Sunday, 4 October 2015

Women Junior Doctors

From the Telegraph

The contracts also change the current automatic pay progression that means a trainee doctor’s salary goes up every year. Under the proposed changes, doctors who take time out of their training for maternity leave or to study for a PhD will not be eligible for the automatic rise.

You get an automatic pay rise when you take a year out to spend it changing nappies? And some people think it's wrong for the government to be stopping this? Are you a better doctor after you've spent a year with rattles and warming bottles? No, so why should you be paid more?

“It’s really difficult if you’re trying to put a roof over your children’s’ heads,” says Tamsett who has just had her first child and is currently on maternity leave. “The fact that I could work part-time was one of the reasons I thought medicine was a good career for me but now I’m faced with the prospect of returning to a job that demands longer hours for less pay.

Go back to work and hire a nanny then. £32K will cover it and you'll be better off if the finances matter.

But female doctors particularly feel they will be penalised by the potential new contracts. “If you’re a mother as well as a doctor, you’re hit extra hard,” explains mother-of-two Dr Rachel Clarke, 42. She gave up a well-paid career in TV production to retrain as a doctor and is now doing her core medical training in Oxford, where she earns around £20,000 a year.

What clown allows people in their late-30s to do medical training? Seriously. It costs £250K to train a doctor and there are limited places. If you consider that someone normally works for around 40 years, that's like training half a doctor.

Sarah, a 31-year-old junior doctor in anaesthetics who didn’t want to give her full name, is worried about the effect the contracts would have on gender equality within the medical profession as a whole:
“As the majority of medical school graduates are now female, it is clear that penalising against trainee doctors for taking parental leave has widespread implications for medicine as a profession, just as we were making strides in the area of gender equality.”

Widespread implications being that more men, and women who would rather hand their kids to nanny go into medicine raising the total capacity of doctors? And this is a bad thing, how?


Bayard said...

It's all just special pleading. FFS, they are not being penalised. If they take a year out then they just don't get the increment for that year, it's not as if they'll be on less when they get back than they were on when they left. Sarah, Rachel and their fellow women doctors should be pointing out that it is unfair on women that it is automatically assumed that the mother will be the one taking the career break to look after to the kids. That's what discriminates against women, not removing the automatic increment for the parent taking the leave.

"Widespread implications being that more men, and women would rather hand their kids to nanny go into medicine raising the total capacity of doctors?

TS, I think you've missed out a word here.

Mark Wadsworth said...

Agreed. Doctors are incredibly well paid, go without a pay rise one year and they are still incredibly well paid. The fact that other doctors are even better paid than you is not really a reason for moaning.

Why do they have increments anyway? Because the whole thing is a closed shop and rigged by those at the top (who have thirty or forty years increments under their belts)?

mombers said...

MW, if doctors are so incredibly well paid, how come so many are leaving and we have to recruit from third world countries? This suggests that they are underpaid... There is a global shortage of doctors and they have the upper hand I'm afraid. Maybe a tax on the assets of their biggest users, the elderly, would help to bring pay up to more internationally competitive levels?

The Stigler said...

I think it's an old thing about being more experienced each year. And this rule probably existed in a time when almost no-one took time off because we recruited men for the job. Not worth bothering for a few blokes that did it, but when it's lots and lots of women, it makes a difference.

Are they? How many have stopped being doctors? I know how many have left the UK - it's about 600 in 5 years. It'd be nice if they didn't, but those are hardly crisis figures... ~100 a year.

When she becomes a consultant anaethetist, that doctor will be on a starting package of £74K a year + considerable holidays and public sector pension. What job can she walk into in Tunbridge Wells that pays that? I know a few people who make that in software, but they've been in the industry for 20 years and are senior managers in large departments. This "oh, we're so poor" is bullshit. They're just crying because Hunt's cutting their pay. And he knows that even with extra antisocial hours, medicine will still be massively oversubscribed.

DBC Reed said...

I am extremely glad medicine is a closed shop: you do not want to delay treatment by sifting through competitive claimants to medical knowledge, some of whom will have bought their degrees from Wanker College, Omaha etc or be franchisees of some gee-whiz neo quack chain
with big Internet presence.
The system of yearly increments is tricky but it does discreetly encourage practitioners to get more experience while being paid in the manner of apprentices etc under the old Guilds system which it possibly derives from.
I did get put into the position of applying to various hospitals for an operation on the NHS, most in different towns. I was rescued on an informal basis by a patriarchal consultant at my nearest hospital.. I also have had experience in London suburbs of an unlicensed taxi where the driver set his own fare and didn't know where he was going; fortunately the younger male members of my family got us out of that one with physical threats.
This blog is too becoming too ready to believe that Market Forces solve everything: our main concern ,the property market doesn't work at all; business cannot make money out of employing people and gets the government to top up their skinflint wages with tax credits.

mombers said...

TS, 600 have left which doesn't sound like a lot but there is a massive shortage and every little 'hurts'. The population is ageing rapidly and demand will just go up and up and we need to add thousands more doctors. My GP's surgery is riddled with OAPs, it's almost impossible to get an appointment. I can't see how this problem is going to be solved without raising pay to attract and retain doctors.
Going after working mothers is futile and impossible - what are we going to do, make them sign pledges to limit the number of children that they have? I'm guessing that doctors already have fewer children than average anyway.

The Stigler said...


I'm not opposed to licensing when it works. But as I had to personally diagnose a problem because 2 GPs, 2 locums and an ENT couldn't figure it out after months, including one GP suggesting the same thing twice ("if this didn't work last time, why will it now" "well, it might"), and me poring over stuff supplied by Dr Google did, you'll have to work harder to convince me that there shouldn't be a market. My mechanic has better diagnostic ability than these people did.

I don't believe market forces solve everything, and taxis are a very good example of where licensing works. You can't legally be a taxi driver in this country without a clean criminal record, valid driving license an insurance. That's good, lightweight regulation. The distinction between minicabs and black cabs works because of different sorts of consumers (locals vs visitors). If you're a tourist in London, you know a black cab is going to know his way around and not shaft you too much on price. On the other hand, my brother always used minicabs because they were cheaper, could tell them where we were going if they got lost, and kept using the same company he trusted.

And plenty of businesses make money. Tax credits mostly exist to allow people on low incomes with kids to live well. If people want that to happen, they can pay for it. Not employers.

The Stigler said...


"Going after working mothers is futile and impossible - what are we going to do, make them sign pledges to limit the number of children that they have? I'm guessing that doctors already have fewer children than average anyway."

How about we make them take on their training costs as student debt? You'd then discourage people who think they can have career breaks and working part-time from going into it. You can still have kids, but you'll be working and paying for nanny to look after them. Don't like it, get another job. Plenty of people who can take your place.

It's estimated that part-time working (almost entirely female) has an effect of 450 to 550 GPS per year being lost.

And my answer to a lot of old people is to put them in front of nurses with a specialisation in old people. No-one else runs diagnostics like the NHS where you put people in front of really expensive people as first line. I'll bet you could take a list of things GPs have to look at for old people and that 90% of it can be put into less than 10 flowcharts, and those flowcharts will solve it 90% of the time. That's how call centres for places like Sky work. "My Sky box is hanging" "Can you switch it off for 10 seconds and back on again" "oh that worked". You don't need a hardware specialist to fix that. You need minimum wage kids with a flowchart. And those flowcharts end with "escalate to a specialist". And I'm not even talking about getting minimum wage kids in but nurses who are themselves trained, but not so expensively trained.

Bayard said...

DBCR, I have to agree with TS. Luckily, I have not had much experience of the NHS lately, but the last time I went to the doctor, I had to tell him what I was suffering from as he didn't know. I knew, because I had had a fair idea and had checked it on Wikipedia.

Having said that, I don't disagree with the idea of yearly increments, just that, as you say, the increments are there to reward experience gained, which you are not going to get if you take a year out. That's hardly believing that market forces solve everything.

TS and DBCR. Tax credits, by and large, neither top up skinflint wages nor allow people on low incomes to live well. They allow people to be able to afford to work part time, so instead of having one person working and one on the dole, you have two people working part time and getting tax credits. It's obviously not quite as cut and dried as that, but we've been through all this before on this blog and argued about the nuances.

mombers said...

TS, piling on hundreds of thousands of pounds onto a medical student will surely push them towards working where they can get the highest salary? Doctors make a fortune in the US, a UK medic could move there and pay off their debt much more quickly. Or tell the SLC to stuff themselves, are they really going to be able to recover the debt?

Women in their late teens applying for medical school are not going base their decisions on a threat of higher debt than other degrees anyway I reckon. If anything, the lower birthrate amongst doctors and other higher earning professions suggests that the opportunity cost of parenthood is already pushing birth rates down perhaps, although of course there are many other factors.

Mark Wadsworth said...

M, but they can't all go to America, can they? The American doctors have their own barriers to entry.