21 Jun 2012

Have doctors lost the pensions PR battle?

As doctors stage industrial action for the first time in 40 years, Channel 4 News asks if the move has lost them goodwill?

Health Secretary Andrew Lansley was quickly on the offensive, accusing doctors of simply protecting their own pensions: “The point is not a legal one, the issue is, is this the right thing to do? Why should patients be penalised?”

The action, in which doctors across the country have refused to carry out non-urgent work, has been a divisive one. In one corner the government is accusing doctors of penalising patients in order to safeguard their already generous pensions. In the other the BMA accuses Mr Lansley of dishonestly misleading the public over the issue.

Mr Lansley said doctors had been putting their own interests above those of their patients.

“These are many of them patients who could only dream of having the kind of pension doctors have,” he said.

“I think where the public are is that they think doctors should be well paid and they are well paid, they think they should have good pensions and they will continue to have good pensions, they think they should put patients interests ahead of their own interests and I agree with them.”

“Misleading comments”

The BMA says that doctors have already had to swallow pension reforms from the last set of changes in 2008. Under those reforms the state pension age was increased to 65 and doctors raised their contributions by 2.5 per cent.

BMA chair Hamish Meldrum said today: “Mr Lansley’s repeated and blatantly misleading comments about the NHS pension dispute only set back what he purports to seek to achieve – a quick resolution.

These are many of them patients who could only dream of having the kind of pension doctors have. Andrew Lansley

“It will sadly confirm that he is simply unable and unwilling to listen to the genuine concerns of NHS staff.”

And behind the to-and-fro and sound-bites and rebuttals, there is a deeper question. Why is the BMA striking over pensions, when it didn’t take equal action over Mr Lansley’s NHS reform proposals?

The BMA responded today that it could not. Industrial action can only be taken over a trade dispute or else it is illegal. Lansley’s NHS reforms, the BMA said, do not qualify.

What have they been saying?

Mr Lansley: Doctors are seeking a more generous deal for themselves whilst which would lead to a more unfair deal for NHS staff overall.
BMA: The government is trying to pit different sections of the NHS against each other. It adds that it is right that better paid members of staff contribute more to their pensions and does not seek to change that.

Mr Lansley: Taxpayers pay an estimated £67bn out of the £83bn cost of doctors’ pensions. Says despite claims that there is currently a £2bn surplus in the pension scheme, because more is being paid in than taken out, that this will change as more and more NHS staff retire and live longer.
BMA: The pension scheme does not work by building up a pot and that the £2bn surplus is paid back to the Treasury.

Mr Lansley: A combination of the global economic situation and people living longer means there has to be change.
BMA: Reform of the NHS pension scheme took place in 2008, negotiated between the government, employers and health unions, in order to make the scheme more sustainable for the future. A Public Accounts Committee report in May 2011 found that the reforms to the scheme are bringing substantial savings to taxpayers, with costs set to continue to be sustainable well into the future.

BMA: Doctors are contributing more than senior civil servants and judges.
Mr Lansley: Most senior civil servants get paid less than £78,000 compared with an average doctor’s salary of £116,500.

Mr Lansley: The reforms still provide doctors with an excellent pension with the average full-time consultant receiving a pension of over £43,000 a year for life as well as a tax-free lump sum of around £135,000.
BMA: The pension scheme is an important part of attracting doctors to the profession. Under the 2008 reforms there was an increase in normal pension age to 65 from 60 and doctors’ contribution increased from 6 per cent to 8.5 per cent.

So who is winning the PR battle?

Max Clifford of Max Clifford Associates says the BMA has made a PR gaff by withholding servicces from the public.

He said: “They have got a very justified claim, particularly when you look at civil servants, but this was the wrong way to go about it.

“They should have found other ways of getting their message out there. From a PR perspective it has not been successful because they’re already well-off and so many people out there are suffering.”

Read Victoria Macdonald's blog: why has it rained on the doctors' parade?

The health secretary’s message has been picked up on Twitter. A major focus of comment on the social networking site has been, as one tweet said: “patient needs are more important than the size of their wallets.”

Student Sam Higham, from Middlesbrough, wrote: “A doctor’s pension upon retirement is approximately 68K per year, the average wage is below 25k”

And 16-year-old Amy wrote: “Seriously don’t see why doctors want to strike, they have one of the highest paid jobs & pension, what more could you want?”

But elsewhere there has also been support with Stefan Liskiewicz in Kensington tweeting: “Why can’t doctors strike?! #doctorstrike If TFL and other services can strike for driving buses, why not life savers?!”

How successful has it been?

The BMA estimates that a third of GP practices have been taking part in the action. The Department of Health has issued rival figures, saying that just one in ten patients have had their treatment, operation or out-patient appointment cancelled.

A spokesman for the BMA added that four in five NHS hospital employers have postponed non-urgent cases scheduled for today, but said that the figures were difficult to predict because doctors taking part will still going to work, albeit only for urgent and emergency cases.

The BMA has also been keen to emphasise it is undertaking the action with “extreme reluctance” and that patient safety is its “absolute priority”.

In the capital, 90% of London hospitals were working normally, an NHS London spokesman said, and 17% of GP practices provided a reduced service.

Hull and East Yorkshire Hospitals NHS Trust said 14 operations and 146 outpatient appointments were cancelled compared with usual figures of 306 operations a day and 461 outpatient appointments. Seven out of 140 operations were cancelled at NHS hospitals in Nottingham.

Around 25% practices covered by NHS Bedfordshire and Luton were affected.

A spokesman for NHS South of England said 468 of 5,000 non-urgent operations were rescheduled and almost 3,500 outpatient appointments were affected compared with an an average of 47,000 outpatient appointments a day.

What’s it all about?

Under Mr Lansley’s proposed pension reforms members of the NHS scheme would have to work up to the state pension age of 68 in order to draw full pension.

NHS staff pension contributions would also increase with the highest earners contributing 14 per cent of their pay by 2014.

There would be a switch from a final salary scheme to a career average re-valued earnings (CARE) scheme for hospital doctors (GPs already have CARE pensions) from April 2015.