NHS doctors' pay
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The following article, written by a junior doctor in Nottingham City, the hospital where I work, appeared in the New Statesman in October 2005.   Its author, Mark Jopling, is one of the least popular doctors in the land, at least among his colleagues, but he is also, of course, correct.   

New Labour has bunged billions at the NHS over the last few years, and the staff, nurses as well as doctors, have pocketed the lot.  They haven't worked any harder - NHS productivity has fallen by up to 1 per cent per year since 1997 according to the Office for National Statistics in 2004.  In fact productivity has fallen over all the public sector, so the private sector must be working a lot harder - national productivity is steadily rising.   

Meanwhile public sector pay continues to rise faster than private?   Public sector workers hang on to their tax-funded pensions after early retirement, while the private sector is asked to work till age 67.  

Poor Dr Jopling is taking heat from his medical colleagues just now, but the private sector workers who pay the tax that keeps the doctors comfortable will understand.  

Jim Thornton 12 Nov 2005

I am one of the least qualified, least skilled and lowliest paid doctors in my hospital. My days are spent searching for missing heaps of patient notes, running errands and chasing up blood test results. I am a ‘junior house officer’, a useful but dispensable cog in a vast machine. Despite my humble position I am paid a whopping £37,000 a year.

If I became a consultant the taxpayer would be sending me home with at about £90,000. Were I to prefer a nine-‘til-five job as a GP then I would be raking in a fat £100,000, more if I played the system well. The overstretched NHS budget sets aside enough cash to ensure that the doctors’ car park is packed with luxury cars and that we can leave the chaotic communities that supply our hospital for big houses in the charming villages and estates out of town.

We are quick to justify our pay with a battery of compelling arguments: we work hard, I know that from experience; we have big responsibilities, I know that from watching my seniors; we are also well qualified and have to endure a protracted training, both in university and on the job. But teachers, social workers and other professionals in the public sector work long hours too, some of that at home and unrecognised. While peoples’ lives don’t depend upon their decisions, life opportunities and security do. It is unfair that our salaries dwarf theirs.

In medicine there has been a long-standing acknowledgement that nurses work hard and are under paid. A nurse starts on a relatively modest £16,000 and works regular nights and weekends. It is usually nurses that give patients the most support during their stressful times in hospital. If a nurse reaches the very top and becomes a nurse consultant then he or she will just about earn what I do now. This pay inequality does nothing to ease our occasionally stormy relationship. The unseen, grey-clad auxiliary-staff who work so hard to keep the wards clean receive a piffling sum. Doctors have succeeded masterfully in condemning this meanness while never questioning the justice of their own salaries.

Amazingly no one objects to our pay, but then we hide the numbers so well behind a tangle of pay bands and percentages that it is unlikely that anyone really knows the scale of the opulence. Also who is going to criticise the pay of such awesome lifesavers.

Writing this will certainly earn me a few enemies, doctors enjoy the money they earn and most feel that it is well deserved. They will not appreciate someone suggesting that their salaries are on a scale that is unjustified and reflects badly upon their motives for joining their profession. To our shame there has not been so much as a whisper in the medical press questioning the generosity of salaries, only a clamouring for more money.

Could doctors pay be redistributed to the more stingily paid members of the health professions and other public sector workers to reflect work load, training and responsibility rather then assumed social standing? Bringing some pay equality into the public sector would thrill those who rightly feel underappreciated. Maybe money freed up could go towards more drugs, machines or nurses, there are never enough. (Last week our ward closed due to a shortage of nurses, the doctors and beds sat idle.)

Alternatively that extra money could be used to address the social deprivations that the medical profession knows are the cause of so much ill health.

Some doctors would certainly rebel, throw down their scalpels, ditch their stethoscopes or fling their couches from the window. They would go private, go to Australia and go loudly. But when the dust settled we would be left with the doctors whose motivation was caring for their patients, and there are many of them. The vacancies created would be filled by the queues of doctors who are on the dole and later, by the hoards of clever sixth formers desperate to enter medical school.

Doctors have often compared their salaries to high fliers in the private sector. This is irrelevant, we are state funded service providers and a salary that befitted this role would be more appropriate than the present excess. We do work hard to for the patients in our community, but off the golden pedestal we have allowed ourselves to be placed upon we could serve them even better.

Mark Jopling. Reprinted from The Spectator  

Click here to email Mark Jopling

19 November.  A junior doctor writes:

As regards the poor berated junior doctor, I disagree. I know a pastoral deputy head teacher who made what he thinks may be the first mistake with serious consequences in a thirty year record of impeccable service. I was on hand to help him deal with the stress he felt. We deal with that often and are renumerated for it. 

It sounds crazy, but a lot of us are struggling. Moving regions and  renting and paying a mortgage is expensive. My house is still on the market. Hidden costs and exams are expensive as is travelling 90 minutes each way on the motorway to work. I pay £30 a week just for the privilege of parking at work, which when I am having to stay with family more than fifty miles away is a little harsh. I could get up at 5am instead of 5.30am to park half an hour away for free, then walk the rest of the way.    

I may be ranting, but Jopling does not appreciate these things, which I believe are worse for others than myself and particularly exacerbated by the current climate of insecurity. (Look at how much people are spending on literally hundreds of job applications.)

We are not badly paid, and nurses do not receive enough financial reward.   But linking the two is not helpful.  I think we are beseiged.  I don't think poor investment in the NHS should be blamed on investment in its workforce!


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