THE thousands of people scheduled for non-urgent operations or outpatient appointments three weeks today that will now be cancelled have every right to feel hard done by.
Hard done by is also how doctors are feeling about changes to their pensions so they have voted to postpone non-urgent treatment and consultations. The British Medical Association's (BMA) ballot for industrial action attracted a 50% response rate, higher t than for similar exercises by nurses or NHS members of Unison but still disappointingly low, given what is at stake. Separate votes for GPs, consultants, junior doctors, staff, specialists and public health found a clear majority in favour of industrial action in all branches of medicine except occupational health.
Despite a commitment to deal with emergency cases, this is a high-risk strategy. Even with the pension changes, doctors will enjoy levels of pay, job security and pension provision that are superior to those of most workers. To withdraw their labour, albeit for only 24 hours and with safeguards when many of their patients are facing difficult financial futures is more likely to lose than gain public sympathy.
That is not to dismiss their case. The crux of the BMA's dispute with the Government (throughout the UK because the Scottish Government has said it will follow the UK arrangements to avoid financial penalties) is that, under changes made only four years ago requiring doctors to work to 65, the current NHS scheme is sustainable. The BMA sees the additional contributions doctors will have to make under pension reform across the public sector as unfair because they will have to pay more than others on similar salaries, such as senior civil servants. It is true that doctors face a steep rise in contributions and will lose out in the general shift from final salary to career average pensions but the current surplus in the NHS scheme will be eroded by high levels of retirement over the next few years.
To suggest reform is unfair to the current generation of junior doctors starting out on a career likely to last 40 years or more, however, is to ignore two realities which doctors encounter every day. One is increased longevity resulting in the need to work longer to provide for a longer retirement. The other is the equally pressing need to ensure lower-paid workers have adequate pension provision if health disparities are not to deepen further. Only this month GPs from the 100 most deprived areas in Scotland pointed out that loss of benefits and worries about job security were causing increased mental and physical illness among patients.
Doctors must be well rewarded for their skills, responsibilities and levels of dedication frequently beyond the call of duty if young people are to be attracted into medicine as a career and retained in the NHS. Recent pay awards have taken account of the requirement on remuneration.
The BMA's best hope, if doctors are not to forfeit their reputation, is that the threat of industrial action will be sufficient to bring the Coalition Government to more constructive negotiation to achieve fairness across the public sector.
If industrial action goes ahead, it will seem a misjudged move on the part of the medical profession. Doctors who feel hard done by can afford to top up their pensions from their salaries. Withdrawing services will gain little or no support from the public or patients, both facing the prospect of stretching modest pensions to cover everydayv essentials.
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