SCOTTISH Health Secretary Nicola Sturgeon appears to want to have her cake and eat it over the controversial issue of NHS pension reform.

At a meeting with delegates from local medical committees yesterday, she was only too happy to make political capital out of the doctors' dispute with the UK Department of Health, which wants health workers to continue working to 68 and pay higher pension contributions. "It is galling to have a government that's willing to cut the top rate of tax while raiding public sector pensions," she told them.

At the same time Dr Dean Marshall, outgoing chair of the BMA's Scottish GPs Committee, accuses the SNP administration of being complicit in the Coalition Government's plans by suggesting its hands are tied. This issue has rumbled on for months and yet is still at the stage of talking about talks. Meanwhile doctors are on the point of balloting for industrial action for the first time since 1975.

Although public sector pensions are a reserved matter, Scotland has its own NHS pension scheme and the Scottish Government could come up with its own solution, including, if necessary, funding any shortfall from its own budget. Is it prepared to put its money where its mouth is? This is a complex issue. Though the scheme is currently in surplus, that could change as the baby-boomer generation hits retirement. Though portrayed by doctors as unfair punishment for government failure to regulate the banks, public sector pension reform is necessary because we are all living longer. Unlike the conditions imposed on many of their patients, the proposed scheme retains defined benefits and GPs can look forward to retiring on £40,000 a year. As today's GPs earn more than £100,000 for what is usually a nine to five job, many may consider that they can afford higher contributions.

On the other hand, having only recently agreed to work on to 65, it is questionable whether it is either fair or desirable to expect them to labour on beyond that, especially when senior staff in the emergency services can still retire at 55. In addition, because they are self-employed, GPs already pay their own National Insurance. In these respects doctors appear to be a special case and deserve to be treated differently.

In future years such tricky decisions could fall entirely to a Scottish Government. We are promised Scottish solutions for Scottish issues. We need one now to settle this dispute.