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Let’s talk about pensions

BMJ 2011; 342 doi: (Published 30 March 2011) Cite this as: BMJ 2011;342:d1939
  1. Kinesh Patel, junior doctor
  1. 1London
  1. kinesh_patel{at}

If you remember The Beatles growing up, you’re probably okay. If Led Zeppelin is more your thing then you’re probably going to be disappointed. And if it’s Kylie Minogue, well you’re doomed on many levels.

Yes: it’s the elephant in the room, the big issue that everyone avoided talking about until the recent Hutton report. Out goes the gold plated final salary scheme, and in comes a new scheme based on career average earnings, which will put an end to that merit award in the last few years of service topping up the pension. Out goes retirement at age 60; in comes retirement at 68 (for anyone who has qualified in the past 10 years).

Older doctors will be allowed to work a year or two less than this. And for all this you have the privilege of paying higher contributions, with less tax relief. Everyone’s up in arms. The BMA, the trade union Unison, and the Trades Union Congress are all incensed. Talk is rife of strike action and protests in the street. “We will not take this lying down,” is the familiar cry.

But what will actually happen? I’m not usually the soothsaying type, mainly because I don’t like being wrong, but this one is easy to call. We will roll over and take it, just like we take everything else handed out to us—from pay freezes to deteriorations in terms and conditions of service—with some disgruntlement but little else. Yes, we’ll moan and groan and there will be rumblings of mass defections to the private sector and abroad, but nothing of any great note will happen.

The only people unaffected by the reforms, those consultants near the end of their careers, may well jump ship while they can, into an easy retirement and with their pension preserved. With salaries frozen for the foreseeable future but pensions still rising with inflation (currently running above 4%), many are asking: why work longer for less?

It’s the solution to the workforce problem that no one expected. Junior doctors waiting for consultant posts, but disappointed by the sudden arrest in consultant expansion due to the financial crisis, will suddenly find jobs opening up where there were none before. Trusts will find that those older consultants, the awkward ones who were trained to have some independence of thought and the management unfriendly ability to say no, will leave en masse.

There is only one way to effect real change here. The prospect of paying large amounts for a pension of uncertain value 50 years in the future may be too much for some doctors to stomach, and we may see an exodus from the NHS scheme. That would turn far more heads than the usual vociferous but ultimately futile trade union protestations.


Cite this as: BMJ 2011;342:d1939


  • News: BMA warns of mass retirement after Hutton recommends end to final salary pensions (BMJ 2011;342:d1596, doi:10.1136/bmj.d1596); Trisha Greenhalgh on working harder for longer (BMJ 2011;342:d1616, doi:10.1136/bmj.d1616)

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