FactCheck: Who really stands to lose out under NHS pension changes?
The claim
“It’s not just about doctors – it’s also about the nurses and the physiotherapists and everybody else in the pension scheme, who are also being asked to pay a lot more for their pensions and they’re getting less back for it.”
Dr Tom Dolphin, British Medical Association, 18 January 2012
Cathy Newman checks it out
Ministers have repeatedly claimed that their reforms to public sector pensions will spare the worst-off. That’s been disputed by the British Medical Association, which is threatening to go on strike. The union, which represents GPs and hospital consultants, says the changes won’t just hit its wealthiest members hard, but low-paid NHS workers too. The FactCheck team has been finding out who’s right.
The analysis
Working out who will be hit hardest by the changes is a tricky business. There are a number of calculator tools and case studies available online, but most of them have been designed either by the government or the unions.
Independent pensions consultant John Ralfe has now produced the most comprehensive independent analysis yet of how changes to the NHS scheme will affect various health workers.
There’s no dispute that most public workers will end up paying more and working longer under the government’s proposals.
The BMA says that in itself is wrong because the deal agreed in 2008 should have been the final word. They say the current scheme is sustainable because £2bn a year more is paid into the scheme than is paid out to members at the moment.
Mr Ralfe, the former head of corporate finance at Boots, says the money being paid out now doesn’t tell us anything about what we will need to pay out in twenty or thirty years’ time as the young NHS workers of today approach retirement.
He said: “It is a nonsense to say that the NHS pensions contribute to the exchequer, which looks at past pension promises. The correct way of looking at pension costs is to say how much has to be put aside today to meet pensions being promised today.”
If you accept that there needs to be some reform to head off the threat of spiralling future costs thanks to Britain’s ageing population, the next question is: how should the burden should be shared?
Doctor’s pensions now
GPs’ pensions are calculated according to their average earnings over the course of their career, but for consultants (hospital doctors), it’s the final salary that matters.
That’s an arrangement that suits both kinds of doctor, as GPs tend to get into higher wage bands earlier but earn lower final salaries, while consultants start off more slowly before getting earning big money later on in their career.
But there are big differences in the overall generosity of the different kinds of pension – and the contributions made by the taxpayer.
According to Mr Ralfe, a GP currently gets a pension equivalent to 33.5 per cent of salary, slightly more than the average NHS worker. The taxpayer stumps up about 25 per cent of salary and the rest is topped up by employees’ contributions – 8.5 per cent of salary for GPs and 6 per cent for other NHS workers like nurses.
With consultants, the overall generosity of the pension is 48.5 per cent of final earnings, and the share of that contributed by the taxpayer rises to a “whopping” 40 per cent of salary.
So pensions for hospital doctors are currently about 50 per cent more generous than hospital staff like nurses as well as GPs.
Mr Ralfe says that a consultant retiring aged 60 after 35 years on the median average salary of £120,000 would get a pension of £52,500 a year plus a cash lump sum of £157,500. The equivalent cost of buying this pension in the private sector? Around £1.6m.
What about after the changes?
The government wants to start calculating all NHS pensions on the basis of career average earnings, rather than final salary. It also wants staff to work longer in line with changes to the state pension age.
And there will be increased employee contributions on a sliding scale for all staff who earn more than £26,557.
In return, NHS workers are being offered a more generous “accrual rate”, the amount earned each year. That will rise from as little as 1/80th of salary [plus a cash lump sum of three times the annual pension], depending on the individual scheme, to 1/54th. Most of the phases will be phased in from 2015 and people within ten years of retirement will see no change.
For GPs and other NHS workers, the reforms will make very little difference to the generosity of their final pensions, but the cost to the taxpayer will fall from 25 per cent of salary to 17.5 per cent of salary for GPs and 23 per cent for other workers. Scheme members will have to work longer and pay more to make up the shortfall.
But the overall value of hospital doctors’ pensions will plummet from 48.5 per cent of salary to 32 per cent, with the cost to the taxpayer more than halved, falling from 40 per cent to 17.5 per cent of salary.
Contrast that with the average NHS worker who, according to Mr Ralfe, will actually see the value of their pension go up very slightly (from 31 to 32 per cent), while having to pay an extra 3 per cent of salary and having to work slightly longer – contrary to Mr Dolphin’s words on Channel 4 News last week.
All of this begs the question of who the BMA is fighting for – its lowest or highest-earning members? If Mr Ralfe’s analysis is correct, consultants have the most to lose while GPs, like other NHS workers, have relatively little to complain about.
That’s why Mr Ralfe suggests that a move to a career-average scheme must be the fairest kind of reform for most NHS workers, and opposing such a move suggest that the BMA is motivated more by protecting the interests of the highest-earning hospital doctors.
He concludes: “The current final salary for Hospital doctors, worth 40 per cent of salary, is undoubtedly extremely generous, half as much again as the rest of the NHS, including GPs.
“Because of the complexity, and lack of understanding, of pensions, this major part of their overall remuneration is disguised. If the BMA believes the overall remuneration of hospital doctors should not be reduced, rather than holding out against the pension reforms, it should make the case for higher, and transparent, basic salaries.”
Cathy Newman’s verdict
So the BMA’s wrong to say nurses are paying more into their pensions but getting less in return, according to John Ralfe. They’ll get the same or slightly extra. Hospital doctors stand to lose the most – but as the average consultant receives a pension of more than £50,000 a year, plus a six-figure lump sum, they might not get much public sympathy.
The analysis by Patrick Worrall. Data supplied by John Ralfe Consulting (www.johnralfe.com)
There are 35 comments on this post
Cathy Newman’s claims to be presenting a ‘Fact Check’ doesn’t stand up to examination. It betrays a slap-dash approach and a basic lack of understanding of the pensions issue. The claim that in future nurses will pay more, work longer AND get less is NOT undermined by Ralfe’s ever-so-clever ‘analysis’ that they will get an annual pension worth 32% of their salary rather than one worth 31% now.
Why? Because the Normal Retirement Age for nurses in the NHS Pension Scheme is being raised from 65 to 68. So, given that they are not going to magically live an extra 3 years to compensate, many will actually lose 3 full years’ worth of their pension, AND they are going to be paying into the scheme for an extra 3 years. So, yes, they WILL be paying more, working longer, AND getting less in return OVER THEIR LIFETIME AS A WHOLE.
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Nurses will get the same or greater pensions–true–BUT ONLY IF THEY WORK 8 YEARS MORE, PAYING FOR IT FOR 8 YEARS MORE AND DRAWING IT FOR 8 YEARS LESS!!!
It is diengenuous of you not to make this important point and to accuse Dr Dolphin of lying. He is not. You just refuse to understand his point.
Hospital doctors get a good pension–BUT THEY PAY FOR IT! The 2008 readjustment made everyone pay more, not just new joiners, with higher earners like doctors paying a higher proportion. There was also a commitment to increase contributions if the scheme paid in less than it drew. Therefore the 2008 scheme is always going to pay for itself at no cost to the taxpayer!!!This was a contract, a deal, for life. It is grossly unfair that after only 3 years the contract will be broken, to bail out the treasury.
I suggest you get a new independent advisor. He is not giving a balanced view.
If you really want to find unfairness, compare doctors with civil servants, local govt, judges and MP’s–they all get similar or better pensions but pay considerably less for it than doctors, and their schemes are in the red already!! Why are they so special to society?
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You’re right about working longer Sean. Under the new deal, nurses’ pensions will be worth the same or slightly more, but they do have to work longer to get them. Most employees, whether private or public sector, are having to work longer to fund their retirement. But they’ll live longer too. Thanks for commenting.
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Pworrall – 8 years of working extra from age 60, is asking a lot from nurses and doctors, who work in a stressful environment and often work anti-social hours on a shift system. It is well known that shift workers have a shorter life expectancy compared to 9-5 workers. It is also known that doctors who retire at 65 have a significantly shortened life expectancy compared to those who retire at 60. Essentially “work till you drop”, we pay more, work longer, get less and may not even be alive long enough to enjoy! All we want is our contract to be honoured and given the reward we deserve.
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Sorry Cathy but there are flaws in your arguements on this.
Doctors pay significantly more in taxes compared to most, take less out of public resources and are therefore net contributors to society. We work long unsocial hours, have to compromise and make sacrifices throughout our life of public service. Our training comes at significant personal cost – physically, mentally and financially. We choose this career knowing this but we want to contribute to a better, healthier society through this public service. All we ask is that we are treated fairly and not get punished and taken advantage of.
Our pension has already deemed to be sustainable. The money paid into the NHS pension fund is far in excess of what is paid out from it. Why should doctors get effectively taxed twice? Doctors work and train very hard and deserve appropriate remuneration.
If we have to contribute more to our pensions to reduce the tax payers burden, I would agree with that. I do not see why we should get less in return for paying in more.
It is a shame the BMA representatives who appeared on Channel 4 News were not more articulate in their arguements
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You are missing the point. We agreed a whole scale reform of NHS pensions in 2008. This was supposed to be future proof but the Government has unilaterally withdrawn. This despite the fact that the NHS pension scheme nets the Government an annual profit of £2 billion. You say pensions won’t change much implying people aren’t really losing out. But contributions will increase substantially (up to as much as 14.5% in some cases) and retirement will be later (i.e pension duration shorter) so that is all “lost money”. This is not a fair reform of the scheme. It’s a simple tax on NHS workers. Why should civil servants, for exmaple, contribute significantly less for the same pension? And why are MPs and judges schemes not being refomed at all?
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Thanks for your comments Steve. On the point of the £2 billion surplus, that is considered a myth by Ralfe (and many other pensions experts), as touched on in the piece. Of course you’re welcome to disagree!
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@pworrall – thanks but actually the figure of £2 billion is NOT mine – it’s from the Government’s own actuaries who presumably inform Government decision.
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I think the goverment need to look at the work load that NHS employees are expected to carry out. Most Nurses, porters etc have a physically demanding and job and are subjected to abuse on a regulaur basis. Now with job cuts and reduced staffing in many areas this also increases the work load and stress levels. Now with the new propsals we are expected to work until we are 68 will this be a physical possibility. We have already made reforms to the pension scheme. One of the reasons I have only in the NHS is because of the pension benifits. I could have joined an agency and made much more money thus costing the NHS more money to pay my wages.
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When doing such analysis, you have to – in the post-reform scenario – also value the impact of a member receiving a pension for a shorter period of time and the move to CPI – the size of benefits received at retirement is only one part of the whole equation. If did this, it is clear that all members in the scheme would be worse off, Those who have a consultant career (or a high flying one) would be heavily affected mainly due to the move to a career average scheme; while the others would be hit by having to work longer and getting less during retirement as a result of CPI uprating rather than RPI. Another point, the pension reform changes is not really an issue of ensuring sustainability: they are more about saving money. Often this is justified by pointing the big disparity between the public and private sector. but this is foolish as the private sector has decided to concentrate wealth at the top and leave the vast majority of workers to fend for themselves, which will is not a great model to follow but a call for change in that sector. However, the change to a career average scheme can be justified on the grounds of fairness between workers so this is a sensible reform.
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Your ‘average’ hospital consultant is a figment of your imagination.
where on earth do you get your figures from?
120k a year and a >50k pension?!
absolute rubbish!
not so long ago you chaps were talking about the ‘average’ GP earning 100k/yr !
You are being rather disingenous here. either that or just plain bad journalism.
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Jo – figures for consultants’ pay are available for the government. Here is a typical study (Slightly out of date but things haven’t changed much since 2010). http://bit.ly/AeHye0
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On the surface, this looks a good reference, but you used the mean of £120k as a basis for pension calculation. This is incorrect, as much of this is not pensionable. Firstly, pension is paid on the first 40 hours/week only. Most consultants work regular paid extra sessions voluntarilly, or the hospitals would go bust–these are not pensionable. Secondly, some do extra temporary “waiting lists” which again are not pensionable and greatly skue the mean by the few very high earners. The figures also include Clinical Excellence Awards–levels 1-8 were reduced by one third in 2011 and levels 9-12 by 50%–the latter have been abolished in Scotland and N Ireland and England will probably follow this year. The top consultant increment is £100k and it takes many years to get there. Mean consultant pay in 2012 onwards will fall dramatically as a result of reduced CEAs and reducing waiting list work. There has been a freeze on inflation pay increases for 4 years. Now they want them to pay more for their pensions. Inflation continues, taxation has increased and consultant realisable income is collapsing. Is it any wonder they are unhappy?
Your advisor should know better!
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When I started out on my career as a hospital doctor the deal was, “earn little, work many hours, put your life on hold ,stay late to ensure the right thing gets done for that sick person.” in return, i have a job i enjoy, a job for life and a comfortable pension.Not a bankers pension. Fair reward. That was the deal. I could have done many careers, and all of them pay a whole heap more and demand less of my time than the path I actually chose. I currently work 1 night in every 4, and I fully expect to do that every 4th night until I retire.
When patient’s see me, they know I will do my hardest to do the right thing for them. In return, I looked for the government to do the right thing for me. They are NOT doing the right or fair thing. 2/3 doctors are thinking about industrial action, something I would have never have thought would happen in my lifetime.
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I will take the hit happily as soon as I see judges,civil servants and MPs doing the same………
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You fail to mention the lump sum issue in this as well. You also miss out the fact that retiring in both schemes at age 60 would mean a 15% loss of accrued pension for those under the new scheme. Makes me concerned how much more of fact check is a misnomer.
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Using Ralfe as an ‘independent’ analyst is at best misleading, FactCheck is or at least was respected as providing an objective view, this piece woefully undermines this position.
No account taken of opt outs, pay freezes, job demands or anything else that does genuinely have an impact on pensions, simply an unquestioned repitition of Ralfe’s particular obsession. The impact of reforms over the last few years is marginalised as it doesn’t suit his argument which seems to be the best pension is the worst pension regardless of the wider cost of poverty income in retirement.
To claim that the mainstream NHS worker ‘has little to complain about’ when the reality is they are being priced out of pension saving is simply lazy journalism. For a lot of NHS workers who are not earning big wages, the increase in contributions by 2015 means that regardless of the scheme’s benefits, they won’t be able to afford to participate. Just like most low and moderate earners in the private sector can’t afford a decent pension.
Who benefits from no one being able to afford to save efficiently and securely for retirement? Not those affected, ‘indepedent consultants’ are probably…
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What a disgraceful interview – is Cathy Newman employed by C4 news or the Conservative party ? This interview was deliberately biased and disengenous from the outset – this is not the standard of journalistic integrity I expect from C4 news. The key facts were simply ignored by C4 from the outset; pay more, work longer , move from RPI to CPI. The effect of these changes is obvious – the pension received will be massively reduced. I would suggest you focus on why failed bankers receive massive bonuses. What you completely fail to understand is that being a doctor is a massive lifelong comittment only undertaken by the best and brightest students. This society’s message is clear – don’t bother with medicine; you have to work for a living and it’s hard going, head off to the city and become a bankster; you get millions for being a useless spiv!
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Cathy
You need to say that “They’ll get the same or slightly extra” each year after retirement . There will be fewer years after retirement so you and your critics are both right. But you should take the point if the usually excellent fact check is to retain credibility
Rob
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Poorly researched, prejudiced, “How many words do I need to submit?” journalism.
Is this really the best Channel 4 can do?
A career in The Independent beckons.
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Dear Cathy,
please get your facts right. There are two pension schemes at the moment. 1995 and 2008.
1995 scheme for consultants is final salary (dependant on number of years of service), a lump sum payment and retire at 60.
2008 scheme for consultants is career average, NO lump sum payment, retirement at 65 (penalised pension if you retire earlier) and increased contributions. NHS Pension workers can move to this scheme.
Yesterday you quoted the 2008 scheme as “feeble”, doctors made compromises to the 2008 deal to make it sustainable. Hospital doctors take a lot longer to get to the higher pay grades because of length of training and career average leads to a lower pension payout.
Without sounding arrogant doctors are highly skilled & extremely hard-working. The government/public must realise that if consultants and GPs were working privately they would get extremely more money. In essence the public are getting a very good deal with what they pay doctors. So be careful what you wish for. Unless this is an underhand way of backdoor privatisation of the NHS. The government have reneged on a deal and are using this as a tax grab. I doubt you would respond to…
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As an admirer and long time viewer of C4 news, last nights ‘Fact Check’ was disappointing. Dr. Dolphin was quite right since it is clearly appropriate to consider total life time contributions rather than ignoring the additional 5-8 years required under the proposals.
Do “Fact Check” fact check their own articles? Dr Dolphin is referred to as both Dr. and Mr. A cursory google search suggests he is a doctor who is not a surgeon and therefore not a Mr.!
I’ll continue to watch and follow Cathy & Jon on Twitter but I’ll be less trusting of what I’m told. Disappointing. Poorly researched and in my opinion a biased argument presented!
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So Cathy – with all the comments above, are you prepared to retract? Or is that a mutually exclusive concept with UK journalism these days?
In 2008 the NHS pension scheme was reviewed and revised with all party agreement. This produced a future-proofed scheme that would net the Governement, at least in the short term, £2 billion annual profit.
But that agreement has been unilaterally torn up for nothing more than ideological reasons and fiscal vandalism.
Doctors are not asking for a pay rise, even though they enter 2012 with their 4th consecutive pay freeze. Doctors are not asking for a better pension than they already have, having agreed to substantial changes and increased contributions in 2008.
Instead they simply want the agreements reached with Government in 2008 (and agreed by all sides that it would be left alone for many years to come) to be honoured.
Instead of trying to take an extra £3billion stealth tax from NHS workers how about the £26 billion of unpaid tax from British business, or the ever-increasing city bonuses, or the myriad tax avoidance scams?
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A few other facts:
Hospital doctors used to pay 6% of their salary towards their pension and in 1998 it became 6.5% in most cases – hardly an onerous increase or a radical change.
NHS employers (you, me, the government) contribute 14% which is more than twice what the employees pay. Private sector employer contributions (where they happen) are usually around the same as employees so NHS staff, comparatively, get a huge extra subvention from taxpayers.
The NHS Superannuation Scheme is not funded and has a net liability of £287 billion as at 31 March 2010.
Why should those with no occupational pensions or pensions they pay through the nose for subsidise public sector pensioners to such a huge extent?
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Dear Framer,
yes it has increased to 6.5%, and higher earners pay 7.5% and 8.5%. The point is if you get paid more you are already paying more as contributions are based on percentages. This is simple maths.
The NHS Pension scheme has always been regarded as one of the best pension schemes in the world. This is a reward to all the hard-working people, nurses, doctors, porters etc. who have given a life-time of public service and from my experience gone over and above the call of duty every single day. There is and always has been a certain amount of goodwill amongst NHS workers. But now we feel enough is enough and we need to make a stand. If the government do not appreciate us then we are willing to make our voice heard.
Please don’t compare the private sector with the public sector. There are many pros and cons to working in both sectors. Like I said before be careful what you wish for. If you want doctors and nurses to work in the private sector, we can do and get paid subsequently a hell of a lot more. The tax payer and individual person will subsequently pay more from there own pocket. As I mentioned before The taxpayer are getting consultants on a good…
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That’s not the point Amir. Obviously with a higher salary more contributions are paid and of course a bigger pension and lump sum and widows pension are earned.
If all doctors and nurses worked in the private sector wages would stabilise at much the same level as the market for their services would not increase. Anyway GPs have it both ways being self-employed (with no weekend work under the Blair reforms plus higher pay)and membership of a gold=plated, inflation-proofed public sector pension scheme.
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Hi Framer,
GPs are a little different. Yes, they are self-employed. They pay the employees contributions and employers contributions (14.5%) so they contribute all of the pension contributions themselves. Their pension is career average and like I said before the pension has been seen as a reward for life-long public service. W.r.t. to their higher wages (which has been slowly eaten away for the past decade with below inflation or no pay rise at all) this was a contract negotiation which took into account their hard work, rewards based on targets and to retain GPs as there was a recruitment problem. W.r.t. not working weekends, this was an opt-out option with a substantial reduction in pay (this was a good outcome for the GPs not so good for the government). I think anyone in the GPs shoes would opt out if they had the chance.
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@Framer – for a viison of the possible future visit this private clinic:
http://www.portobelloclinic.com/index.php
They charge an annual membership fee of £300 for adults and £150 for children. They then charge between £130 (members) and £170 (non-members) for an adult consultation and between £130 and £135 for a child. A house visit will set you back at least £180 during the day and if you are not a member you won’t get one.
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I work in an NHS practice of 5400 patients. We provide over 20,000 appointments a year. Our turnover is about £1million per year but out of that we pay 3 full-time nurses, a full-time manager, a phlebotomist, a medical secretary, 5 reception staff and a cleaner. We also pay for all of the up keep and maintenance of the building as the NHS will only reimburse the rental costs. Only after all these expenses have been paid do we then pay ourselves our share of the profit. No GP in the practice makes £100,000 a year.
So how much does a consultation cost in our practice? Nothing to the patient and about £50 to the NHS. What about a house visit? The same – nothing to the patient and about £50 to the NHS. And what if you cancel or miss your appointment? There is no charge for that.
But what if you are not registered with us? It doesn’t matter – if you are in our practice area, even as a temporary resident, and you are an EU citizen or a citizen of another country with which the UK has reciprocal healthcare agreements, you will get a consultation or house visit free of charge.
At less than £200 per patient per year I think that represents value for money and I don’t feel…
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deal.
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Getting the “same” or nearly the same pension amount after working between 3 and 8 years longer to get it, is not the same pension. Drawing many years less pension benefits, and paying in considerably more is not the same pension. This is not the “same” thing, it is a far more expensive thing version for a inferior product. This apparent ignoring of the longer working life is a worrying example of ignorance or worse an example of biased reporting.
I led the Bma pensions negotiations on pensions during the 2005-8 review. The scheme is designed to be financial viable for the next decade or so, the governments desire to change pensions is specifically designed to increase tax income to the treasurery and to decrease payments out – this is nothing more than a tax that only the public sector worker has to pay.
I assume now we will see the same type of changes to the MPs pensions which seemingly are not public sector??
Rather than dragging public sector pensions down to inadequate private pension levels why don’t why work towards improving pensions for…
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Very disappointed in this and it makes me really question ‘fact check’ overall (and fool that I am I thought was a very good innovation from channel 4). It is clear to me nurses will lose out on the main question analysed, as the estimates on annual pension payouts vary from a slight decrease (yes that’s possible) to a slight increase, yet they also lose several whole years of benefit because they now have had to work longer. Overall the total pension payout is a clear reduction (unless working longer somehow makes you live even longer still !?) so the arrow should be pointing to ‘fact’, well in the green. Shame on you Channel 4 news.
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Amir – obviously the self-employed have to pay employers’ contributions. Why ever not? GPs employed by PCOs don’t pay however.
I’d be interested to know what “the substantial reduction in pay” for not working out of hours amounted to as GP income rose overall in that deal.
That “anyone in the GPs shoes would opt out if they had the chance” doesn’t tally with your notion of a lifetime of public service apparently rewarded less than those who labour outside the state sector.
That is a rather tired meme as is the notion that the private sector charges through the nose (and would if it was the only option). Anyway many doctors seem happy and able to use it when they need to.
It is the unconscious sense of entitlement in the public sector that concerns me most and the increasing hatred of those non-aristocrats outside of it.
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Hi Framer,
the substantial reduction in pay quoted to me by a GP was a five figure sum. The GP contract at the time has nothing to do with Pensions. You are bringing other issues into this debate.
I’m not a GP but a hospital doctor. From what I understand, there was a recruitment problem in GP, GPs were working extremely long hours with very little financial renumeration. The GPs negotiated a very good deal for themselves and rightly so. The government did make a mistake about out-of-hours cover. At the time I remember a lot of hospital doctors not liking the idea of GPs being able to opt out, but this was a choice that they decided to make. Some GPs opt out and some don’t. The majority of Drs go into medicine knowing that this is not a 9-5 profession and are happy with this, but we make a lot of sacrifices in life because we love the job that we do. I don’t go to work because of money I go in every day trying to do the best I can for my patients and I love it. It’s not about entitlement, we look after the public and the public should look after us. The government made an agreement 4 years ago and are coming back to steal from the easy targets.
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Correct Amir – GPs voted for the new contract in 2004 because of the OOH opt out. Without it the contract would not have been supported by GPs in my view but the Government would have forced it through anyway and made that quite clear. The decision to offer an OOH opt out was the Government’s not the BMA’s.
I lost £6000 opting out – twice as much as I previously earned from being on-call 1 or two midweek nights and every 2nd or 3rd weekend. Without the opt out rural practice in Scotland would have gone to the wall in under a decade as we were no longer able to recruit people willing to do the onerous on-call rotas.
The new contract of 2004 had a “slush fund” at the start so our earnings jumped dramatically in 2005/06. But that has all gone now and my most recent accounts show that I am now back earning what I was earning in 2001 – tens of thousands less than the oft-quoted £100K.
I certainly don’t feel “gold-plated”!
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