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GPs are facing their biggest decision since 2003

The profession must now decide if it will consider industrial action over this unjustifiable pension deal, says Dr David Bailey

If you're a BMA member, you will have received, or will shortly receive, a survey from us in the post. It's vital that you complete it, as we're arguably facing our biggest choice as a profession since the contract negotiations in 2003.

Just as then, the implications on either side of the equation are very serious. Either we accept major changes to our pensions, or we prepare for the first ballot of doctors on industrial action since the 1970s.

The comparison with the 2003 contract ballot is also appropriate because our pensions are a crucial element of our remuneration – they're essentially deferred pay. Putting it bluntly, if you have an NHS pension, the Government's final ‘offer' will hit you very hard indeed. 

First, it will cost you much, much more, with your monthly pension deductions going up sharply in April. Contributions will rise massively, particularly for GPs with flatter income profiles throughout their career. If you're currently contributing 8.5%, you will have to pay a jaw-dropping 14.5% by April 2014, and virtually all full-time GPs will pay an extra 6% of their superannuable income by then. 

Doctors currently under 50 will also have to work longer to get a full pension – up to 68 depending on your age now. And although we already have a pension scheme based on career earnings, most GPs stand to get a worse deal in retirement.

Let's say you're 40 and a partner. Had you been able to remain a member of the 1995 section of the scheme throughout your career, with average earnings you'd receive a pension of £54,005 and a tax-free lump sum of £162,015 at age 60. Under the proposed career average scheme, you might eventually receive a pension of £80,819, but you would have to exchange part of it if you wanted a tax-free lump sum and you would have paid an extra £161,278 in contributions. You'd also have to work seven years longer before being able to draw your pension in full. Drawing it early would lead to actuarial reductions of 5% per year below your state retirement age.

The loss of the final salary pension – which is effectively a loyalty and excellence bonus – might also change employed doctors' perspectives later in their careers, and would be likely to alter working patterns. This is all being done on the pretext of ‘affordability', yet the civil service scheme appears to be able to provide the same benefits on about 70% lower contributions.

What's more, the NHS unions have already agreed (just three years ago) to a cost-sharing mechanism that protects the taxpayer against any future cost increases. None of the additional contributions will go toward your pension and are effectively a tax by the Government on the public sector to pay for funding shortfalls elsewhere. This extra ‘tax' will primarily affect higher paid public servants including GPs.

Contrary to some of the media reports, the unions have not agreed to the ‘final offer'. The BMA spent 2011 putting the case in the strongest possible terms to the Government that its changes were unjustifiable, particularly in the context of the 2008 reforms. We've now arrived at a point where further improvements to the offer through negotiation are not possible. 

However, I should emphasise that it's also too early to be talking about what form any industrial action might take, who would be balloted, or when. Before that, we have to gauge the views of our members. 

We need you to familiarise yourself with the Government's offer (visit bma.org.uk/nhspensionreform or register for one of our pensions roadshows), but most importantly to complete the survey. Doing so will let us know not just what you think of the offer on the table, but also what action you would be prepared to take next.

Dr David Bailey is deputy chair of the BMA's pensions committee and a GP in Cardiff