Dr Tony Goldstone πŸ’™ Profile picture
May 6 β€’ 18 tweets β€’ 60 min read Twitter logo Read on Twitter
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 πŸ‘‡

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 Β£38,764/yr
"Junior" docs (all gds) ⬇️⬇️DOWN Β£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 πŸ”ΌπŸ“ˆ(red shaded)- prices UP FAST

InflationπŸ”½πŸ“‰(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 πŸ‘‡πŸ˜” 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

May 1
1/29 We need to talk about these graphs πŸ‘‡

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
Read 29 tweets
Mar 21
1/ There's no doubt whatsoever that the changes announced in #Budget2023 will significantly help #NHSpensiontaxcrisis @JosephineCumbo

Many have contacted me since last week to say they are changing plans

Would make 3 points

(i) The media focus is on LTA but changes made to AA
2/ in the level has increased, and also a partial fix to #FixNegativePIAs and also minor changes to the taper. All of these will help doctors not reduce hours & avoid extras

(ii) The media focus is also on retirements only, but capacity in the NHS is also about how much work one
3/ can do *before* retirement. Changes to AA & LTA will help reverse the trend to reduce hours where people were being stung unfairly by both taxes. This element of πŸ”Όhours much more likely to make a big long lasting impact
Read 6 tweets
Mar 15
1/ BREAKING - #Budget2023 🧡 is now live

Chancellor @Jeremy_Hunt is on his feet and starting to give his speech. I'll be tweeting live on anything related to NHS pensions in particular (& lots of changes expected so pay attention!)

Read to the end, & RT once you have!
2/ There has been intense media speculation over the last week so we are expecting that will be movement on #pension taxation as per the headline of the @Telegraph yesterday.... so lets see what makes it to the FINAL budget 🍿
3/ Please make sure you read to the end

As with all of these things #TheDevilisInTheDetail, this 🧡 will expand during the chancellors speech, & finally detail will be added once the budget documents are added later this PM (including any required addenda as more detailed known)
Read 19 tweets
Mar 15
1/ Good article by @FT covering budget leak in Telegraph yesterday with a range of diverse opinions

ft.com/content/248b0d…
2/ The @FT covering a point I made yesterday questioning why the LTA is rumoured to be restored to its near previous peak, however the AA (a *much* bigger problem in the NHS), is being restored only to a fraction of it
3/ And whilst I agree with the quote it will help people doctors remain in the worforce.... (though raising the AA more would help even more) .....
Read 5 tweets
Mar 14
1/ Pleased that the government finally appear to be listening mode πŸ‘‡as to what will work (addressing root cause of the "doctors tax" as they call it - AA & LTA) rather than what wont work (massivley complex flexibility)

Some thoughts, please read & RT
2/ First things first - the obvious point. Whilst both taxes (AA & LTA) important, AA is significantly more of an issue than the LTA (& also has complexity of tapering). But lets take them in turn
3/ Weve been hearing for a while that government know the LTA is a problem for higher earner in the NHS. @BorisJohnson hinted that he will "fix it" in 2019
Read 12 tweets
Mar 11
1/ Good article @GPonlinenews

"GPs and consultants will continue to be 'pounded unfairly' by tax penalties despite changes to the NHS pension scheme announced by the government, doctors' leaders have warned."

gponline.com/nhs-pension-ch… Image
2/ @Vish_Sharm "Fundamentally, these changes do not directly address the issues caused by annual or lifetime allowance and do nothing for the tens of thousands of mid-career consultants and GPs, for whom partial retirement would not be an option" Image
3/ BMA pensions adviser Dr Tony Goldstone said on Twitter that the decision to delay partial retirement rules until October this year was a 'very poor decision' that could drive some doctors out of the NHS. Image
Read 7 tweets

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