By Lewis Morrison
This is a historic week for the medical profession as the British Medical Association (BMA) ballots doctors on industrial action. We are taking this unprecedented step in protest against planned UK Government reforms to the NHS pension scheme, which will result in NHS staff working longer and paying more into their pensions.
These reforms have not been negotiated, nor have they been agreed. They are being imposed upon NHS workers and, despite our best efforts, the Government will not enter into negotiations.
In its efforts to convince the public that what the Government is doing is correct, the Treasury says that all public sector pensions are now unaffordable and in need of significant reform. But not all public sector pensions are the same and these arguments cannot be levelled at the NHS pension scheme – which has recently undergone significant reform and which has been shown to be affordable and sustainable for the future. These changes are unnecessary and unfair.
Unnecessary because the NHS pension scheme was extensively reformed in 2008, and far from being in deficit provides a positive cashflow to the Treasury of around £2 billion a year. In 2008, the BMA agreed to a tiered contribution scheme where those who earned more paid more in contributions. We also agreed to an increase in the normal retirement age to 65 – and, perhaps most importantly, we agreed a cost-sharing arrangement where any future cost increases in the scheme would be met by pension scheme members, not by the NHS or the taxpayer.
On any reasonable test, the current coalition Government proposals are blatantly unfair. The reforms mean that all public sector employee contributions could rise by 6 per cent over the next three years regardless of where each employee group started. So, senior civil servants paying as little as 1.5 per cent will see contributions rise to about 7.5 per cent of salary, while senior NHS workers on the same income will have to pay 14.5 per cent. This is totally unreasonable.
These increases are nothing to do with the “improvement” of the NHS pension, but are a tax on public sector workers to fund the deficit of the Treasury, caused by mismanagement of the banking industry.
That doctors are considering industrial action is a reflection of just how angry they are at these reforms – but we want to be clear that our argument is with the Government, not with our patients. To that end, the form of industrial action we are proposing is based on an overriding commitment to patient safety. All emergency care or other care urgently needed would be provided, with doctors attending their place of work as usual. If someone urgently needed care, it would be provided.
However, services that could safely be postponed would not be undertaken on the day. In hospitals, this would mean that some non-urgent procedures and outpatient appointments are postponed. GP surgeries would not offer advance-booked appointments, but would be open and fully staffed so that they could see patients in need of urgent attention who turn up on the day.
The BMA hopes to work with NHS managers at a local level to plan for the industrial action, to ensure that patients are aware of the reduced services on the day and have as much notice as possible of any inconvenience or cancellation of appointments.
There is, of course a Scottish dimension – and while devolution has offered us opportunities to do things differently in Scotland, this is not necessarily the case when it comes to NHS pensions. The Scottish Government runs the NHS pension scheme north of the border and has told its NHS staff that while accepting the need for public sector pension reform, it has followed the Treasury lead of increasing employee contributions under the cosh of a pound-for-pound deduction from the Scottish block grant if it deviates.
Ultimately there is little scope for deviation from the UK proposals, particularly as the UK Government intends to legislate on its pension reforms and these will apply in Scotland.
Industrial action by doctors has always been a last resort. This Government, however, has left us no option other than to proceed with the first ballot of the profession since the 1970s. The solution is in their hands.
– Dr Lewis Morrison is a member of the BMA Scottish Council and chairman of the BMA’s Scottish Consultants Committee.