The health secretary better be careful his changes to GP pensions don’t put his other more cherished reforms in the deep freeze.
Britain has been gripped by a freezing winter over the past week, but the ice health secretary Andrew Lansley is skating on still looks thin.
He is bullish to the point of belligerence when he insists there can be no compromise over his health reforms, even as they come under close scrutiny from within his own Government and strong challenge from GP leaders.
Just over a month ago, Mr Lansley was insisting he had the broad support of the profession for his commissioning plans.
He could hardly credibly claim that now, with the RCGP and BMA joining forces to oppose key elements of the white paper – particularly its intention to hand responsibility for NHS rationing to GPs.
Mr Lansley is having to defend his NHS reforms against scrutiny by key coalition figures, notably Conservative policy guru Oliver Letwin.
It is hard to stress how much he needs to keep GPs on board for at least the more popular aspects of the white paper, such as the plans to allow them to reshape NHS care.
In that context, there are two places he would be advised not to go. He ought to avoid hammering GPs on their pay, although he is already ignoring that advice by freezing the pay review process for two years. And he should surely avoid clobbering GPs on their pensions, which is why it is so disappointing to learn that his Government plans to do just that.
Of course, it’s no news that the Government has public-sector pensions in its sights. It is waiting eagerly for the final report from Lord Hutton as the trigger to pounce.
But GPs have already undergone a round of tough negotiations over their pensions and been forced to agree to many of the key recommendations Lord Hutton is likely to make, notably an increase in employee contributions. It is both depressing and deeply unwise for ministers to be planning another round of pain.
The Department of Health reveals this week that its planned reforms to GP pensions will involve ‘progressive changes’ in employee payments.
The real question though is what else they will involve, with strong speculation the BMA may be asked to agree to a compulsory switch to the terms of the new NHS pension, which has a retirement age of 65.
As one indication of how popular that might be, the new NHS terms and conditions have been taken up by only 6% of those to whom they have been offered.
Another, more colourful, indication comes from Bob Senior, chair of the Association of Independent Specialist Medical Accountants. He insists forcing doctors to work until 65 would prompt protests ‘to make the student demos look tame’.
GPs may not be about to start flinging fire extinguishers from the roof of Conservative Central Office. But if they are denied their promised pensions after long and hard careers, the profession will be gripped with a cold fury.
Mr Lansley has already seen GPs’ initial sunny optimism over his white paper darken with the longer nights. He’d better be careful that pensions reform doesn’t so chill GPs’ attitudes to the Government that it puts his cherished reforms in the deep freeze.