The coalition is facing industrial action by doctors for the first time since 1975. I have always considered myself a Conservative party supporter. However, in the 30 years since I qualified as a doctor it is illuminating that while in power the Conservative party has, on most occasions, instituted a pay freeze or below-inflation rises for the medical profession. This sends a clear message that the party does not value NHS medical care, despite political platitudes.
I predict most GPs and consultants over 50 will defer their benefits or take early retirement after 2015, when GP contributions will rise to 28.5% before added years. This will be because of the reduction in the lifetime allowance you have also introduced, which many will breach, and the increased contributions that make the benefits of staying in the scheme marginal.
GPs will follow the actions of many of their dental colleagues and form limited companies, so reducing their tax to the level of corporation tax – this is already happening among locums.
When new doctors join a practice they will join the company, leaving the NHS scheme if they are still in it. Under the age of 50 doctors will defer benefits, as they will be forced to retire at 66 to 68 – which many will not want to do if in the 1995 scheme.
Many will leave the country, especially if you follow the last 30 years of pay policy.
The Conservative party needs to decide where it stands on the provision of free healthcare and the NHS.
Obviously a completely free market – as many in the party would like – is incompatible with the NHS being free at the point of use, and this would condemn you to electoral failure. The policy of managed decline of doctors' pay and pensions means they are unlikely to co-operate with any reforms – and whether you like it or not, they are essential to healthcare and healthcare reform.
From Dr Geoff Davies, Clive, Shropshire
Open letter to Owen Paterson, Conservative MP for North Shropshire