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NHS
Jan 19, 2017 10:44:53 GMT
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Post by Deleted on Jan 19, 2017 10:44:53 GMT
My previous post
Comparing the price of Hamilton tickets
To healthcare
Might have seemed stupid and obtuse
I think what people didn't realise is
That I actively save for ill health
If someone on the board had a stroke And couldn't walk or look after themselves
What provision do they have other than banking on the NHS?
Just as you would not be able to live only off a state pension
I don't think people can assume the NHS can reliably look after the range of health needs they might think it can for very much longer
And people might need to readjust their expectations
Or stump up some cash
Which might be savings or money they use for enjoying themselves going on holiday or to the theatre
This would show how much they really value health
I think people will have to start making financial sacrifices
In 10 years time We might be posting
Should I see the new show for £500
Or shall I pay for my blood pressure medications for 2 years instead
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18,845 posts
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NHS
Jan 19, 2017 12:47:48 GMT
Post by BurlyBeaR on Jan 19, 2017 12:47:48 GMT
Why aren't timewasters who turn up at A&E with common colds and cut fingers etc just turned right round and sent away? I don't understand why this is entertained.
I'd stick a paid for private walk in centre next to every A&E, refer these jokers to it and let them pay for their cough syrup and consultation.
Simplistic I know but I do think we create some of these problems by being so soft.
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NHS
Jan 19, 2017 12:58:09 GMT
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Post by Deleted on Jan 19, 2017 12:58:09 GMT
Why aren't timewasters who turn up at A&E with common colds and cut fingers etc just turned right round and sent away? I don't understand why this is entertained. I'd stick a paid for private walk in centre next to every A&E, refer these jokers to it and let them pay for their cough syrup and consultation. Simplistic I know but I do think we create some of these problems by being so soft. Often they complain And each and every complaint has to be addressed and answered If the patient is not happy with the response They can escalate to the ombudsman Which is run by the government And has the final say You can't argue against them Most of the time they favour patient choice and views This leaves front line clinical staff in a precarious position and individuals are understandably not wanting to take the risk E.g. A patient may ask for paracetamol to be prescribed If a doctor refuses and the patient escalates this Invariably the doctor will be found at fault and advised they should have prescribed it if it was indicated and the patient refused to buy it The system does not support change Although it's not nice to say it The system is on the side of the patients Which makes refusing anything on a case by case and face to face basis difficult Although ironically overall services and treatments are being withdrawn and scaled down all the time
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NHS
Jan 19, 2017 13:09:24 GMT
Post by alexandra on Jan 19, 2017 13:09:24 GMT
"I have increasingly contemplated leaving my work over the last 2 years because I am working in a system I don't trust anymore"
And when you do, you will get a generous lump sum and an absolutely stonking public pension for the rest of your life, worth over a million pounds if you live a normal life expectancy. The kind of money the rest of us can't hope to save up (and if we did, it would produce an annuity of around 4%. The striking junior doctors never mentioned that.
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Post by Deleted on Jan 19, 2017 13:36:35 GMT
"I have increasingly contemplated leaving my work over the last 2 years because I am working in a system I don't trust anymore" And when you do, you will get a generous lump sum and an absolutely stonking public pension for the rest of your life, worth over a million pounds if you live a normal life expectancy. The kind of money the rest of us can't hope to save up (and if we did, it would produce an annuity of around 4%. The striking junior doctors never mentioned that. Please I am not relying on the NHS pension It is this sort of narrow minded Daily Mail comment which I find stunting I don't even pay into an NHS pension All the savvy people are buying up property in London It offers a much better return And pensions have nothing to do with poor patient care It's a totally bizarre sour grapes comment So doctors are supposed to offer patients rubbish care and do a bad job And keep their mouths shut Because they are going to get a pension at the end of it? Many of my friends have left NHS work before the age of 35 Thereby forfeiting the NHS pension anyway In order to have a better working environment and less stress They don't want 45 years of misery for a pension They aren't greedy and have more sense and resources We aren't all sitting with our mouths open waiting for the government Others have chosen to opt out of the pension contributions (as high as 14.5% anyway) and to invest this money in other assests You need to get a financial advisor ASAP [br) If you are so badly off ask yourself why and consider moving to a country with cheaper living costs and where the government don't treat grass roots workers like sh*t But your own personal poor financial foreplanning has nothing to do with poor NHS funding
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NHS
Jan 19, 2017 13:47:02 GMT
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Post by Deleted on Jan 19, 2017 13:47:02 GMT
This is something that I think comes from the crumbling of social cohesion in society. First, "Doctor Mum" used to be nearby. Her and Gran had seen it all before and knew a nappy rash from a meningitis one. Now they live so far from the grandkids, there's nobody near at hand to ask. So "better safe than sorry." Second, I'm afraid there is a deep lack of "common sense" around. The old "wait and see" has been replaced by "I read that article where someone died / Doctor Google (the crazy sites, not the official ones) says that... People forget to balance what they read in the media with the idea that those who write this stuff are not medically qualified but do need a great story to fill a page and get themselves paid. Third, yep, there is a massive distrust and lack of respect for "the establishment." I'm not arguing the hows or whys of how that happened (I feel it the same as everyone else), but on the one side you have the dedicated trying to do good, in the middle the "don't cares" of both sides" and on the other the entitled who, as Parsley says, are out for themselves and don't see the broader picture. I'm not talking genuine negligence, but those cases over a paracetemol - and those warned to look after and take responsibility for themselves who just won't. It's a massive, massive and almost insoluble problem, not just cash but attitudes and education, I feel. I agree Is insoluble
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Post by BurlyBeaR on Jan 19, 2017 15:12:19 GMT
Blimey, I've just agreed with parsley on something... ... could someone please call me a doctor? Theatremonkey, you're a doctor. Taxiiiiiiii!
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4,631 posts
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NHS
Jan 19, 2017 18:15:42 GMT
Post by Phantom of London on Jan 19, 2017 18:15:42 GMT
The British people are very passionate about the NHS and the BBC and will fight tooth and nail to keep both.
I though the point of having a Triage Nurse in every A&E, is to wheedle out the 'malingers', send them on their way with 2 days worth of paracetamol, they think they have got treated, so no complaint?
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NHS
Jan 19, 2017 22:17:06 GMT
Post by Mr Snow on Jan 19, 2017 22:17:06 GMT
Parsley on the one hand I can see that you really care, that you remember far longer the one patient you couldn’t help because of NHS limitations, than the 20-29 you send home happier each day. If you could turn that passion into positivity you might achieve something. Instead you radiate negativity (I bet you patents pick this up) and you spend your time with others who like you have given up and find it hopeless. I met people with your views in the NHS and Teaching 30 years ago and yet here we are. People are living longer and more people receive treatment than ever – SUCCESS. But we never did provide total healthcare to everyone and its more contentious when we fail.
Just reading this thread will remind you there are millions of people successfully being treated each and every day in the NHS. Don’t underestimate the great work you and your team do. Yes the no of limitations on you are growing and you find it intolerable, but saying its insolvable is no answer. Its nihilism. And get used to it, life is cruel, good people die and you just don’t like having to live within societies means.
And I do have a lifeteimes experience of living and socialising with employees of the NHS and its not my experience at all that “most staff have given up”. Just walking though a hospital the workers attitudes are really not that dissimilar to any large organisation. Perhaps you need to get out more.
The one thing we agree on is that it is a political football. There is no secret Tory plan to break up the NHS (come on Julian Assange show me that one!), they are s+++ scared of it and that prevents them taking big decisions like closing hospitals that don’t provide effective and efficient cover. They are just trying to keep the budgetary increases (and the facts show there are real increases every year) manageable. Just like Tony and Gordon did when it was their turn. Labour don’t want it to become apolitical because a Tory F up is the only thing they will have going for them at the next election. So they invent straw man arguments about what the Tories are going to do to the NHS. Well the Tories have had power for 28 of the last 40 years and the NHS is still here.
The same is true for lots of government expenditure, costs are rising and the tax take isn’t.
Somehow we need to get people to go back to read Beverage the ''architect of the welfare state”. He wanted the government to find ways of fighting the five 'Giant Evils' of 'Want, Disease, Ignorance, Squalor and Idleness. His report published in 1942 foresaw the dangers of a growth of dependency on a benefit culture and the waste that could come, but he though it worth the price to get the country back together after the war. These were problems that could be tackled later. He was against much that bedevils a free at he point of service provision. But to many people I am demonisng the 'working class', just by pointing this out.
But the budget remains key – there isn’t' enough money in the world to give everyone optimum treatment. Once that is set then hard choices can be made. The NHS cannot continue expanding its range of services to an ever ageing population unless robotiseation produces some huge economic boom. I'm not holding my breath and we are still borrowing money just to keep today’s government expenditure intact – a day of reckoning is due. So with Brexit to distract us all, how we get to an apolitical NHS is the real difficulty...but like a lot of political nettles it can be dealt with ...
PS Parsley please don’t call me ignorant of the situation when you know nothing about me. Also I'd like to point out that any target in an organisation like the NHS that isn't regularly breached is just not worth having. It sets no challenge. Targets have radically imporved waiting times. I bet you were against their introduction and now you use them as more evidence to support your viewpoint. . The breaches point us to the problems. This is basic management and I somehow get the feeling you just aren’t interested in that. You rather just moan about how hopeless it is.
I have said my piece. Thank you.
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NHS
Jan 19, 2017 22:35:28 GMT
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Post by Deleted on Jan 19, 2017 22:35:28 GMT
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NHS
Jan 19, 2017 22:47:07 GMT
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Post by Deleted on Jan 19, 2017 22:47:07 GMT
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NHS
Jan 20, 2017 10:43:22 GMT
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Post by synchrony on Jan 20, 2017 10:43:22 GMT
I actually agree with much of what Parsley has said.
I'm not a doctor but have many friends who work in the NHS and are extremely demoralised and considering quitting because of what is happening. It is terrifying.
I get the impression that much of the problem is caused by funding cuts in social services so people unnecessarily take up beds because they cannot be discharged (there was an article in the news today about a hospital having to go to court to remove someone who refused to leave for two years even though he was fine!!!).
I'm fortunate enough not to have needed the NHS much, but I do care. But don't know what to do about it (I'd be glad to know). I don't think it's even slightly a joking matter.
When I read criticism of the NHS in the news, I'm sure it's of little consolation to NHS workers, but it doesn't make me think badly of the NHS. It makes me loathe Jeremy Hunt and the government who seem to be actively trying to make the staff's life as miserable as possible.
I have voted Tory in the past, but this, together with Brexit, has ensured that I will never do so again.
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155 posts
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NHS
Jan 20, 2017 10:48:24 GMT
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Post by synchrony on Jan 20, 2017 10:48:24 GMT
"I have increasingly contemplated leaving my work over the last 2 years because I am working in a system I don't trust anymore" And when you do, you will get a generous lump sum and an absolutely stonking public pension for the rest of your life, worth over a million pounds if you live a normal life expectancy. The kind of money the rest of us can't hope to save up (and if we did, it would produce an annuity of around 4%. The striking junior doctors never mentioned that. I'm not a doctor and am in a fairly low paid job. But I find this comment to be blind to reality and agree with Parsley's response to it.
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NHS
Jan 20, 2017 11:12:47 GMT
Post by alexandra on Jan 20, 2017 11:12:47 GMT
Don't be silly, Parsley. I am not suggesting that the NHS pension is the source of all the NHS's woes, as you well know. But you mentioned the junior doctors' strike, and I was pointing out that people never mention their extremely favourable pension. I know many NHS staff including in my close family who have retired in their fifties because their public pensions (to which they have contributed something, yes, like many of us do, but to which the state also contributes handsomely, unlike to the rest of us) will keep them for the next 30 odd years in considerable style. So yes, they work hard, but for rewards which are frequently underestimated, and ought to be taken into account in pay disputes. As for the NHS funding crisis: raise taxes.
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NHS
Jan 20, 2017 11:14:44 GMT
Post by alexandra on Jan 20, 2017 11:14:44 GMT
How is it blind to reality, synchrony? Are you saying the pension isn't generous? Do you know what doctors get?
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155 posts
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NHS
Jan 20, 2017 11:33:37 GMT
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showgirl likes this
Post by synchrony on Jan 20, 2017 11:33:37 GMT
How is it blind to reality, synchrony? Are you saying the pension isn't generous? Do you know what doctors get? Yes, I have many doctor friends. For the amount of training they do, the stress of the job and the long hours they put in I think it's really not that much. Certainly as a junior. Would I stick at a job that caused me that much stress, with no life, just for the pension? Definitely not. None of the NHS workers I know went in to it for the money.
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NHS
Jan 20, 2017 11:37:08 GMT
Post by alexandra on Jan 20, 2017 11:37:08 GMT
"I think it's really not that much. Certainly as a junior."
I'm not talking about their salary, as I think was clear.
"None of the NHS workers I know went in to it for the money"
Another straw man.
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Post by andrew on Jan 20, 2017 22:57:00 GMT
"I think it's really not that much. Certainly as a junior." I'm not talking about their salary, as I think was clear. "None of the NHS workers I know went in to it for the money" Another straw man. The pension was completely gutted for new entrants into the system a few years ago, so if you really think it's the problem alexandra then I've got good news for you. Timewasters, incomplete medication courses, is all a red herring, the magnitudes of scale involved dwarf those problems. My perspective on this as someone inside the system is that healthcare for the UK costs a certain amount, and at the moment it's being met by the taxpayer. If you try to do anything other than this, the same cost has to be met, except this time it's by somebody who's not the taxpayer. It's still you, it's just you in a different way. And presumably if it's by a private enterprise, even if that's just an insurance based model or whatever hybrid you come up with, then Richard Branson makes a healthy profit somewhere in the middle. If the system is breaking because the need is so huge, then in addition to doing what we can to restructure, we have to swallow the fact that it needs more money. The largest, unhealthiest generation ever is retiring and it's not going to get any easier. We need to be cognisant of the fact that we have a surprisingly efficient system which per capita we spend not a relatively large amount of money on, and maybe we need to spend more. Nobody likes that fact, nobody wants to say it, but maybe it's true. Letting the NHS collapse will not suddenly alleviate the massive healthcare costs the country has, it just shifts it into the hands of private companies and lets in even more people exploit than are already allowed to. From my personal position, if the NHS goes private, I stand to work legal hours for the first time for probably more money. Don't let it go private.
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NHS
Jan 20, 2017 23:04:31 GMT
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Post by Deleted on Jan 20, 2017 23:04:31 GMT
"I think it's really not that much. Certainly as a junior." I'm not talking about their salary, as I think was clear. "None of the NHS workers I know went in to it for the money" Another straw man. The pension was completely gutted for new entrants into the system a few years ago, so if you really think it's the problem alexandra then I've got good news for you. Timewasters, incomplete medication courses, is all a red herring, the magnitudes of scale involved dwarf those problems. My perspective on this as someone inside the system is that healthcare for the UK costs a certain amount, and at the moment it's being met by the taxpayer. If you try to do anything other than this, the same cost has to be met, except this time it's by somebody who's not the taxpayer. It's still you, it's just you in a different way. And presumably if it's by a private enterprise, even if that's just an insurance based model or whatever hybrid you come up with, then Richard Branson makes a healthy profit somewhere in the middle. If the system is breaking because the need is so huge, then in addition to doing what we can to restructure, we have to swallow the fact that it needs more money. The largest, unhealthiest generation ever is retiring and it's not going to get any easier. We need to be cognisant of the fact that we have a surprisingly efficient system which per capita we spend not a relatively large amount of money on, and maybe we need to spend more. Nobody likes that fact, nobody wants to say it, but maybe it's true. Letting the NHS collapse will not suddenly alleviate the massive healthcare costs the country has, it just shifts it into the hands of private companies and lets in even more people exploit than are already allowed to. From my personal position, if the NHS goes private, I stand to work legal hours for the first time for probably more money. Don't let it go private. Lovely post What is your role? If you are happy to say?
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Post by showgirl on Jan 21, 2017 0:21:39 GMT
One of the ongoing frustrations for many ordinary taxpayers who wish the NHS not only to survive but thrive, is that they would gladly pay more tax for this but don't have the option.
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Post by Deleted on Jan 21, 2017 7:28:46 GMT
One of the ongoing frustrations for many ordinary taxpayers who wish the NHS not only to survive but thrive, is that they would gladly pay more tax for this but don't have the option. Totally agree with this. And I am also not complaining about our local council charges increasing next year to help with Social Care costs.
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3,478 posts
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NHS
Jan 21, 2017 8:29:12 GMT
Post by showgirl on Jan 21, 2017 8:29:12 GMT
One of the ongoing frustrations for many ordinary taxpayers who wish the NHS not only to survive but thrive, is that they would gladly pay more tax for this but don't have the option. Totally agree with this. And I am also not complaining about our local council charges increasing next year to help with Social Care costs. With you there, Jelly Bean - maybe you also live in Surrey (as I do), where there will be a referendum on increasing council tax by 15% to pay for Social Care.
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3,478 posts
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NHS
Jan 21, 2017 8:41:34 GMT
Post by showgirl on Jan 21, 2017 8:41:34 GMT
And here's a link to a volunteer-run website (with Twitter account, too) for members of the public wishing to show support for the NHS and create a stronger voice for their views: www.nhsmillion.co.ukNot sure how much it will achieve but worth a try.
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Post by andrew on Jan 21, 2017 12:11:06 GMT
Lovely post What is your role? If you are happy to say? A junior doctor. Still feeling a bit chilly from last years picket lines, and even more demoralised.
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NHS
Jan 21, 2017 13:35:40 GMT
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Post by Deleted on Jan 21, 2017 13:35:40 GMT
Lovely post What is your role? If you are happy to say? A junior doctor. Still feeling a bit chilly from last years picket lines, and even more demoralised. LOVELY What are you FY/ST/CT? I hear your demoralisation But at least you have the theatre to escape to! I am not sure what to suggest or what your long term career plans are But I am truly grateful I am not a junior doctor anymore I really think I was the literally the last of the "heyday" We had free accomodation as House Officers Excellent study budget Band 2A for all our jobs Bacon rolls at the weekend from the ward sister The relative pay that juniors get now is 40% lower than I was paid in 2006 There is just no excuse And this is why things like £200 tickets for Hamilton piss me off And people wonder why NHS staff choose to locum It's to avoid being on the breadline And to keep their heads above inflation A little bit of bitterness and empathy for others Try to keep your chin up and not to let the system get you down If you want some automomy over your work life I would highly recommend GP As it gives you so much flexibility over working patterns And I would recommend doing some locums which really give you confidence and experience
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NHS
Jan 21, 2017 13:44:46 GMT
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Post by Deleted on Jan 21, 2017 13:44:46 GMT
Question for Parsley et al: Should we abolish the GP / Hospital referral system? And indeed reform the entire GP system into something else? Is the little house with 4 or 5 GPs redundant and costly, when everyone could just go to a hospital GP unit and be triaged by them there? Not trying to make political points or statements or anything, just very curious if there is another option for it all? I will reply And extensively Later 😀
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NHS
Jan 22, 2017 10:21:30 GMT
Post by alexandra on Jan 22, 2017 10:21:30 GMT
Andrew, for the last time I am not saying that the lavish NHS pension is "the problem". What I am saying is that when the terms and conditions of NHS staff are considered, the fact that the average GP and senior doctor will receive many hundreds of thousands of pounds from the scheme over the course of their retirement is rarely mentioned and should be taken into account. And I'm very well aware of the changes made in 2015, but the employer (the taxpayer) contribution has actually gone up.
I can see that the considerable benefits you will get in retirement seem distant to a junior doctor (until it's suggested they might be reduced), but trust me, when you get to middle age, with life expectancy well into the 80s, you will realise how valuable they are.
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NHS
Jan 22, 2017 10:33:14 GMT
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Post by vdcni on Jan 22, 2017 10:33:14 GMT
People are worried there won't be an NHS in 10-20 years time and your contribution was to say hey all those junior doctors will have a great time when they're pensioners!
All a bit of a pointless diversion really.
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NHS
Jan 22, 2017 11:53:38 GMT
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Post by Deleted on Jan 22, 2017 11:53:38 GMT
Andrew, for the last time I am not saying that the lavish NHS pension is "the problem". What I am saying is that when the terms and conditions of NHS staff are considered, the fact that the average GP and senior doctor will receive many hundreds of thousands of pounds from the scheme over the course of their retirement is rarely mentioned and should be taken into account. And I'm very well aware of the changes made in 2015, but the employer (the taxpayer) contribution has actually gone up. I can see that the considerable benefits you will get in retirement seem distant to a junior doctor (until it's suggested they might be reduced), but trust me, when you get to middle age, with life expectancy well into the 80s, you will realise how valuable they are. The average contribution from a doctor over their working life will be anything from 150K to 200k From their salary to their pension This is at 14.5% Most people would balk at paying that and would not be able to afford it even as they need the money at hand If you invested this instead into a property in the right part of London or internationally You would get a way better return than the NHS pension over 40 years I don't see your point And as I said lots of people are choosing to opt out of their pension So I still don't see your point I don't want to turn this into a defend the doctors thread But are you aware doctors pay up to 20K per year out of their own pocket to indemnity insurance which is compulsory? To protect themselves from complaints and litigation These charges have more than doubled in the last 10 years
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NHS
Jan 22, 2017 13:28:28 GMT
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Post by greenice on Jan 22, 2017 13:28:28 GMT
All of the public sector employment pension schemes still provide excellent value for money, even after the recent changes. The contribution rate in some of the schemes is undoubtedly high, however it would be very difficult if not impossible to achieve the same benefits independently with the same monthly payments placed elsewhere. All of the investment risk is yours, as is the cost of inflation proofing, and the scheme also provides protection pre retirement; ill health and death benefits.
Even if you are fortunate enough to achieve very good growth every year, the £1M lifetime allowance on pension funds would cap retirement income at well below the level a doctor with around 40 years of service could expect from the scheme.
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