Pledge of allegiance

I didn’t think I would be re-blogging on this topic so soon, wonders never cease! The discussed changes in the junior doctors contract is a cause for concern. I read only this morning that Dr Kitty Mohan, Co-chairman of the BMA’s junior Doctors Committee (the doctors union) is considering industrial action. How can you not when 35,000 doctors have signed a petition for this in a matter of days?

The request which has caused umbrage is the change in normal working hours, from Monday to Friday to Monday to Saturday ignoring the extra salary incurred for the Saturday. This change is expected to slash earnings by 40%, and not surprisingly the GMC has received 1,644 requests allowing doctors to work overseas.

The emphasis on equity of pay in the political sector over modern day working practices is the exact opposite. Notable examples are a minimum wage, end to zero-hour contracts, and let’s not comment on the incessant London tube strikes over overnight tube provision!

About the author

Neuro Doc Gnanapavan


  • I'm coming to the conclusion that doctors are the biggest bunch of moaners and resistant to any changes. It's a relatively well paid job – especially at the consultant level with a bit of private practice. Junior doctors know it's a slog for the first ten years – then they reap the rewards later on. There are options for doctors who are not happy – work overseas of get a job in the city. Time to stop moaning. Perhaps doctors would prefer a zero hours contract working for Lidl or Matalan – then you'd have something to moan about. I don't know one doctor living in a council house or driving a banger.

  • My daughter has just started as a junior doctor. She trained for 6 years. She regularly works 10-12 hour days, with little time for a break. She has been told the days the hospital can let her have off for her holiday entitlement in the next few months- a few in October and a few in November. I asked her does job satisfaction make up for it? She says there is little time to make relationships with patients it is so busy- patients waiting to be discharged sitting in the lounge so new patients can be put in their beds- and patients and their relatives complaining to her about cancelled ops or tests. She regularly works 12 days in a row with no extra time off, although I presume she gets paid for weekends. She has told us that next year, although she will be more experienced, she will earn less than this year. She really has a poor work/life balance and there seems to be no end in sight, its just getting worse. She may seek to work abroad. We've told her to give it a couple of years, and if she still is unhappy, then leave the profession and train for something else. The government can't tax bankers as the best of them will leave the country, but they seem to have no worries about junior doctors leaving the county or the profession

    • It is a form of modern slavery – the average working week in the EU is less than 40 hours/week and I do not see why contracts for junior doctors should be any different. I thought I saw 90 hours week mentioned somewhere? Doctors are just people, at some point they will be so tired that patients will be in danger.
      The junior years in medicine are exhausting both physically and emotionally. I hope junior doctors win, nobody wants zombies making important decisions and prescribing medicines.

  • I think that doctors have it pretty sweet here in the UK. We, the tax-payer, fund your training and accommodate your learning in our NHS hospitals, and then for you guys to turn around and say your off overseas is no different from bankers threatening to relocate to other countries if imposed with new working conditions.

    Doctors get great final salary pensions paid for by us. In Canada, also a socialist health service, doctors have to fund their on pensions privately. Britain sorts you out generously. Be thankful, bro.

    I have a plane to catch. Kiss you on both cheeks. Ciao.

    • Fiddlesticks Dre…you're mistaken if you believe that the tax payer pays for the training, the doctors families do. The current debt is £50,000 even after this for each individual. After qualification you pay out of your own pocket for professional development. Does the post office ask their clerks to pay for their training courses? Secondly, we pay for an NHS pension which we'll never see the light of (difficult to opt out from this) and a second private pension. Thirdly, I don't think comparing the banking culture to a service sector that has never received bonuses, but has had its salary frozen since 2011 ( is a fair comparison. This has become a profession for a rare fortunate. Adios!

    • Dear Dr Gnanapavan, I agree with Dre to an extent.

      Teachers, civil servants and all public sector works are inflicted with austerity pay cuts. Doctors, however, earn a lot comparatively speaking.

      I think you guys will find little sympathy from the public on this matter.

    • I am completely shocked by the attitude of the people in this blog. They think doctors have it cushy- and no doubt over the next few weeks we will be having a lot of spin in the press how cushy doctors have it by way of the govt. wanting to push through their reforms. A basic junior doctor's salary after 5-6 years training is about £23000 a year. I am sure that although the salary of a factory worker, toilet cleaner, tube worker or teacher is less than that they do not have the responsibility for someone's life. They can walk out on the job at any time- they don't get the emotional blackmail of we have no one else to to do it and we need you now.
      It is not just a pay cut. It is expecting you to work all hours god sends and a pay cut. I don't say teachers have enormous holidays but they get a lot more free time than doctors, as do civil servants. The public sector aren't getting pay cuts, just no pay increases. Have you tried phoning a local authority after 4.30 on a Friday? It's like the Marie Celeste

    • Doc Gnanapavan, you're out of touch with the British people. The comparison of your profession to that of a blue collar post office clerk is unfair as the latter is semi-skilled work.

      Also, the NHS doctors' pension is gold-plated. You choose a second private pension whereas most of us can't even sufficiently fund our private stakeholder pensions which are seriously poor. You qualify for 'essential worker' perks, whereas we're totally out priced of everything.

      Dre, thanks for being brave enough to point this all out. Safe flight, mate.

    • Oh come on, anon 4:04pm! You know that that £23,000 you allude to will rocket to way more as you progress the career ladder. Don't pull the wool, mate.


      This page outlines the pay for doctors from 1 April 2015.
      Doctors in training

      All doctors in training earn a basic salary and may be paid an additional supplement depending on their working pattern.

      In the most junior hospital trainee post (Foundation Year 1) the basic starting salary is £22,636. This increases in Foundation Year 2 to £28,076. For a doctor in specialist training the basic salary is between £30,002 and £47,175.

    • Yes, that's exactly the salary scale. I started on £22,000 – it's good to see that 13 years on this has not moved! Looking back, when I was in the 4th year of medical school I was contacted by Merrill Lynch as they'd obtained a list of students with high grades to whom they'd like to offer alternative job options. The offer was a starting salary of 45K, they later added a car and a flat to this offer. As you'd guessed I didn't take up the offer. I chose to become a doctor for all the unquantifiable reasons which keep me coming back into work day in, day out. I'm equally aware, my tree hugging personality wouldn't have suited the shout timber personality of the square mile.

    • Anon at 7.07pm they would be able to have some annual leave, so they wouldn't work for 90 hrs a week for 52 weeks of the year.

  • Poor old junior doctors. As a former Met Police Detective Constable I regularly worked nightshifts and 90 hour weeks. I wasn't allowed to strike. But I loved the job – that's why I joined. I've no doubt that junior doctors put in long shifts etc. but that's the job. People do get ill at night and at weekends! If you don't like the terms and conditions attached to a job – get out rather than moan. A friend's wife was a doctor in Kosovo and got 600 Euros a month. The new development of detached houses in my town has got a fair share of hospital doctors / consultants. Doctors / consultants do pretty well financially. A young soldier in the British Amy is happy to put his / her life on the line for £25k. Doctors should have a 3 month stint as a factory worker, street cleaner, or deep sea fisherman. Might give them some perspective on the real world.

    • Pension after 30 years service is good. Free travel in London. But I also had to face football thugs, a knife wielding assailant, and deal with the aftermath of 7/7. You probably earned more than me sitting in a warm lab cutting up mice. But at least I had job satisfaction and the public was grateful for keeping them safe.

    • I'm presuming you've been in a casualty on a Friday or Saturday night? Remember who dealt with the casualties of 7/7.

    • I have MD2, by the time the Met police arrived the thugs had legged it, leaving the cleaners to clean up the trail of blood they left on the floor.

  • I don't have much sympathy for junior doctors. Interesting stats from the BMJ:

    "Although 39% of trainees went to a non-selective state school and 24% went to a selective state school, 34% were privately educated, even though private schools educate just 7% of pupils across the UK. The remainder preferred not to say where they had been educated.

    Around a 10th (11.5%) of the respondents said that they grew up in households that received income support to bolster pay, and 8% received free school meals. Almost two thirds (64%) of the trainees grew up in the UK’s most affluent areas and just 6% in the most deprived."

    I'm sure rich mummy and daddy could help out their little rich kids as they struggle to become consultants.

    • Brilliant post!

      Doctor don't know how lucky they have it. My GP drives a Jaguar to his surgery with a private number plate saying 'Dilip1'. This is in a very deprived area, too.

    • I grew up in Middlesbrough. I most certainly don't have a silver spoon in my mouth and my school was state. I worked hard, really hard to get into med school whilst my friends were giving the local constabulary a run for their money. I was at uni for a 6 years working in a bar during term and as a carer during holidays. I still left with £50,000 of debt. That's was 10 years ago. I still haven't paid off my loan and i most certainly don't drive a jaguar and no I don't earn £100,000 like the daily mail world lead you to believe. I'm a gp now and work 12-14 hours a day and generally don't get a chance to pee (not great with an ms bladder) let alone give my patients the time they need/deserve. Yes I could leave, many are but who on earth is going to treat us then? I hear lots about feeling neglected or unsupported from people with Ms but what do you think the future will hold if there aren't even any doctors left! So yes you keep telling them to work in Aldi or go off to the city but the only people that are going to suffer are us.

  • Great. Looks like the lot of you actually want to drive our doctors abroad. What exactly is that going to achieve?

    • Dre and other commenters are right. Doctors need to get a handle on public opinion. They are trained by the NHS and have a duty of care. I say we should legislate that junior doctors give at least 10 years service in Blighty before they can move abroad, or else they should be fined.

    • We'd get more people training as doctors who are interested in medicine as a calling, not bleating on about how awful everything is… low pay, long hours…. Perhaps they'd swap places with an MSer reliant on state handouts after loosing their job. Wrong blog for political stuff – stick to MS research news.

    • It would end bow-tie production in the UK (my pompous GP wears one) and golf clubs would see a big drop in income. My local Mercedes and Jaguar garages would see a fall in sales. Quite a few benefits I'd say. MD2 – don't be too supportive of doctors – remember Dr Crippen and Harold Shipman?

    • MouseDoctor2 , people here seem to think that hospital jobs are like stacking shelves – you just walk into the business and can start making yourself useful :-). Yeah, right. It takes 20 years of very hard work to even put a foot in that bleeding junior doctor job.

    • To anon 4.13- that would be good. And also anyone who has borrowed money from the government to pay for their degree should not be allowed to travel or work abroad until they have paid it back, or if they can't get jobs should have to do voluntary work in the NHS for the good of the public who have supported them-eg porters or cleaners

    • Perhaps you'd like to keep them in chains whilst they pay off their "debt"? The mere fact that students these days are forced to borrow money from the government for their education (which is a right not a privilege) is an outrage. The Germans had it right when they abandoned this sorry experiment (hardly a hotbed of socialism).

    • Sorry MD2- I was being ironic about student debt. It was just the idea of forcing doctors to work for 10 years post grad in the NHS that made me mad

    • What about three years they need to work for the NHS to contribute to paying off the fees. It wouldn't be forcing them, if they want to leave they can but would need to pay back pro-rata of their training fees if its before the three years.

    • After graduating training is not finished are people work in the NHS during this period.

      However, we have been training people who can not find jobs as places are being filled for example by EU doctors. Therefore many UK trained doctors are moving to Australia or the US

    • "Sorry MD2- I was being ironic about student debt. It was just the idea of forcing doctors to work for 10 years post grad in the NHS that made me mad"

      Sorry Anon, my irony meter is on the blink.

  • Aneurin Bevan famously said that in order to create the NHS he had been forced to "stuff doctors' mouths with gold". 60 years later – not much has changed. Many people have jobs with long unsociable hours and low pay. Why do doctors think they are a special case. If you don't want long unsociable hours and relatively low pay, don't train as a doctor. There's plenty of other talented people who will take your place.

    • Errr at this rate there isn't going to be anyone to fill their place. 50% of gp training post are not filled and competition for hospital training jobs is near non existent. Give it another 10 years and we'll be going to France for treatment. Oh no sorry that's already happening.

    • So the highest band nurses are on 80,000 a year I've heard some on 100,000… I'd rethink your comment about double the pay of a nurse.

    • It costs a lot to train a nurse, but it sad to say that many of then have left the profession within about 2 years and part of that is pay.

      There are some that do OK and they are at the top of their profession and get rewarded for that and the responsibility that they have. Chancellors of Universities get much more and then we can look at any business men and these at the top of the pile get big rewards too. You can argue the rights and wrongs of the amounts of salary scales between the top and bottom.

      However at the lower end of the spectrum the pay is probably not as good as it should be otherwise, it would be seen as a good progression and would be full of native English speakers and the NHS they would not be hiring nurses from say the Philippines, which they do. In the provinces outside London the situtation may be different but in North London this is a reality

      The same is for science 30 years ago I would see about 80% British Males applying for a job, now it is is 80% female and probably about 80% non-UK. However this is another debate for Mr. Angry to have a xenophobic rant about, but as a profession is sadly not seen as a job career choice as it has such a terrible career structure and path.

    • Anon 8:06 I've just had a look on a huge hospital trust's recruitment website. Not many jobs there offering those salaries, in fact couldn't see any.

  • Don't worry everyone, I'm working as hard as I can to abolish the NHS as soon as possible to address your concerns about doctors or anyone else earning a decent living.

  • Discussions on topics detailing major shifts in healthcare are of relevance to this blog. The comments may not be palatable to all, but if you have something to express then do so. Having read the comments, overall there is a negative atmosphere, but this will have no standing on how the chess pieces move in the next couple of weeks to draw it to a conclusion. There is a manifesto which needs to be filled, the tide of privatisation is creeping ever closer, and there will have to be concessions on both fronts.

    • Doctors were all private before the NHS was formed and many do private work on the side now. Perhaps if doctors agree to earn a maximum of twice that of a senior nurse, the public would have some sympathy. Too many join the profession in the same way as law or accountancy – they want status and cash. The public will always have sympathy with hardworking nurses who are poorly paid. I once worked with a surgeon who was in the territorial army. He was called up for a tour of duty in Iraq and he freaked out – they would compensate him for his NHS salary for the three months, but not his private practice (at the time he was on £150k a year and another £250k with his private practice). Trainee doctors know the score – ten years slog and then they hit the big time. Many GPs get £120k.

    • For those wanting status and cash there are plenty of other professions that pay better. Medicine is misery, day in – day out. Nobody comes to see you to have a good time if you are a doctor.

    • I don't accept that medicine is a misery….. I see the job satisfaction that docotrs get when they have people responding to their treatments, however it is a tough thing to do.

  • Workers of the world unite (not against each other)

    There is a societal problem in that people are not fairly paid for their work. I want a junior doctor to have sufficient time to learn and spend time with patients. Also I want the lady working two jobs to raise her family to have enough. I don't know the answer but we will not find it snipping at each other.

    My brother was a doctor diagnosed with MS during medical school had an attack 3 weeks before the end of surgical training. He had some recovery then spent next four years working on psychiatry; walked out of last aural exam – collapsed never took another step. EDSS 8.5 since then 10 years ago.

  • Calm down, calm down. In the future most doctors a well as MS specialists will be outsourced to people in India. Most of the work of a doctor can be performed over a Skype connection so there won't be a need for a physical person present to make a diagnosis of MS for example.

    You can try to fight it but it will be a losing battle.

  • Having trawled through all the above comments and responses I think the only comment that really surprised me was from Anonymous Friday, September 25, 2015 12:53:00 p.m.: (her daughter) has said that next year, although she will be more experienced, she will earn less than this year….. How this can happen I do not understand, nor approve of.
    As a matter of interest, maybe some people here would be interested/aghast/shocked to hear that in Germany, and maybe other countries, once a person has qualified as a doctor they are obliged to work for one year in a hospital without any remuneration. No salary, no free parking, no subsidised food or lodging, ABSOLUTELY NOTHING

    • No money……… food……..someone is paying somewhere in the chain or do they have to stay at home with their parents:-).

      People are being trained and it is not unusual that you need to stay in a system that trained you, but in Germany does the medical student have to pay£50,000 plus debt to deal with, Germans often speak good English and can come an get that Doctors salary in UK:-)

      Germany have not gone down the ludicrous path of student fees, a Blairite created problem following from Thatcherite ideas.People achieving big salaries, eventually pay large amounts of tax and many will pay more in tax in a year than they took from the state system for their education.

  • Well I for one sympathise with the junior doctors. These are people who have spent years longer than others gaining their degrees accruing massive debts. To start on a salary of £23k is ridiculous, especially in the South East. A spare room in a house share can easily cost £750 per month. I want the brightest people to be training to be a doctor but the NHS is competing with law firms who offer £40k as a starting salary for trainees – which goes up by £20k two years later when they qualify.

    I don't think the comments on here are representative of the majority view in any sense. I am hugely grateful for the NHS and the people that work in it and this proposal can only damage it further.

  • I think these comments are representative of the the general population of Britain some are believers of the Daily Mail there's nothing good in the world so forget any collective action and others think that even if some people get treated badly by their employer (public or private) thats not an argument to treat everyone badly

    It shocks me however that people think that Junior Docs should work a 90 hour week (BTW even those with rich mums and dads are included) and be grateful for £23k. Even if after 10 years this morphs into personalised number plates and white Discovery (which I seriously doubt but all those folks with a little story about a GP or a consultant seem to think)' we need to focus on the issue. The proposal will demoralise an already stretched NHS staff across the board and we will see quality of patient care suffer.

    This will play in to the narrative of private does it better and if we were consumers then a miracle would happen and the NHS would be fixed. It isn't better and for consumers read mugs and to fix the NHS we need honest compassionate dialogue.

  • What else does this say about the NHS, I love the idea of the NHS but it really is struggling…
    5 billion pounds of NHS money lost to fraud, it's greed.
    Money needs to be spent on preventive health, the nanny state argument is weak.

  • There are questions and answers which need to be considered carefully:

    1) Is the public happy to be seen by a someone who is not a doctor for their health problems? Is there a barometer for this – say it is a simple scrape, what happens if there is an underlying fracture? What happens if during your work up it is picked up that you have clinical signs consistent with a neurological disorder? What about if you get run over, shot or are stabbed?

    2) What is your level of emotional investment in protecting your own health? When the chips fall what is really important?

    3) Should the medical faculty stick their neck out and really start providing a health service which makes sense? Even if this means obtaining funds to improve existing resources from 'x' source.

    4) Should the UK government bundle the existing monetary deficits in failed trusts, as a result of the PFI schemes which now affect service provision and patient safety?

  • I pay for private health insurance even though my income is very low (below 12k a year), I live on my own. I have paid for private dental care for around 10 years now. My health is my priority and I will do what I can to protect my health.

  • Apart from funding their long training to become a doctor, which isn't all covered by the state as many on this blog seem to think, junior doctors or someone has to fund what is called an 'elective'. It is part of a doctor's training in all unis I know that they have to spend about 8 weeks working abroad. This is anywhere in the world apart from the UK. They do not get paid and have to pay for their living expenses and flights for that time

  • The NHS is to rapidly expand the number of people in "doctor's assistant" roles. 22/09/14

    The Department of Health said the medics – known as physician associates – allowed busy doctors to spend more time with patients. However, some concern has been raised that the more junior posts will be used to replace more expensive doctors, damaging care. What do think about these NHS plans NDG?

    The job requires a science or medical degree plus two years training. Might sign up for it myself, I have a science degree and have studied at postgrad level. I could specialise in MS.

    • My thoughts? The distilled version is that it will be more work for me; ultimately the name at the top of the patient's bed is the Consultant's. The General Medical Council will have a field-day with this one.



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