Hello, dear Surrey Circle Health reader and welcome back to your regular monthly health news summary, having had a couple of months hiatus, not due to globe-trotting but rather the logistics of instigating a change of network broker partners, which bodes well for my brokerage firm having transferred from a mortgage-based network to one who specialise in Private Healthcare, having been recommended by a respected seasoned industry professional to join much acclaimed Sante Partners. Trusting that you enjoy these four articles from the past month: –

10^th BBC – Hospital waiting list tops 7.5 million in England

The waiting list for hospital treatment has topped 7.5 million people in England for the first time. It means nearly 1 in 7 of the population is on an NHS waiting list for routine treatment, including hip and knee operations. The number hit 7.57 million at the end of June – up by 100,000 on the month before.

NHS England said strike action had had an impact – junior doctors walked out for three days during June. That led to the cancellation of more than 100,000 appointments. The waiting list now more than 3 million higher than it was before the pandemic. Of those on a waiting list, more than 383,000 have been waiting for longer than a year.

The NHS is also continuing to struggle to see cancer patients quickly enough. Only 59% started their treatment within 62 days following an urgent GP referral during June. NHS England said it had been incredibly busy with a record number of tests and checks carried out and the number of people starting cancer treatment – nearly 30,000 – was close to a record high.

‘Significant Pressure’

The release of the monthly data comes ahead of the next round of junior doctor strikes with British Medical Association members due to begin their 4-day walkout on Friday at 07:00 BST. NHS England warned patients to expect “significant disruption” as junior doctors, who represent nearly half the medical workforce, walk out of both emergency and planned care. Later in August, consultants will take part in their second walkout.

Prof Julian Redhead, from NHS England, said: “Today’s data is a reminder of the significant pressure on staff with this summer currently on trajectory to be the busiest in NHS history, all while industrial action continues to disrupt services.” Roy Deighton, of the NHS Confederation, which represents hospital managers, said it was “unsurprising, but regrettable” that the waiting list had hit such a high.

11^th BBC – How much do junior doctors really get paid?

Junior doctors in England are starting their fifth round of strike action with no sign of a breakthrough in their bitter pay dispute with the government. The doctors’ union, the BMA, made headlines earlier this year when it said pay had fallen so far behind inflation that its members would be better off serving coffee than treating patients. The government described that as misleading and said the average junior doctor earns between £20 and £30 an hour.

In reality, that term – junior doctor – covers someone fresh out of medical school right up to those with a decade or more of experience. Pay is complicated, with salaries varying massively as medics move up grades when they become more skilled and start to specialise. BBC News asked two junior doctors, at different stages of their careers, to show us their wage slips and explain exactly how much they earn.

The New Starter

Dr. Robert Gittings graduated from medical school in Liverpool after studying for a master’s in infectious disease biology. Last summer, he started his first, or FY1, year as a junior doctor in London and is currently working on the infectious diseases ward as part of his rotation – where doctors get experience in different types of medicine.

“In my hospital, we have a lot of tuberculosis patients, patients with uncontrolled HIV, and we also get pneumonias and, sometimes, we get a tropical infection coming in”, he says. Robert is paid a basic salary before tax of about £2,450 a month for a standard 40-hour week – or just over £14 an hour. Then there are additional roster hours – which are compulsory – taking his average working week to 48 hours.

Under what the government calls a “final offer”, his pay will go up in October in two ways: a straight 6% pay rise and £1,250 permanently added to annual salaries – both backdated to April. That though falls well short of the 35% increase for which the BMA has been asking to make up for years of below-inflation rises. For Robert, the latest pay offer would be worth roughly £250 a month before tax.

He also receives extra payments each month:

• Another £1.04 an hour to cover the higher cost of living in London.
• An extra £147 for night shifts – about £5 an hour in June before tax.
• A fixed £122 a month as he must work one in every five or six weekends.  

With a total of 189 hours worked in June, £3,117.36 was earnt in gross pay. With total deductions of £953.35, means that Dr. Gittings take home income is £2,164.01 for the month of June 2023, equating to an annual salary of roughly £37,000.

“Sometimes night shifts can be really busy”, he says. “There have been times when I’ve had to manage a patient by myself who is deteriorating, and I have to do everything for them, just with advice over text message.”  

Junior doctors like Robert typically spend 5 or 6 years in medical school before starting their jobs. He says he graduated with about £50,000 of debt including tuition fees and in June paid back £75 in student loans from his salary. There are other deductions including £257 – or 9.8% of his wages – for a pension, with the NHS contributing 20.6% under the latest career average scheme, more than most private sector pensions.

He says he is now looking to take a year out to work abroad – probably in Australia. “I’m not confident the pay here is going to improve as much as I’d like it to,” he says. “I would really quite strongly consider staying there.”

The Speciality Registrar

Dr. Kiran Rahim qualified from medical school in 2011 and now treats sick children as a paediatric registrar – one of the most experienced junior doctor grades. “I was at work yesterday and it was really, really busy,” she says. “I was managing A&E – so taking in all the paediatric referrals, all the sick kids who needed to be seen. “Then managing the acute stay ward, making sure the children were getting their treatment, accessing and booking scans for them.”

Kiran has taken three years out to have children herself and is now working part-time while she looks after her young family, meaning her training – and her time as a junior doctor – has been “elongated.” For an average 3-day week, she is paid a basic salary before tax of roughly £3,315 a month – or just under £28 an hour – which is the same rate as a full-time doctor. Like Robert, she also receives London weighting.

In July, she was paid another £292 for night shifts and £132 for working 1 weekend in every 6/7. She says the “vast majority” of junior doctors at her level end up working extra unpaid hours before they can go home at the end of the day. “I can’t just leave a sick patient because it’s unsafe, and it’s not fair on the people who are already fighting fire on the next shift,” she says.

As evidenced by her payslip, Kiran did pay more tax than usual in July at £1,060.46 PAYE and £389.83 for class A NI, after she says she worked extra shifts earlier this year to cover staff sickness – that money should be refunded later by HMRC. She has just finished paying off her student loan, although she says – like other junior doctors – there are unavoidable costs which do not show up on her payslip.

She pays £433 a year to the GMC to be on the doctors’ register. There are charges to be a member of the Royal College of Paediatrics and Child Health, and she has had to pay thousands of pounds in exam fees. Plus, there is the cost of personal indemnity insurance – just under £700 a year – to protect her in case she is sued for medical negligence.

In a typical month, Kiran says she takes home around £2,400 after tax and deductions for a 27-hour week. If she was working full-time, then she would earn a total annual salary of roughly £69,000. “Pay is important but so are all the other things that make you want to go to work,” she says. “This is not the job I signed up to do 10 years ago and I have seen a decline in morale, in our working environment and in our working conditions.”

The government says it has accepted the latest recommendations made by an independent pay review body and its most recent offer represents an 8.8% annual pay rise for the average junior doctor in England. “Our award balances the need to keep inflation in check while recognising the important work they do,” says Health Secretary Steve Barclay.

24^th The Independent – Covid cases double in a month as scientists warn about spread of new variants

Hospital admissions are said to have increased after the discovery of Eris and Pirola strains, with cases almost doubling  in a month after the rise of the two new variants. According to the most recent government statists available, 875 cases were logged in England on August 11, compared to just 449 a month earlier. Hospital admissions have also risen by a fifth in a week.

UKHSA statistics show Covid cases in England rose from a seven-day rolling average of 373 on July 8 to 879 as of August 8. Also, 589 out of 6,500 neighbourhoods in England had detected at least three Covid cases in the week to August 12. The uptick comes after reports of a new variant called Eris which makes up one in four new cases. Also, another strain nicknamed Pirola is quickly spreading globally, Mail On-line reported.

Eris, officially known as EG5, accounted for 17.3 per cent of American cases as of 5 August, up from 7.5 per cent in the first week of July and surpassing a number of Omicron descendants like XBB.1.16 (15.6% per cent of cases), XBB.2.23 (11.2 per cent) and XBB.1.5 (10.3 per cent). The US is also seeing an increase in hospital admissions with coronavirus, its first significant uptick since December 2022. Pirola, known as BA.2.86 strain, has also been reported in Israel, Denmark and the US.

The UK Health Security Agency (UKHSA) said they are unsettled by the variant and suggested the rapid spread could suggest an international transmission. The total number of cases logged is now more than ten across seven countries and four continents since the strain was discovered earlier this month. Dr. Simon Clarke, a microbiologist  from the University of Reading, told Mail On-line: “We still don’t know how BA.2.86 is going to behave in a widely vaccinated population, but it appears to be travelling around the world on aeroplanes and has probably been doing so for a while.”

“The almost complete lack of surveillance means that we don’t have a full understanding of its spread, but it seems inconceivable that it would be limited to the case in London.” With the rise of new Covid strains and hospital admissions, scientists have called for the return of facemasks. Christina Pagel, a member of the Independent Scientific Advisory Group for Emergencies that advises on the virus, said: “Without ramping up surveillance, and in the face of waning immunity, we are travelling into winter more vulnerable and with blinkers on.”

Prof Pagel predicted the new wave could cause extreme pressure on the health service, with a repeat of last winter’s “unprecedented” NHS crisis of Covid, flu and respiratory virus that came all around the same time.

24^th Daily Mail – NHS to hit 1million cancelled operations because of strikes

Health chiefs are bracing for five days of major disruption as consultants down tools ahead of the bank holiday weekend. Routine care is expected to reach a standstill over the next 48 hours causing a ‘massive headache’ for hospitals, whose numbers are already depleted due to staff holidays.

As today’s action got underway, the British Medical Association announced plans for further strikes in the autumn, adding October 2, 3 and 4 to those already confirmed on September 19 and 20. Union officials said it was with ‘heavy hearts’ that consultants would head to picket lines today, stating it is 150 days since the Health Secretary last met with them.

More than 700,000 NHS appointments have been cancelled since the strikes began seven months ago. In the latest five-day walkout by junior doctors, more than 100,000 were called off. England’s backlog, for procedures like hip and knee replacements, now stands at 7.6million, official figures revealed yesterday. It means roughly one in seven people across the country are currently stuck in the system awaiting care. More than 380,000 patients have gone a year without being treated, often in agony.

Health Secretary Steve Barclay said he was ‘disappointed’ consultants had gone ahead with their action which comes despite a 6 per cent pay rise, while thanking those who ‘cut short’ annual leave to cover the last strikes by junior doctors. Consultants have also benefited from recent changes to pension rules, he said, and could expect to retire at 65 on an income in excess of £78,000 a year, adding that ‘this pay award final.’

Official figures show more than 897,000 routine procedures and appointments have been delayed due to eight months of strike action, costing the NHS an estimated £1billion. This tenth round of largescale strikes is set to tip the number of delayed treatments over the one million mark, with the true scale of disruption caused likely to be far higher.   

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So, there you have it good people, things certainly haven’t improved since June’s update, with this month’s visual from the BBC really capturing the acceleration of the record numbers stuck on waiting lists since the advent of Covid – It really doesn’t take the proverbial ‘rocket-science’ to see that the need for Private Medical Insurance, in order to support our NHS, has never been greater. If you concur you know where to come! Until autumnal October please take care, wary of the increased cases of Covid, whilst enjoying the advent of the new football season.

Take good care,

Yours sincerely,

Daniel Donoghue

MD, Surrey Circle Health

Specialist Whole of Market PMI Broker