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

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…
Image
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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