The first ballot of doctors on industrial action since 1975 will go ahead within weeks if the coalition government does not rethink the major changes it is making to NHS pensions. Many if not most people would get exercised about any threat to pensions and their work arrangements and in this regard GPs are no different. In other respects they are quite different. GPs take a long time to be trained but they are paid well. They are highly trusted by the public and risk jeopardising this, and but for the skill and knowledge of GPs the statistics on healthcare of the population would be very poor indeed.
Nevertheless, GPs are human – they expect to be paid for their jobs and to have the security of maintaining their lifestyles when they get into old age. And all too often one hears of the personal price that some GPs pay for a high pressured job. Medicine, as Professor Sir Cyril Chantler has said, ‘used to be simple, ineffective and relatively safe. It is now complex, effective and potentially dangerous'.
So naturally many GPs are furious with the threat to their pensions – to some this is hard to stomach on top of increasing responsibilities through ill-thought, poorly worked out reforms which they are being forced to implement. The BMA says that two-third of doctors and medical students are willing to consider some form of industrial action. Should this come as a surprise? Perhaps not.
GPs are not thrilled at the prospect of being forced to work until the age of 68 when many will want time for themselves and their families. Furthermore, which member of the public will want to be treated by a GP who is fading in his memory or his enthusiasm to work? We know that an increasing number of GPs face ill health in their advancing years of practice and also that there are more chances of them having to face the wrath of the GMC during their senior years.
I argued in my earlier articlefor industrial ballot over NHS reforms, and it is regrettable that the BMA denied us one. That was over principle, and this is about personal financial gain. At a time of increasing youth unemployment, and when doctors fare better than other sections of society, it would seem selfish to ballot for industrial action over pensions.
However there are compelling reasons why doctors are angry and hurt by the coalition's assault on many fronts. As many readers will be aware, NHS staff agreed to major changes to their pensions only four years ago. As a result, the scheme is delivering £2bn to the Treasury each year and staff bear the responsibility for covering increases in costs due to improvements in longevity.
Currently the NHS pension plan is in surplus, with more funds entering than leaving it, and the overall pension fund for public sector workers will be in surplus for a few years still. The departmental line on doctor's pension in the media is utter rubbish. For instance, "the taxpayer pays your pensions": GPs pay for their own pension pot which is, in effect, a simple savings scheme except for the anomaly that GPs will pay in more than they can get out. It's like putting £100,000 in the bank and after 30 years getting £90,000 back.
Then there is the line that ‘GPs' pension is a final salary scheme': it's career-average. And what about ‘GPs pension is gold-plated'? It is simple logic that if you contribute to a good pension pot that at the end of it you get your just reward.
The public may not like it when GPs resort to some form of industrial action, but they will have to understand that this is not something that comes easy to them, and many will struggle with the ethics of such action especially as they are so closely linked to the community.
Some in the media will portray doctors negatively, as well as distort the lines between industrial and strike action. But allowing the government to walk over them GPs undoubtedly leave them demoralised, angry and make them hostages to any other radical scheme that any government might propose in the future.
The last industrial action in 1975 by consultants and junior doctors has caused neither lasting damage to doctors' image, nor harm to the public. This one will be forgotten too, and if the outcome is favourable towards protecting GPs' pensions then the coalition will have gained the goodwill and the continuing enthusiasm of many through the testing years of traumatising reforms.
I fully support Pulse's 'Say No To 30%' campaign, and encourage every GP to make signing the petition their first step towards action. The magazine has pledged to highlight to the national media the key arguments against the changes, as outlined in this article - but it is up to us GPs to back the BMA's day of action.
Dr Kailash Chand is a former BMA Council member and set up the ‘Drop the Health Bill' e-petition.
