Dr Tony Goldstone Profile picture
Radiologist/CIO. Director Goldstone PenFinTech. Dep Chair @bma_pensions. Nat Advisor BMA on Pensions (19-24). Passionate re NHS. Thoughts mine. Tweets personal

Jun 29, 2024, 33 tweets

1/ NEW & IMPORTANT: Quarterly NHS pay data updated 27/6/24 👇 In BREAKING NEWS NEW charts now show ALL SECTORS have reached #FullPayRestoration (though NOT, of course, the NHS)

We MUST fix pay/retention to fix #WaitingLists

Please read whole [long bumper] 🧵 & share widely/RT

2/ You'll notice when ministers are in the media, they often talk about how hard "your viewers/listeners" have been hit by inflation. But what we need to do is separate fact from fiction (aka LIES), it was 👇excellent @jburnmurdoch @FT chart that really showed this well last year

@jburnmurdoch @FT 3/ But its not just government ministers gaslighting NHS workers that they have no right for their pay to keep up (like everyone else's), it was also so-called "independent" DDRB👇

Apparently doctors & dentists should not be protected when "its not taking place in other groups"

@jburnmurdoch @FT 4/ It was this blatant gaslighting that we are the same (or even better than other groups), not only from government but also from the allegedly "independent" DDRB, that inspired me on the back of the excellent @FT work to develop this pay erosion model based on official stats

@jburnmurdoch @FT 5/ Like many people I found the @FT charts extremely compelling. There are many different ways to measure pay loss, but I wondered if I could add consultants to the charts which I did - JBM kindly provided a graph to compare and as you can see they were essentially identical

@jburnmurdoch @FT 6/ There's a small difference (circled) in "all workers all sectors" (an @ONS dataset) during the initial phase of COVID as I have chosen to average pay each month over the prior 12 month period (to better match the @NHSDigital Earnings Estimates methodology) = fairer comparison

@jburnmurdoch @FT @ONS @NHSDigital 7/ As with the now expired charts I previously produced (they went to Dec'23 as that was then most recent data set) I added some other comparators, which are directly comparable to the NHS i.e. professional, technical & scientific- MUCH better/fairer comparator for NHS staff👇

@jburnmurdoch @FT @ONS @NHSDigital 8/ Worth pointing (again🥱) that *ALL* the variables in these charts are *official statistics*. Its either pay or inflation from the @ONS (comparables), NHS pay & waiting list data from @NHSEngland

Average pay is chosen as that is what's used by GOVERNMENT. And MOST commentators

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland 9/ The bottom line in the charts remains that NHS pay has STILL been *COMPLETELY DESTROYED* compared to 2009, but the whole economy fared pretty well vs CPI inflation, the most commonly used measure of "headline inflation" which is generally preferred by government & economists

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland 10/ Taking each group (NEW March 24 vs OLD Dec 23 as previously)

Finance & Bus. ⬆️ +9.2%,prev+7.9%
Prof Sci & Techn ⬆️+5.8%, prev+4.6%
All workers, All sectors ➡️0.0%,prev -0.9%
Nurses ⬇️⬇️ -7.4%,prev-7.9%
Junior Doctors ⬇️⬇️-23.2%, prev-23.6%
Consultants ⬇️⬇️-20.7%, prev -21.9%

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland 11/ Its not only unions noticing. @JCribbEcon @TheIFS pointed out recently....

"Consistently cutting the pay of higher-paid public sector workers is unlikely to be sustainable in the long term if the government wishes to recruit and retain skilled workers."

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS 12/ Interestingly the IFS use the same methodology as I have (and many others) with average pay vs inflation. They get a slightly lower figure in part due (somewhat arbitrary) choice of start date; but also using a different measure of inflation (CPIH vs CPI).

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS 13/ Had @TheIFS used same start date (start of austerity) & CPIH (their preferred inflation measure) they would get more similar erosion to my CPI charts (CPIH chart below👇for comparison). Just look how others have done vs CPIH i.e Finance UP 12.3% Prof/Sci UP 8.8%! #MindTheGap

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS 14/ So what do those pay cuts actually mean for real terms pay had it kept up with CPI (& there's *STRONG* arguments for using RPI which is also valid, for example as it includes mortgage interest payments & used in student loans). It means NHS staff pay has been BRUTALLY cut👇

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS 15/ Compare that to the "whole economy" and the differences are simply flabbergasting.

NHS = BRUTAL Real-terms Cuts - £3.3k-36k/ each and every year DOWN

Whole economy = NOT so much - six pounds down - £4k/yr UP

Please *ANY* politician tell me this is "FAIR" or REASONABLE 👇

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS 16/ Or maybe someone from the @bankofengland pipe up and tell us inflation "hurt" us all, and we STILL need to show "restraint" to keep our inflation targets

I think the public sector, and the NHS has been "restrained" a little too tightly, dont you?👇& P/S pay ISNT inflationary

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland 17/ As above, I've used CPI for my charts essentially because that's what government prefers to use (when it suits them, not in student loans where they use RPI which generally runs higher). Often £100k+ for med students. Disgraceful double standards. Pay erosion WORSE++ with RPI

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland 18/ With the exception of the outstanding JBM at the @FT & @instituteforgov who start pay charts at the start of "austerity" (which was when serious pay erosion started), other commentators arbitrarily choose Aug 2010 start as this is when one of the NHS digital data sets starts

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov 19/ Its perfectly possible to stitch this together to earlier copies of the same pay data (needing a small adjustment to account for the different junior grades recorded by headcount), and I would encourage those commentators to do that - otherwise its very unscientific…

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov 20/ …comparing apples with oranges when they are INVARIABLY quoted by the media (or by politicians) comparing to other figures including from the BMA and others.

If people want to "fact check" compare like with like, or not at all please!

#DontCompareApplesWithOranges

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov 21/ A few months ago we got the (tragic) news that public satisfaction has reached a RECORD LOW😔.

Some politicians blame "covid". The public who vote in a few days, are saying its "long waiting times, staffing shortages & lack of funding"

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov 22/ The data really do no support this being about "covid". Its MUCH deeper than that. Look at the @FT charts on the right - #waitinglists (& other metrics) are a #politicalchoice

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov 23/ Public satisfaction with NHS is ALSO a #politicalchoice- we *NEED* a government that values the NHS.

And that @VictoriaAtkins @wesstreeting requires government to restore pay if you want to fix waiting lists (& A&E waits & cancer treatments waits) you need to #FixPay.

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting 24/ Because pay is *CRUCIAL* to recruitment & retention.

Look how public satisfaction has fallen off a cliff, as NHS pay has fallen off the same cliff. Its all related to #RETENTION

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting 25/ I need to repeat that I have charted "junior" & consultant pay as they have the best data which are "official stats". SAS grade doctors (who just ended *current* dispute) & GPs (who voted 99% to reject their contract imposition) have seen similar,or worse but are more complex

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting 26/ So I have gone into some detail about "past", we must turn to the future. And the future is @payreviewbodies i.e. the "DDRB"

We now know per 👇 chart, economy as a whole (blue line) has now reached "pay restoration" versus 2008/9 based on CPI. Other comparators, even more

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting @PayReviewBodies 27/ Now, its our turn. Its quite right general population have reached #PayRestoration, & many have beaten inflation with pay up in real terms (& these esp. Prof Sci & Tech is our real comparator)

But to avoid more #DoctorsStrike government needs to commit to #FullPayRestoration

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting @PayReviewBodies 28/ @bma_consultants were clear with DDRB on their new ToRs "DDRB must take these into account now for the 2024/25 round, particularly IF WE WISH TO AVOID FURTHER INDUSTRIAL DISPUTES."

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting @PayReviewBodies @BMA_Consultants 29/ Indeed @thebma have been crystal clear with the DDRB & government

"IF THE 2024/25 pay award following the DDRB process is UNACCEPTABLE, they would take FURTHER REPEAT STRIKE ACTION to secure the pay awards their skills and expertise deserve."

You HAVE been warned

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting @PayReviewBodies @BMA_Consultants @TheBMA 30/ The NHS's most valuable commodity is its staff. And how those staff are valued by you is a #politicalchoice.

Just like waiting lists - its a political choice to fund the NHS (and its staff) adequately, or allow it to go terminally into decline.

Voters are watching 👀👇

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting @PayReviewBodies @BMA_Consultants @TheBMA 31/ But just like stocks & shares "past performance is no guarantee of future results".

Neither @conservatives or @UKlabour should assume past performance will GET or KEEP them elected.

We need to understand how you will #FixPay #RETENTION #FixWaitingLists #PayRestoration

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting @PayReviewBodies @BMA_Consultants @TheBMA @Conservatives @UKLabour 32/ Our NHS is on its knees. Staff (& voting public) know it. Its not due to striking NHS workers or (just) covid, but due to political choices @10DowningStreet

RT if you want this (or next) government to make the choices to fix this mess now #payrestoration #fixDDRB

@jburnmurdoch @FT @ONS @NHSDigital @NHSEngland @JCribbEcon @TheIFS @bankofengland @instituteforgov @VictoriaAtkins @wesstreeting @PayReviewBodies @BMA_Consultants @TheBMA @Conservatives @UKLabour @10DowningStreet 33/ And as for @VictoriaAtkins claim last week that resident (junior) doctors have the “most generous settlement in the public sector” from “independent” DDRB that’s just not true. These new charts show the full year effect of DDRB and they are STILL bottom of the chart

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