it.
Christoph Lees, MD, MRCOG
NHS consultant obstetrician, London W14

Sir, Gregory Shenkman (letter, Apr 27) misses the point about striking doctors. There are two ways to withhold your labour from the NHS: strike or leave. Those who are striking (in their thousands) for a sustainable NHS show a stronger sense of duty and vocation than those who are leaving (in their thousands).
Mary Cole


Free markets in health workers distorted – a perverse incentive created by politics

Knee Jerk responses and short-term actions are not in the long term interest of health.. In a “free market” politicians threaten to cap agency/locum fees.

Which party espouses the market philosophy, and then tries to subvert individual response?

Our NHS is in serious danger – we should be scandalised – GPs are being paid not to refer cancer patients to hospital and free hearing aids are being axed. All the politicians are cowards.. This is a healthcare system under strain, but where is the debate?

In an undercapacity market who can blame the nurses or doctors? £190m is “comeuppance” for politicians. NHS nurse recruitment from EU ‘too aggressive’!

Who abuses free health systems most? Will the US have to ration overtly?

Lets sell the family silver – abandon your Health Service to market forces and covert rationing

Perverse incentives and unintended outcomes and consequences – an ironic, confounding and idealistic volte face. Short term policies are dominating. Knee jerk responses and rationing will follow..

This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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