GPs and their hospital-based colleagues are striking this Thursday – 21st June – over changes to pension rights that would see younger doctors working to the age of 68 – the new state retirement age for everyone – and pay higher contributions.
The big question is not why younger doctors should not fall into line – with the pensions at the end of the process generous ones. Some get up to £50k per annum.
The real question is why many of our GPs are getting an NHS pension in the first place.
We sent this question to NHS Highland this morning:
‘We are unable to understand why GPs are amongst those prepared to strike on pensions issues.
‘GP practices are now almost universally serviced through what are business contracts – they apply on that basis, are considered against those criteria and are awarded contracts on service delivery.
‘This is very different from the earlier situation where individual GPs were appointed as employees of a health service.
‘We do not understand why, then, GPs appear to be given NHS pensions.
‘They are considered as self-employed, they are businessfolk.
‘We would expect that their pensions would therefore properly be their own concern.’
We received the following carefully worded reply:
‘I can tell you that GPs have been part of the NHS pension scheme since 1948 however in terms of answering your question I have been advised that you would be better putting your call through to the BMA who should be able to advise / point you in the right direction.’
We did exactly that – repeating the question verbatim to BMA Scotland and letting them know what NHS Scotland’s response had been.
We have now received this response from BMA Scotland:
‘As NHS Highland have explained, GPs have been a part of the NHS pension scheme since 1948. GPs are independent contractors and the terms of their contract includes membership of the NHS pension scheme.’
We can understand why, at the point where delivery of primary health care changed to an arms length service treated as a private sector business contract, those GPs who were already members of the NHS pension scheme should, in fairness, have been allowed to remain in it until their retirement.
There is, however, no defensible reason why new entrants to the profession following that change of delivery method should ever have been given NHS pensions.
This was clearly the power of special interest lobbying by the BMA at work in the face of government either weak or desperate to shuffle of as much responsibility as possible, whatever the cost and the logic of the cost.
GP contracts are already feather bedded. The responsibilities they carry are far less that they once were. The number of add-ons – of which the NHS pension benefit is one, underlines the grandiloquent carelessness our culture has been taught to accept in dealing with public money.
Where GPs fail to deliver what they promise on the award of a practice contract, there is little that can be – or is – done to redress such a situation. And there are no changes made to the financial terms of the contract.
Last month’s ballot of 104,000 members by the BMA returned a majority of around 4-1 in favour of the strike action proposed for Thursday. (And by the way, they will still be paid for the day because they are available for emergencies.)
4-1 is no narrow majority but a very substantial one.
Since then it is said that many are changing their minds, faced with the nature and volume of public disgust.
Today’s (19th June) Daily Telegraph quotes an MP – Conservative Sarah Wollaston – who is a former South Devon GP, as saying that ‘scores’ of doctors have told her that they are now unhappy: ‘I’ve had quite a few doctors contacting me saying “I did vote for action, because I wanted to express that I’m not happy with the pensions deal, but I’ve no intention of striking.” When it comes to the crunch, it will be a minority of practices that take action. Some doctors thought it was “madness” to take industrial action over pensions. Once you lose the public’s trust, it’s difficult to get it back.’
One can only hope that once the public wake up to the reality of this situation, it may be difficult to get the pensions back, never mind the trust.
Self-employed businessmen in other fields have to make their own pension arrangements and expect to do so.
GP practice contracts are not time specific.They are open ended.
The contract holder may normally continue to operate the practice for any length of time, without compulsion to retire.
There is nothing to stop a GP business with such a contract – if they do as other business people do and sort out independent pension arrangements – in turning in their contract at any age they like, younger or older and living on the considerable profits they will have made from the practice, in addition to their private pension.
This country, Europe and well beyond it are, in reality, facing potentially the worst recession we can remember with what is now widely accepted to be the inevitable collapse of the euro.
In Greece there are middle class professionals who cannot afford to eat and who are going to soup kitchens – with the Greek Government-to-be talking, unbelievably, about putting up VAT on food.
The British economy – which will be far from immune from the consequences of what is coming, even though this country is not a member of the eurozone – may avoid the worst excesses of the disaster of where Greece is today, but it will not avoid it all.
We predict that the medical profession will fear more to lose what it should not have than go all out to grab what is denied to others – and that the strike will fail to impress government.
Regardless of however strong or faux-responsible the doctors look on Thursday, government should demonstrate the resolve to play fair by taxpayers and the average working person – and make sure that no NHS GP contract from now on includes the indefensible goody-bag of an NHS pension.
Note: NHS Highland later described to us the GPs stance on pensions thus:
‘GP’s pay (Superannuation) into the NHS Pension scheme. The scheme is administered by the Government, the Government is altering the terms of the scheme. GP’s like all members of that pension scheme have a right to object to any change to that scheme.
‘They would first negotiate and then if required take industrial action against the scheme administrators, (not the patients or NHS Highland), to allow their views to be heard.
‘The concept is that GP’s are in a dispute with the administrators of their pension scheme, in this case, the government.’
This is useful information.
It does not make any impression on the issue that many current GPs should not, as self-employed private sector businessfolk, be given NHS pensions.
We are now interested to discover how many other areas of responsibility blurred between past and present practice, see private sector business employees on Whitehall pensions. Defence?