Dr Tony Goldstone Profile picture
May 6, 2023 18 tweets 60 min read Read on X
1/18 THOUGHT for the #Coronation W/E:

Our NHS is a "jewel in the crown" of UK. But pay in the NHS has been #RoyallyScrewed 👇

If you want to understand why nurses, junior doctors (& potentially consultants) are striking, start with this graph
Short🧵 pls read to end & share/RT Image
2/18 Firstly H/T @jburnmurdoch - the graph above was very much inspired by his excellent analysis & charts on NHS pay. This thread of his (which excluded consultants pay) is very much worth a read

@jburnmurdoch 3/18 But coming back to my chart you will see that measured against "consumer price index", pay versus that measure has completely failed to keep up inflation - with

Consultants ⬇️⬇️DOWN £38,764/yr
"Junior" docs (all gds) ⬇️⬇️DOWN £17,394/yr
Nurses DOWN ⬇️£5,146/yr Image
@jburnmurdoch 4/18 Its worth noting by the way that the term "junior" doctor includes all grades of doctors who may be 0-15 years after (5-6 years of) medical school - professionals who may be doing brain surgery independently & other complex tasks. Image
@jburnmurdoch 5/18 The most common come back when people talk about public sector pay is that "everyone has taken a hit" especially given high inflation, but as @JohnBMurdoch showed very nicely in his charts, NHS workers, especially junior doctors, have fared worst of all Image
@jburnmurdoch @JohnBMurdoch 6/18 Adding in consultants to that chart, you can also see comparisons not only to "ALL workers in ALL sectors" (@ONS blue) but also perhaps a more apt comparator "professional, scientific & technical" (@ONS grey) ..... Image
@jburnmurdoch @JohnBMurdoch @ONS 7/18 Or since austerity was caused by the 2008 financial crisis whereby colleagues in the finance sector were able to create too much money, too quickly - lets add in the comparator of "Finance & Business Sector" (@ONS green line) Image
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi 10/18 And if anyone says "but their pension is great" remember that pension is directly linked to pay - so huge erosion of their pay has led to huge erosion of their pension. So you *cannot* fix pay by robbing their pension.

#DontRobPetertoPayPaul
#DontRobPensiontoFixPay
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi 11/18 And as I explained last week

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 @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi 12/18 The *ONLY* way pay can compensate for this are with *CONSOLIDATED* pay rises, a one off "bonus" does nothing to help you pay NEXT years higher prices, or later years, or indeed higher prices in your retirement (another reason why rises must be consolidated i.e. pensioned) Image
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi 13/18 This weeks (albeit local) elections have shown two things IMHO

1) People are clearly not happy & I suspect very much at the top of the agenda is the perilous state of public services

2) The next general election will I believe be quite close & largely fought on the NHS Image
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi 14/18 It is also very clear that the problems in the NHS have been at least a decade in the making - waiting lists >7m, dire 4 hour A&E performance and worsening excess mortality 👇😔 Image
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi 15/18 But equally past performance is not a guarantee for future performance, and Ive not heard ANY of the major parties explain how they will get out of this mess.

One example i.e. @wesstreeting - scrapping non-dom & doubling med student / nurses wont help IF you cant #RETAIN Image
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi @wesstreeting 16/18 My belief is we can *ONLY* fix this properly by getting those lines can get back to zero. Thats what "pay restoration" means. The ONLY way to get there is with ABOVE inflation, consolidated pay rises. The solution is as simple as that. That's what #payrestoration is Image
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi @wesstreeting 17/18 My analysis (like @FT one) used "CPI" which is preferred by government & economists. But I think there is a strong argument to use "Retail Price Index" - after all thats what government continues to use in student loans & also includes mortgage payments which are going up
@jburnmurdoch @JohnBMurdoch @ONS @CommonsHealth @ERunswickBMA @TheBMA @patcullen @rcn @NHSEmployers @NHSProviders @NHSConfed @BrineMP @lucyallan @PaulBlomfieldMP @paulbristow79 @MartynDaySNP @CGreenUK @PauletteHamilto @drcarolinej @RachaelMaskell @JamesMorris @TaiwoOwatemi @wesstreeting @FT 18/18 Our NHS is in a dire state. None of this is due to striking NHS workers, or (just) covid, but due to political choices @10DowningStreet

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

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More from @goldstone_tony

Oct 30
1/ Well after intense media speculation re: budget (speculation incl. reduction of tax free lump sum to £100k; flat rate relief at 30 or 20%; lifetime allowance re-introduction & pension "flexibility" [i.e. balance between pay & pension] .. speculation can now END....
Pls RT 🧵 Image
2/ Its now time for @RachelReevesMP to deliver her first budget ... I'll be live tweeting anything significant with a focus on #pensions and #pensiontax (if there is indeed anything!)

So keep following! Appologies for any typos/errors read to end for any corrections & docs Image
3/ So following #PMQs there is a statement that the contents of some of the budget has been made public before the budget and expresses dissapointment that this has happened Image
Read 27 tweets
Oct 17
1/ Longtime followers may remember this update from 4.5 years ago. Id met the then head of @nhs_pensions and the senior leadership team. They made lots of promises to improve things around Annual Allowance that BADLY needed improvement....

Pls read, share and RT
2/ Chief among those promises was to have an end to waiting till October for a PSS. Indeed no more brown envelopes. 85% of people would get their "digital brown envelope" by June (starting in 2020) 👇

3/ And furthermore for those that dont get automatic PSS (then around 85%), 15% would be able to see in this portal, from June 2020 why they DONT have a PSS i.e. you need manual calculations, or they cant issue one as they are awaiting info from employer

Read 14 tweets
Sep 7
1/ ICYMI Ive done a couple of videos 📹 on the tapered annual allowance - and why it could be hugely problematic for higher earners in the NHS *THIS* tax year (24/25)

Its crucial you have an understanding of chart 👇 if you are in affected groups.

Please share 👇/ RT & 👀📹 Image
2/ This was the first of two videos introducing the problem via a real case study

I discuss why its crucial that @wesstreeting @jamesmurray_ldn get an urgent grip of the dreadful tax policies they inherited affecting lower and higher earning consultants

3/ In second video I discuss a case in more detail & look at some strategies to try & mitigate this nightmare tax cliff.

None are desirable & tax needs changing to remove the huge discincentives to not to extra work, or worse still, reduce current

Read 4 tweets
Aug 20
THOUGHT FOR THE DAY: many senior doctors desperate to help waiting lists & would be willing to give up evenings/weekends to help out.

But current tax rules will mean some could end up #PayingToWork 👇

RT if you want @wesstreeting @jamesmurray_ldn to fix this ludicrous tax trap Image
2/ Per the chart with taxable income 242,400 after income tax, NI and AA post tax pay is around 95,056.40

However the same member earning 199,999 also gets 95,083.88 post income tax, NI, and AA

Why would this member do over £40k extra work, and PAY TO WORK?? Image
3/ Looking at it the other way the member earning 200,001 takes home 72,584.96

But the member earning 157,500 takes home essentially the same 72,559.40

*HOW IS THIS FAIR*

[CLUE: it isnt] Image
Read 6 tweets
Jun 29
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

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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 33 tweets
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

Image
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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

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