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

Dec 26, 2024
1/ V. Important 🧵 if you are CONSULANT in England. This week I used my FREE modeller to identify & correct an error in #AnnualAllowance for 24/25 which I suspect may be a common error. It will save me over £2,600 from my AA liability, buckle up & see if you are affected
Ps RT Image
2/ As many of you will know Twitter/X is now really difficult to see the information you want to see from the people you follow so please help by RT, but also sending your colleagues on whatsap / FB groups if you think this will help them Image
3/ In preparation go onto ESR, download Mar '24, May '24 + Nov '24 payslips & 23/24 TRS (+/- 22/23 TRS) - and then I will talk you through IF you are also affected by this "misallocated arrears" error, tell you how to model the impact of this, and how to correct thisImage
Read 21 tweets
Dec 12, 2024
1/ THOUGHT FOR THE DAY: Whilst I'm grateful for the changes to LTA/AA, the AA and the dreaded #taper still remain. And here's your regular reminder why its PARTICULARLY unfair, and stupid, in the NHS (from @BMA_Pensions @TheBMA evidence to DDRB).

Short 🧵pls read & share Image
2/ We are all in CARE now, so should all be paying generally the same employEE contributions.

But we aren't - and its worst - by a garden mile - in the NHS per this chart showing the ratio of conts from the highest earners : lowest earners in the public sector 👇Image
3/ So unlike in the private sector where there is no difference in cost for higher vs lower owners other than tax relief, we go through this ridiculously unfair step in the NHS - far worse than anywhere in the public sector - that strips away our higher rate reliefImage
Read 5 tweets
Dec 10, 2024
1/ very important and NEW: @nhs_pensions have overnight issues guidance on 23/24 tax year where they have failed to send you a pensions savings statement on time (which was their legal duty)

nhsbsa.nhs.uk/public-service…Image
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2/ the bottom line is they expect you ESTIMATE your carry forward and PIA and any charge in the normal timescale ie by Jan 31st 2025 …. Which is going to be extremely difficult ….. Image
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3/ after you estimate you will have until Jan 26 to correct your estimation based on the real figures Image
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Read 13 tweets
Oct 30, 2024
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, 2024
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, 2024
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

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