Dr Tony Goldstone Profile picture
May 1, 2023 29 tweets 49 min read Read on X
1/29 We need to talk about these graphs 👇

We have nurses & junior doctors on strike & consultants potentially joining them very soon. Lets talk about inflation & pay. How to fix this car crash (& perhaps more importantly, how NOT to). Please read full 🧵 to end and share / RT ImageImage
2/29 Lets start with the excellent pay graphs from the excellent @jburnmurdoch from the @FT published this week.

What do they show? They show we are NOT "all in this together" ImageImage
@jburnmurdoch @FT 3/29 Let me explain. The top blue line - representing "all workers" from "all sectors" are broadly close in pay terms where their pay was in March 2009 - before austerity began to bite (around only 3.1% below in real terms) ImageImage
@jburnmurdoch @FT 4/29 But nurses when measured against "CPI" measure of inflation are up to Dec 22 (the latest @NHSDigital data) are DOWN 12.2% and junior doctors a shocking 23.6% DOWN against this measure Image
@jburnmurdoch @FT @NHSDigital 5/29 Now you may have seen other figures, because of different ways of measuring the loss. First it depends WHEN the comparison STARTS- @FT graphs starts in Mar 09 (12 m to March 09) when public sector pay austerity broadly started, @NuffieldTrust👇 misses v steep initial loss Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 6/29 Secondly there are different measures of inflation. The most commonly used is CPI or "consumer price index", others include "retail price index". The former is preferred by government & economists.
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 7/29 The latter RPI runs higher generally, but is a valid measure & is even used by government i.e. in student loans.If you think these are bad 👇 those losses against RPI are much greater - nurses would be DOWN 23.7%, and junior doctors DOWN 33.6% (to Dec 22). Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 8/29 Finally there are different pay measures. The @FT have used official @NHSDigital "average earnings" data including for example overtime, out of hours payments etc. Others comparison may use basic pay, or "take home" pay which would include for example pension contributions Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 9/29 So many ways to skin a cat. If done correctly they are all valid. So since @jburnmurdoch excellent & shocking chart (LT) gots lets of traction, I set out to see if it was accurate. To do that, I set out to see if it was reproducible from publically available data (RT) ImageImage
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 10/29 And unsurprisingly given the total legend that is @jburnmurdoch @FT, his chart is accurate and reproducible. Junior pay is tricky due to contract change, but I broadly agree with his methodology to overcome this hence my chart (RT) is virtually identical to his (LT) ImageImage
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 11/29 The initial FT chart look at two groups who have already ballotted for IA - nurses & junior doctors. Other groups have seen similar terrible erosion of pay and are about to ballot if government don't get their act together including consultants which I have added below👇 Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 12/29 As noted above, there are different ways of looking at pay erosion for example using this "@FT methodology" (LT; gross earnings; CPI) vs for example that seen in the BMA pay campaign (RT; take home; RPI) - both are correct but expressing the loss in a different way ImageImage
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 13/29 So like junior doctors, consultants have seen AWFUL erosion of pay which is broadly equivalent to juniors when measured this way.

I can see why @jburnmurdoch has used "all workers, all sectors" as the comparator, but there are others which might be more representative Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust 14/29 So for example @ONS have other pay comparators like "professional, scientific & technical" which might be a more apt comparator for highly skilled doctors & nurses - this comparator does better than inflation in the same time period (grey line) Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS 15/29 Or perhaps noting the @bankofengland comments this week we all "need to accept they are poorer", maybe lets compare to how others are doing in another @ONS dataset "finance & business services" (grey line)

Maybe everyone isnt feeling poor in equal measure @bankofengland ImageImage
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland 16/29 So in summary so far, there is HUGE inequality on whose pay has been eroded. Nurses and in particular doctors of all grades, have seen the largest cuts making the UK very uncompetitive & "leaky" and unable to *RETAIN* doctors & nurses
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland 17/29 Lets now move onto solutions. To do that we need to UNDERSTAND inflation. There are two charts below on inflation, both showing the same thing - inflation.

The top graph show HEADLINE INFLATION. This is how prices change vs 1 year ago.

Bottom graph shows PRICES Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland 18/29 So when Inflation🔼📈(red shaded)- prices UP FAST

Inflation🔽📉(green)- prices still go UP but more UP SLOWLY

The crucial point is that *PRICES ARE ALWAYS GOING UP* (unless inflation is negative, which is rare) Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland 19/29 The *ONLY* way pay can compensate for this is with a *CONSOLIDATED* pay rise, a one off "bonus" does nothing to help you pay NEXT years higher prices, or later years, or indeed higher prices in your reitrement (another reason why rises must be consolidated i.e. pensioned) Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland 20/29 So you will have heard that inflation is coming down. And thats right it is coming down. So the @OBR_UK predict inflation will come down rapidly, largely due to falling energy prices which are now similar in price to the start of the Ukraine invasion. ImageImage
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK 21/29 Its great that inflation is coming down, but you're still poorer as prices will not come down, just rise more slowly.

To fix that your pay needs to rise. And many leading economists have debunked the myth that public sector rises are inflationary

@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK 22/29 So given at the time of writing this thread our nursing colleagues @theRCN are on strike, and have rejected a pay offer from government, lets have a quick look at that offer. To look at that offer, lets consider the impact of falling inflation as predicted by @OBR_UK
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK @theRCN 23/29 So @OBR_UK also predict what will happen to pay across the whole economy (thats the dotted blue line), now extended to end of 25/26. So the "whole economy" will be back up above that "zero" baseline (and no doubt our other comparators will do even better than that) Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK @theRCN 24/29 So where does that leave NHS staff? In a difficult place I would say. The 6% non-consolidated "bribe" (down orange arrow) helps staff for that year (22/23) but then leaves them right back where they started, which is massively down. Doesnt seem "fair" or "generous" me Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK @theRCN 25/29 I can see why @theRCN @unitetheunion @SCoRMembers have rejected this pay deal- quite frankly IMHO its an insult to their intelligence as as per the orange line below (broadly the same most AFC workers), it doesn't fix their underlying pay issue (assuming 2% 24/25; 1% 25/26) Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK @theRCN @unitetheunion @SCoRMembers 26/29 In the context of historic pay awards and predicted inflation, those predicitons are not at all unrealistic where pay has been severely restrained by the "not so independant after all" pay review bodies
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK @theRCN @unitetheunion @SCoRMembers 27/29 Similarly if government think these sorts of pay awards (i.e. 5%/2%/1% for 23/24-25/26) - or ANYTHING close to this, these pay disputes will NOT be going away any time soon Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK @theRCN @unitetheunion @SCoRMembers 28/29 To fix this properly, pay needs to be restored so those lines can get back to zero. Thats what "pay restoration" means. You can ONLY get their with above inflation, consolidated pay rises. The solution is as simple as that. That's what #payrestoration is Image
@jburnmurdoch @FT @NHSDigital @NuffieldTrust @ONS @bankofengland @OBR_UK @theRCN @unitetheunion @SCoRMembers 29/29 Our NHS is on its knees (left). Our 7m+ waiting lists and rising avoidable deaths are not due to striking NHS workers, or (just) covid, but due to political choices.

RT if you want government to make the choice to fix this mess now & properly #payrestoration #fixDDRB ImageImage

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More from @goldstone_tony

Mar 29
1/ NEW & IMPORTANT: LOTS of new data this week incl new pay data 28/3/24 👇 NEW charts incl NHS satisfaction (SPOILER: Its grim #MindTheGap)

MUST fix pay/retention to fix #WaitingLists- next GE WILL be won/lost on NHS.

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

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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 Image
@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" Image
Read 35 tweets
Feb 24
1/ *VERY* concerned about the quality & type of information coming to @BMA_Pensions members to allow them to make choices in regards to McCloud.

For members who chose to move to 2008 (so called "choice 2", we saw the first of this information last week - deep dive 🧵
Pls RT

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2/ OK first of all, lets rewind. Pre 2008 we were all in the 1995 section. For most members that had a fixed retirement age of 60, and gave us "80ths" of final salary. Work 40 years, get 40/80ths or 1/2 of your final salary. Simple. Back in the day contributions were 5% or 6%
3/ As we all started to live longer, government felt this was unnafordable as we were spending longer in retirement. So they introduced the 2008 scheme
- 1/60th not 1/80ths
- Retire at 65 not 60
- So called "Reckonable" pay - based on best of 3yr in last 10, inflation adjusted
Read 30 tweets
Feb 22
1/ NEW: Consultation response out & confirmaiton of rates 1st April '24 , dropping the 13.5% tier.

Grateful government listened to concerns about feezing the top tier so tiers WILL uplift with CPI, not creating (another) "fiscal drag" for higher earners

gov.uk/government/con…
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2/ This repesents a change from previously announced where tiers were to be uplifts of AFC awards (largest employee group). I had suggested a "double lock" of greater of CPI or announced awards, which was supported by the scheme board, but sadly rejected by government Image
3/ @BMA_Pensions again raised concerns that the @nhs_pensions has a higher contribution rate than many public sector schemes, and has the steepest structure.
We continue believe it should be much flatter, or flat, in a CARE scheme will all paying the same for the same £1 pension Image
Read 6 tweets
Jan 15
1/ NEW & BREAKING: @instituteforgov supported in analysis by @CIPFA issue an UPDATED pay erosion chart for NHS workers including @TheBMA doctors & @theRCN nurses👇

WHY is this so relevant: This now includes pay data released in '24 to Sept '23 INCLUDING 6/12 of 23/24 pay awads
2/ This crucially important 📉shows

- pay erosion in NHS from austerity
- uses CPI preferred by gvmnt & some economists
- crucially shows 6/12 effect of DDRB 23/24- starting basis for all pay deals (i.e. not a lot) Image
@RobLaurensonD4P @_VivekTrivedi @TheBMA @BMA_Consultants @BMA_JuniorDocs @Doctors_Vote 3/ So this chart uses the latest available data (released in 2024) includes the latest pay deals

Despite this @BMA_JuniorDocs down a STAGGERING 25.0% in real terms

REMEMBER: This is using CPI, not RPI, which would produce a higher figure (RPI includes mortgage interest etc) Image
Read 11 tweets
Jan 7
1/ *Deeply* worrying from @RishiSunak @10DowningStreet on @bbclaurak

Watch the clip in full 👇and pick out the blatant untruths - its so unbelievable they went unchallenged Laura K?

Apparently "The government has now reached resolution with every other part of the NHS. ....
2/ "Nurses, midwives, paramedics, consultant doctors, specialty doctors most recently. "
"So EVERY other part of the NHS workforce, and I'm grateful to them for everything they're doing, has reached a resolution with the government on a reasonable, fair pay settlement. "
3/ According to our PM

"The only people that haven't are the junior doctors."

How can this go unchallanged?

To be clear @BMA_Consultants (nor @BMA_SAS) have *NOT* "reached a resolution with government on a "reasonable, fair pay settlement"

This is simply NOT true
Read 15 tweets
Jan 5
1/ NEW & IMPORTANT: So we need to talk about NHS pay. NEW shocking [post DDRB] data just in 4/1/24 👇 (SPOILER: Not "fair & reasonable")

We need to fix pay/retention to fix waiting lists- increasingly clear next GE will won/lost on NHS

Please read whole 🧵 & share widely/RT

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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), and it was 👇chart from excellent @jburnmurdoch @FT that really showed this well Image
@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), its also the so-called "independent" DDRB👇

Apparently doctors & dentists should not be protected when "its not taking place in other groups" Image
Read 31 tweets

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