Thursday, 9 February 2012
Fairness and Pensions
Speaking as someone who has worked in and around the NHS for years - as well as using it from time to time - my view is that while there's much to be admired there's also a great deal that could be improved.
But the trouble is that the NHS is so riddled with vested interests these days - that it's difficult to see how any radical changes can come about.
For years policy makers have talked about the need to refocus health spending - by spending progressively less on hospital based care and more on community based care.
Part of that debate has also accepted the benefits of integrating care services - by having a single provider instead of the present set up - whereby NHS and council-led services fight for supremacy and control over spending budgets.
Years later people are still talking about these issues as opposed to bringing forward plans to get rid of these turf wars - and focus on the needs of ordinary people.
Now everyone is agreed generally on the direction of travel - but nothing happens because the opponents of change influential within the NHS establishment - the likelihood is that nothing much will happen unless it suits the interests of the BMA.
The solution to every problem seems to be to form more committees and create elaborate structures - in which every professional group under the sun is represented and has their say.
In other words they talk interminably about things - for years on end - and ultimately the 'system' grinds to a complete halt and nothing changes.
But the NHS way of doing things affects other issues as well - foe example pensions for the most highly paid staff - doctors, senior nurses and other managers - of which there are many thousands.
Now a typical person in this group - not a real high-flyer - is currently able to retire on a pension of @ £50,000 a year - plus a tax free lump of around £150,000 after years of earning a high salary.
But their pension package is artificially boosted by the final salary element - by delivering what to most people looks like extraordinary amounts of money - a huge tax free lump sum and a generous pension which is much more than most people earn.
Now many of the people in this group get to retire at 60 if they want - much earlier than others - and they can even go on and work elsewhere including in the private sector for example.
To my mind this is an enormous waste of public money - such generous treatment for those at the top cannot be justified as far as I'm concerned.
So I would cap these pensions and lump sums at more reasonable levels - because they are film star amounts of money to most people - and that's on top of being very well paid out of the public purse for years.