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Pension changes are not about protecting the taxpayer – they’re about revenue raising

The BMA hasn't voted to ballot on industrial action for forty years and reading health minister Simon Burns's article you might almost wonder what all the fuss was about.

That GPs already have a CARE (Career Average Revalued Earnings) scheme is true - although the minister compared the government offer to the 2008 scheme, which currently covers perhaps 1% of GPs. But any suggestion that all public service schemes are the same is simply untrue.

The NHS pension scheme, unlike most other schemes, was radically reformed in 2008 with increased contributions, a higher normal pension age for new entrants and a cap on employers' contributions, which specifically protects the taxpayer from bearing future costs. Furthermore the NHS scheme over the next five years is expected to deliver £10 billion more to the government than it pays out.

The new changes are NOT about protecting the taxpayer - they're about revenue raising, and in a rare moment of candour the government have been quite explicit in stating how much extra they want to raise by 2015 from the NHS scheme.

That 3.2% figure may not sound much until you realise that what they mean is 3.2% of the total pensionable income of the whole NHS workforce – all 1 million of us. The problem for many doctors is that the increase will be 6% by 2014 – almost double what we pay now.  In simple terms this will mean just under £300 per month out of taxed income for a typical GP partner.

Even more important is the problem for patients, who deserve the best and brightest doctors. Junior doctors qualifying with £30k in student debt and looking forward to paying an extra £200k throughout their career - five years salary for most juniors - are far less likely to commit to a lifetime career in the NHS.   Of course, many doctors are completely competent and happy to work into their late sixties or seventies.

However, medicine is demanding and stressful – recent research suggested that an alarmingly high number of GPs already demonstrate signs of burn-out.  Putting pressure on them to continue working to 68 or longer is only going to exacerbate that problem.

It's not surprising that more than a third of doctors over 50 intend to retire early if the changes go ahead.  And the same  thoughts will of course be occurring tonurses, porters and all the other staff who have dedicated their careers to the NHS.

The BMA's dispute is with the government not patients and we will make patient safety our first concern at every stage of any dispute. That is specifically why BMA council ruled out strike action and why we are carefully considering the form of industrial action short of a strike.

The government is fond of saying we're all in this together, although you might question how much this applies to bankers receiving tax-funded bonuses. But even in the public sector there is considerable variation. In the principal civil service scheme, senior civil servants receiving the same income as GPs will be paying about half as much in contributions for similar benefits.  

In fact doctors in general and GP partners in particular seem to be paying a uniquely high price for a crisis not of our making. The minister in his article utterly failed to address the issue of the unfairness of tiered contributions in a CARE scheme where higher earnings at the end of one's career, unlike in final salary schemes, have no additional benefits

A system which more than doubles contributions over six years across virtually the whole profession and introduces a much higher retirement age and lower pension is not the "minor readjustment" that government spin and right-wing newspapers would have you believe, it is a sustained attack on the long-term finances of every UK doctor. GP partners also pay the employer's contribution, that is, the funding we receive for it through the global sum can't be seen to fairly cover it. Taking into account added years payments, some GPs will be contributing well over 30% by 2014.

So the offer is ‘proportionate and fair', minister? No, I'm afraid it's not and that's why the BMA is balloting.

Dr David Bailey is a GP in Caerphilly and the chairman of the GPC in Wales