HC Deb 22 November 1966 vol 736 cc1335-56

12.20 a.m.

The Minister of Health (Mr. Kenneth Robinson)

I beg to move, That the National Health Service (Superannuation) (Amendment) Regulations, 1966, a draft of which was laid before this House on 8th November, be approved. I think it might also be convenient for the House if we discussed at the same time the similar Regulations for Scotland.

Mr. Deputy Speaker

Yes, that would be convenient.

Mr. Robinson

Thank you, Mr. Deputy Speaker. The Regulations covering Scotland are almost identical, and the Joint Parliamentary Under-Secretary of State is here in case there is any specific point raised, although I find it difficult to anticipate any specific section of the Regulations upon which points could be raised.

The superannuation scheme for some 400,000 persons engaged in the National Health Service is currently provided in the National Health Service (Superannuation) Regulations, 1961. These Regulations make further changes and, at the same time, revoke the 1962 amending Regulations. These new Regulations are both, I am afraid, lengthy and complex; but that is unavoidable. They make five major changes, as well as a number of minor technical amendments and changes, to what is already a complex scheme covering so many people in many different categories. The main changes are set out in the Explanatory Note on page 42, and the first major change to which I should draw attention concerns the method of calculating the superannuation benefits payable to doctors and dentists retiring from general practice.

Since these practitioners are paid by fees, and not by salary, their income tends to fluctuate, and it has always been recognised that the normal method of relating benefits to earnings in the last years of service is not suitable for them. Instead, benefits for these practitioners have been assessed as a flat-rate percentage of career earnings; that is, one and a half per cent. of total superannuate re- muneration up to 31st August, 1962, and 1¾ per cent. since that date.

For some time, the professions have represented that practitioners' pensions calculated on this basis are too low compared with those of salaried officers, whose pensions are related to earnings in their last three years of service. Last year, in their charter for the family doctor, the British Medical Association stated that: the implementation of our new pay proposals will necessitate a complete revision of the family doctors' superannuation scheme and the elimination of the defects of the present scheme. At the same time, for benefits based on short service, the present flat rate of one and three quarters per cent. has proved to be too generous.

We have been able to meet the professions' representations, in a new formula by which there will be an ascelating series of percentages applied to earnings in successive periods. This new formula, which is set out in Regulation 8, provides for pensions of doctors and dentists in general practice to be based on one and a half per cent. earnings during the first ten years, one and three quarters per cent. during the second ten years, and so on up to two and a half per cent. for all years after the fortieth.

This formula represents a radical change in the method of calculating practitioners' benefits and is the outcome of long discussions with the professions. We think that it is a significant improvement, and the professions accept that it is fair and reasonable. It is not unfair to say that we have succeeded where the previous administration failed, because these discussions date from long before the change of Government.

Regulations 4 to 12 apply the same formula to the calculation of other superannuation benefits, including lump sum retiring allowances and death gratuities, and make some consequential amendments. Transitional provisions in Regulation 59 ensure that existing practitioners will have their benefits calculated on the old—that is the present—basis, if that is more favourable.

The second major change concerns the method of assessing benefits of specialists employed in hospitals on a part-time basis. Although salaried their benefits have been calculated on the same percentage basis as general practitioners, but the new escalating formula would give the wrong result if applied to them because of their different career earnings pattern. Provision is accordingly being made in Regulations 13 to 20 for the benefits of part-time specialists and other superannuable part-time staff, to be related to their average rate of earnings in their last three years of service, which is, of course, the normal basis for assessing benefits for salaried doctors. To achieve this, future part-time employment will be counted as a proportionately reduced period of whole-time service and the rate of earnings used for calculating benefits will be that appropriate to whole-time employment.

There are also associated changes, one of which makes superannuable those very few part-time hospital doctors and dentists who are not so already. The transitional provisions provide that benefits of existing part-time specialists will be calculated on the old basis if that is more beneficial to them.

Regulation 21 provides an optional improvement in the widow's pensions provisions. At present a widow receives one-third of the husband's rate of pension, and to meet the cost the husband's lump sum retiring allowance is reduced by two-thirds. A married male officer retiring in future will be able, if he wishes, to surrender the remaining one-third of his lump sum retiring allowance to provide a pension for his widow of one-half of his own pension. Similarly, the widow of an officer dying in service will in future be able to receive a half-rate instead of a one-third rate pension by surrendering the balance of the death gratuity that would otherwise be payable. These provisions are optional and the present arrangements are being continued for those who prefer them.

At the same time we are abolishing by Regulation 22 a restriction which has been in the scheme for a long time whereby a widow who was entitled under the scheme to a benefit in her own right could not also receive a widow's pension in respect of her husband's service. In future she will be able to do so.

Regulation 23 and Schedule I introduce into the scheme for the first time a system of allowances in respect of the dependent children of officers with at least 10 years' service who die either in service or following retirement on pension on or after the date on which the Regulation comes into operation. All children dependent on the officer are covered by the arrangements, including adopted children, step-children and illegitimate children. The provision applies to the children of female officers in the same way as to those of male officers. The allowances will be paid until age 16 or beyond that for a child who continues in full-time education. There are two rates of allowance set out in Schedule 1, the rate for wholly orphaned children being double that paid where there is a surviving parent or stepparent.

The last major change to which I should draw the attention of the House is contained in Regulations 24 and 25 and concerns redundant officers. Redundancy is not a major problem in the National Health Service, but it does occur from time to time following administrative reorganisations. The 1962 amending Regulations provided immediate pension for officers with at least 10 years' service who were made redundant after age 55. This provision is repeated in these Regulations, but it is extended to provide for benefits to be frozen for those who are declared redundant under age 55.

This fulfils an undertaking given to the General Whitley Council and the Service when the improved arrangements for redundancy payments were introduced early this year. It also incidentally does precisely what I asked my predecessor but one to do, but in vain, in the debate on the 1962 Superannuation Regulations. The frozen benefits will normally be put into payment at age 60 or age 55 for certain special classes including nurses, but will be paid earlier if the officer becomes permanently incapacitated. Freezing benefits in this way is optional and, if he prefers, at any time before he actually starts to draw benefits the redundant officer can choose instead to have his contributions plus interest returned to him. There are consequential provisions dealing with the reinstatement of the earlier service if a redundant officer again becomes employed in a superannuable capacity either in the National Health Service or under some other scheme to which we can transfer accrued pension rights.

The Regulations from 26 onwards are described as "miscellaneous". Many are technical amendments or to remove anomalies that have come to light. I will not trouble the House with an explanation of every one. I will, however, mention briefly the more important.

The actuarial investigation of the scheme as at 31st March, 1962, disclosed a surplus. In 1960, when the previous valuation disclosed a deficit, an additional contribution of 1½per cent. of each employee's superannuate remuneration was imposed on health service employers in order to meet part of that deficiency. The deficiency has been met in substantially less time than was then expected.

The improved state of the superannuation fund is due to a number of factors, including an increase in the valuation rate of interest, later retirements, and a greater number of withdrawals from the scheme than had been assumed at the previous valuation. As the additional contribution was introduced solely to help liquidate a deficiency that no longer exists, its purpose has been achieved and it can now be discontinued. This is done by Regulation 29(2).

Regulation 41 makes some changes in the application of abatement to pensions of re-employed pensioners whose earnings in their new employment are paid from public funds. Since the inception of the National Health Service Superannuation Scheme, the Regulations have provided that, on such re-employment, a pension is abated to ensure that the pensioner does not receive more by way of pension plus remuneration of the new employment than the rate of pay that he was receiving immediately before his retirement.

This rule operates somewhat unfairly in the case of doctors and dentists retired from general practice as, during the last years of their careers, their earnings tend to decrease. Accordingly, we are now providing that, on the re-employment of such pensioners, abatement will be related to the average of the three consecutive years of highest remuneration. We are also providing that, where a pensioner takes on a series of short-term employments, abatement will be related to his earnings during the whole of a calendar quarter, instead of, as now, during the period of his employment.

Because the effect of these amendments will be to increase the aggregate income of some pensioners—that is, pension plus pay of re-employment—they will not become operative until the end of the standstill period, that is from 1st January, 1967.

Regulation 48 enables the arrangement to be brought to an end whereby employees of the Medical Research Council are admitted to the scheme. This is in accordance with the wishes of the Council, which is introducing its own superannuation scheme.

The last provision to which I might draw attention is that in Regulation 50(b), which increases from £3,500 to £6,000 the overriding limit on the amount of a dental practitioner's remuneration which can be counted for superannuation purposes in any year. This amendment brings the present limit, which was introduced in 1950, into line with current money values and earnings. It does not, of course, involve any increase in a dentist's earnings. What it does is to increase the amount of those earnings that can reckon for superannuation.

There has been full and detailed consultations with all the staff interests concerned about these various amendments, including the British Medical Association and the British Dental Association, and, although on one or two points there have been representations for wider improvements than we are able to make, I can say that the Regulations are broadly acceptable to them. Indeed, we believe that their introduction will generally be welcomed.

12.35 a.m.

Mr. Paul Dean (Somerset, North)

I am sure that the whole House is grateful to the right hon. Gentleman for his lucid explanation of these complex Regulations. He will no doubt remember that when he stood at this Box when the 1961 Regulations were introduced he welcomed them, but also complained about their complexity. I welcome these Regulations and, although I complain about their complexity, I appreciate that it is inevitable when one is dealing with so large a number of different categories of employees. We wish to see these Regulations put into operation speedily, but on an important matter like this we ought to devote a little time to considering what the Minister has told us. I should like to make a few comments and to ask a few questions.

I am glad to hear that there has been full consultation with the bodies concerned and that they are broadly in agreement with the proposals which the Minister has put to us. We on this side of the House attach great importance to occupational pension schemes, which are now widespread. We welcome their spread and we want to see them extended as a valuable supplement to the National Insurance pension. It is important that these schemes should keep pace with the evolving concept of what a good superannuation scheme should provide, and nowhere is that more important than in the National Health Service where the staff are often overworked and underpaid and where the discontent has reached disturbing proportions and where the brain drain is serious.

We are debating these Regulations against the sombre background of the pay freeze, which has hit a substantial number of the staff in the Health Service and which has necessarily affected their pension position as well, the pensions being based on the pay which they receive and, in quite a number of cases, on the increases in pay which they have had to forgo because of the freeze.

I should like particularly to welcome four main features of the Regulations. The first is the new formula for calculating the pensions of practitioners. I welcome the greater weight which the formula gives to earnings in the later stages of a person's career. I have one reservation about this to which I will refer later, but generally this formula is a welcome advance in the superannuation arrangements for practitioners.

I also welcome the widows' benefits. We attach great importance to occupational schemes of all kinds providing better cover for widows, whether the woman happens to be widowed during the working life of her husband or after his retirement, and we also attach importance to choice as to type of benefit which a widow can take. The Regulations provide for both of those things.

The dependent children's allowances are also a welcome step forward and the abatement of the pension on re-employment—Regulation 41—is particularly important to encourage people to remain in employment or return to work, and I am thinking here particularly of married women. The abatement of the pension by reference to the best three consecutive years rather than the last three years is certainly a welcome step in encouraging this desirable move.

Having welcomed these main features I should like to put one or two questions to the Minister and to make one or two criticisms of the Regulations. The first question concerns the date on which the Regulations come into force. It is said in Regulation I that Regulation 41 will come into operation on 1st January, 1967, and the others within 14 days of the Regulations being approved by both Houses of Parliament. Speed is of great importance in this matter, as the Minister knows. There is quite a substantial number of people who will be retiring shortly, and before the end of the year.

I should be grateful if the Minister could say when he expects the Regulations to be in operation. I hope that it will be before the end of the year. I hope also that he can give a categorical assurance that none of these Regulations is in any way affected by the prices and incomes freeze. My next point is one with which the Minister dealt, namely, the finances of the Scheme and Regulation 29(2) in particular, providing for the ending of the employers 1½ per cent. supplementary contribution, which was imposed in 1961 to meet the deficit.

This was intended to be in operation for about 20 years, but it has been removed after about six years. As the Minister will appreciate, there are some misgivings among a number of National Health Service employees about the removal of this additional contribution. The Minister has explained the reasons for it but I note that the Government Actuary's Report on the scheme states on page 12: The margin is not enough however to justify any reduction in the rate of contribution. As the financial effect of future salary increases will become progressively more important it is desirable to retain some margin as a provision against future deficiencies. I do not feel that the Minister's explanation of the ending of this additional employers' contribution entirely clears up the matter. There are differences of view between his actuaries and between some experts outside.

The next point concerns the new formula for calculating the pensions of practitioners. I have already generally welcomed the formula, but there is one serious weakness, and this is the main point which I put to the Minister. It concerns the older practitioners who will do very badly under this formula. Broadly speaking, those who were aged 45 or over in 1948, when the scheme began, will get little or no benefit under the formula. These are the men and women who have borne the burden during the heat of the day, over a long period, and in many cases they will retire with no benefit from the escalating formula.

I regret that the Minister has not found some way of weighting this formula so that the older people receive some recognition. As he will realise, and as the House realises, a substantial number of people is involved—something like one-seventh of those practising. When one realises that the average pension for a G.P. retiring now, having served since 1948 is only about £725 the House will see that there is real substance in the point that I am making. There is little doubt that there will be a sense of injustice on the part of these people when they compare their lot with that of their younger colleagues.

The problem of the older pensioner constantly features in debates on public service pensions. From both sides of the House, the problem is constantly put of those who retired longest ago and who both have small pensions and also suffer the effects of inflation over a long period. All parties and Governments have recognised this problem and have tried in the various Pensions (Increase) Acts to meet it. It seems to me, however, that tonight's Regulations will aggravate the problem. It is as if they are deaf to the lesson which we should by now have learnt about the problem of the older public service pensioner.

I believe that the Minister has lost an opportunity to try to minimise these problems in the future by giving some weighting in the new Superannuation Regulations so that the older people would derive some benefit. It could well be that had the Minister decided to retain the 1½ per cent. supplementary employer's contribution, this would have given him leeway to enable him to do this. It may be that he would have liked to do this but that the Treasury has stopped him from doing so. This, therefore, is a point to which I hope that the Minister will give serious consideration, otherwise the anomalies and the injustices which we are trying to get rid of will be aggravated.

I understand that the new formula applies to dentists only temporarily because talks are in progress. I assume that the Minister intends to reconsider the position when the talks have been completed.

I have one point with regard to abatement of pension on re-employment. I refer in particular to the quarterly basis of calculation. The Minister will, I think, appreciate that this can cause difficulties, particularly with dentists whose earnings are based on a fee for an item of service. Their income cannot easily be regulated to keep within the limits for abatement. I hope that the Minister will further consider the possibility of either a yearly basis or a yearly reassessment should experience show that the quarterly basis causes difficulties for dentists and others.

My final main point concerns the preservation of transferability of pension rights, to which the Minister has briefly referred. We on this side believe that pension rights should be portable, for two main reasons. We feel that the time has now arrived when occupational schemes have developed to a sufficient extent for them to be regarded as deferred pay to which a man or woman is as much entitled as to weekly or monthly earnings. We feel, too, that portability is valuable—and, indeed, necessary—from the viewpoint of mobility of labour. The Regulations certainly make minor improvements in this respect, but, broadly, transferability under them is possible still only within the public service. If an employee goes outside the public service, he will get nothing more than the return of his own contributions.

I quite appreciate that the Minister must be sensitive about any provision which might make it easier for people to leave the National Health Service. None the less, I believe that it is quite wrong that we should attempt to chain people to their employment by their pension rights. I hope that he will at least make greater use of his powers under the 1961 Regulations to grant transferability to superannuation schemes outside the public service where it is appropriate.

I want now to refer briefly to three small but quite important points. The first is the case of an employee who has not completed 10 years' pensionable service. I have no doubt that the Minister knows of cases where it can cause hardship. I know of a mental health officer with 9½ years' service who is not able, owing to retirement, to qualify for a pension. I wonder whether the Minister has considered the possibility, in cases of that kind, of the employee being able to make up his contributions and so qualify for a pension under the scheme.

The second point is the case of a practitioner who is fined for breach of his terms of services and loses not only the pay which is deducted but the pension rights on that pay because the contribution is withheld. In a case of that kind, the person concerned is being punished twice, and it is not fair to him.

The third point relates to the determination of questions. Regulation 84 of the parent Regulations lays down that the Minister shall decide questions in dispute under the Regulations. I believe that it is wrong that any Minister should be the judge when he is himself an interested party. I hope that the Minister will feel able to make some changes in that respect. As far as I can see, there is no change in the Regulations which we are discussing—

Mr. Speaker

Order. If there is no change in the parent Regulations, we cannot discuss it now.

Mr. Dean

I am sorry, Mr. Speaker. Then I will leave that.

I am afraid that I have detained hon. Members rather long at this late hour, but I am sure that the whole House will feel that anything which concerns the terms and conditions of service in the National Health Service is immensely important and worth devoting time to, particularly at a time when employees in the National Health Service are under great pressure and many have a strong feeling that they are not getting a square deal.

In spite of the criticisms that I have made, we welcome the Regulations as an advance towards better superannuation in the National Health Service. But I hope that the Minister will watch the working the Regulations carefully and listen sympathetically to suggestions for improvement in the future.

12.54 a.m.

Mrs. Jill Knight (Birmingham, Edgbaston)

There is precious little encouragement to become a doctor or a nurse or a medical auxiliary in Britain today. Most of us have been lobbied by doctors in our constituencies. They are usually pale young gentlemen who come clutching red dyed bank statements, with horrifying stories of medical moonlighting and the ways in which they have to supplement their inadequate incomes. But if some hon. Members have not had such visits from their constituents, I am sure that they are all well aware of the very serious problem of the medical brain drain which is going on, and it is not something that can be shrugged off.

I do not know whether the Government imagine that these Regulations are a sort of panacea for these ills, and I have a vision of the right hon. Gentleman, like some Canute in reverse, standing on the seashore waving these draft Regulations at the advancing tide of medicos as an incentive to go back up the beach and try again. If that is the case, I must tell the right hon. Gentleman that it will not do. For one thing, a pension is a very long way off to a young doctor, and, for another, what these Regulations do about superannuation really does not greatly help, because pensions are still based on a percentage of earnings, and if the earnings are too low, the pension will be too low. It is as simple as that.

I think that the change mentioned in paragraph (g) of the Explanatory Note on page 42 is very welcome. As my hon. Friend the Member for Somerset, North (Mr. Dean) said, this is an excellent new suggestion that the best three consecutive years before retirement should be the ones to count, instead of the last three. I acknowledge that this is a great help, but if the Minister thinks that this will wholly satisfy the doctors, again he is wrong, because the older doctor has a very real superannuation problem.

He is a double victim of the Government's incomes policy. The loss of income which he has suffered for the past six months from April to October is one thing, but, because his pension is calculated on his income, he will suffer from the pay pause long after he has ceased to earn. I cannot understand why it is not possible for a doctor who is within three years of retiring age today to pay superannuation on the additional remuneration which he would have received with effect from 1st April if the ice curtain had not slammed down and if the Government's promises had been kept. After all, the Prime Minister and the Government fully accepted the Review Body's award. It was agreed on all sides to be fair, and the increase was promised. If the Regulations permitted the arrangement which I have suggested, at least some of the unfairness would be averted.

The principle that pensions should be exempted from the full effects of the Government's standstill wage policy seems to be a sound one, and I think that it is merely quibbling when we are told that because this principle cannot be applied elsewhere to every pensioner, it cannot be applied here. This is an unfair anomaly, and undoubtedly the doctors are feeling very sore about it when, as my hon. Friend said, they already have cause to be uneasy because of their age in the existing set-up.

These Regulations are all very well, until we come to the elderly, and this point needs to be made very strongly indeed. What the Government seem to be saying here is that all men are equal, but that the elderly shall be slightly less equal than the rest. Perhaps this point had not struck the right hon. Gentleman. The right hon. Gentleman is a kindly man, good to animals, and no doubt excellent with children, but he must try to be a little more sympathetic towards the elderly.

There is another point to be made about the older doctor. It is not wise to throw him on the scrap heap promptly when he reaches retiring age. If he is hale and hearty, he still has many contributions to make in a field which is not overstaffed, to put it mildly. Do these Regulations provide sufficient encouragement for the G.P. of pensionable age to go on working? I rather doubt it.

There is also this point about the transferability or preservation of pension rights about which we have heard. This again is a very important point, and I thought that it was one which had been accepted by the Government as a fair principle. I gather that the National Health Service superannuation schemes are still not to be fully transferable, and will not provide full preservation on change of job. The Minister must recognise that this aspect must be looked at again. If it is a fair and right principle elsewhere it is right and fair in the National Health Service, and the present situation should be rectified.

Can the Minister explain the operation of the time limits? Perhaps he would pass another little note to his hon. Friend and get an answer, because the question of the time limits is very important. I cannot understand what he means by them—and there are other conditions, which are too vague, which must be satisfied before superannuation rights can be transferred. These are not clear. Perhaps, with the splendid arrangements for information to be quickly transmitted to the Front Bench, we may get an answer very shortly.

There are some good things about these Regulations, and I applaud those, but to gain wholehearted support the Minister should put forward wholehearted Regulations.

1.0 a.m.

Dr. M. P. Winstanley (Cheadle)

I want to associate the Liberal Party with the somewhat qualified welcome already given by the hon. Member for Somerset, North (Mr. Dean) on behalf of the Conservative Party to these new amending Regulations. I will not weary the House by referring to points of approval; I have no wish to delay the acceptance of these Regulations, many of which are long overdue. But I support the remarks of the hon. Member for Somerset, North and the hon. Member for Birmingham, Edgbaston (Mrs. Knight) about the somewhat elderly doctor. When I use the term "elderly" I do so in terms of the normal age of entry into the profession at the beginning of the National Health Service. It is regrettable that opportunity has not been seized to neutralise an anomaly of which the Minister was already aware.

I want to express my doubts and misgivings relating to the steps of escalation outlined in Regulation 8(2, a). There might have been merit in these steps having been somewhat smaller and the time intervals less prolonged. One accepts the principle of the steps and the escalation, but I would very much appreciate it if the Minister would at least tell us why this time sequence has been adopted.

My reservation is rather more serious, from my point of view. I am aware that when the hon. Member for Somerset, North raised a question that was not relevant to the Regulations he was properly ruled out of order. I hope that in referring to that fact I have not alerted the Chair to my intentions in such a way as to foil my design, but my attitude to these Regulations, which I, along with other hon. Members, will shortly be asked to approve, is somewhat coloured by my present fears about what might happen if disputes; should arise under them.

The Minister is aware that the profession has expressed some anxiety on this point over the years. Indeed, he will no doubt be aware that the former Minister of Health informed the profession that he would look at the matter and seize an early opportunity of bringing forward possible Amendments to the old Regulation 84 in the 1961 Regulations. I hope that if the Minister endeavours to clear up this point—which I am sure would be most helpful to me and other hon. Members—he will not be ruled out of order, since I am sure that this is relevant to our attitude to these amending Regulations.

I have no wish to detain the House. That is my only main reservation. These Regulations are overdue and will be welcomed by the medical profession—as they are welcomed by my hon. Friends and myself.

Mr. Speaker

The hon. Member was out of order in discussing another set of Regulations. I was perhaps over-generous. We can discuss only the Regulations before us.

1.5 a.m.

Mr. Robert Cooke (Bristol, West)

My hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight) has mentioned with greater charm and at greater length the points which I wished to raise. I would remind her that Canute was a great king who got his feet wet proving the futility of the advice tendered by his civil servants. Let us have that on the record for all time.

I hope that the Minister, who we all know is a kind and generous man, will deal fully with the question of those whose pensions are related to their last years of earnings, which earnings are affected by the prices and incomes freeze. If they are prevented from getting the fruits of an award which has been agreed, some may have a reduced pension for the rest of their lives. The case has been made that this may not amount to very much in many cases, but before we approve the Regulations I hope that the Minister will clear up this point. If he cannot put our minds at ease, at least he should tell us how these National Health Service employees will be affected if the freeze prevents them from getting any increase in salary on which their pension would be based.

It is the older people who will be affected, who gave many generous years of service before the National Health Service came in on 15th July, 1948. We owe it to them to see them right in their retirement. I am sure that the Minister will be careful not to stray without the scope of the Order, but, in giving us the information about those people who come within the scope of the Order and whose pension may be affected by the wage freeze, perhaps he can say whether there are any outside the scope of the Order, but, nevertheless, employed in the National Health Service who are also so affected.

1.7 a.m.

Mr. Alick Buchanan-Smith (North Angus and Mearns)

The Minister said that he had great difficulty in seeing the difference between the Regulations for England and Wales and those for Scotland. I assure him that his difficulty is not half as great as mine in finding the differences. It would be unfortunate if, when the debate is over, the Joint Under-Secretary of State for Scotland, who is sitting beside the Minister, should wonder whether his journey here was really necessary. I wish therefore to raise one point of particular importance to Scotland.

I refer to the employers' supplementary contributions. The Minister said that the decision to discontinue these contributions from employers was based on the Third Report of the Government Actuary, who, I understand, has not yet completed his survey in Scotland. This discontinuance of the scheme for Scotland is merely based on preliminary investigations. While I have no reason to think that the situation in Scotland is different from that in the rest of the United Kingdom, can the Under-Secretary give us any more information on what stage the Actuarial Report has reached and whether there are any more definite facts available on which the decision to discontinue the supplementary benefits in Scotland can be based.

I support my hon. Friend the Member for Somerset, North (Mr. Dean) in what he said about the problems faced by the older members of the profession. We are perhaps missing an opportunity in this, if there is a surplus in one part of the scheme which might be used to help those less fortunate members of the profession, particularly the older ones. This is a problem not only on the medical side of the public service but in other sectors as well. As we all know who deal with the problems of constituents and organisations representing people retired from public service, this problem is much wider than just the immediate situation of the medical profession. In a scheme like this where there is a surplus in one part of the scheme and money available to deal with the problems of this particular group in the profession, it is a pity that we should let this chance slip by without hearing the reason why this should be the case. I would ask the Minister to reply to these points.

1.10 a.m.

Mr. K. Robinson

With the leave of the House, I should like to try to answer the points raised in the debate. Perhaps I could deal first with the points raised by the hon. Member for Somerset, North (Mr. Dean) for the reason that he spoke first, that his list was numerically longer than that of any other hon. Member, and that a number of the points he took were echoed by other hon. Members opposite.

He asked me about the date of operation of the main Regulations. I understand that one particular Regulation, because of the prices and incomes standstill, will come into operation on 1st January, but we hope very much that all the others will be in operation well before the end of the year.

I would hope that time will be found to debate these Regulations in another place in the course of the next week or so, which would mean that the Regulations would come into operation during the first weeks of December.

The hon. Member for Somerset, North, and a number of other hon. Members, brought up the question of the discontinuance of the supplementary employer's contribution, and I think that the hon. Gentleman, no doubt unwittingly, quoted the Government Actuary out of context because the quotation he gave was not in relation to supplementary employer's contribution. It was in relation to the financing of the scheme as a whole, and he did say that he was fully in agreement that the special contribution was no longer necessary and supported its cessation.

What he was saying in the passage quoted was that it was desirable that not all the surplus that was available in the scheme should be used to make immediate improvements in the scheme but a certain amount of it should be held back for future needs, and this has been done.

I would emphasise that this is an actuarial scheme and what we can do and cannot do is not entirely a measure of the generosity of the Minister and the Government but is much more a matter of ingenuity in dealing with the scheme in such a way as to make the maximum improvements which those covered by the Regulations would like to see.

Mr. Dean

The right hon. Gentleman would agree, would he not, that there are some experts among the professions who do not agree these actuarial calculations?

Mr. Robinson

I do not think it is a matter of disagreement with calculations. It is that we considered, and I think we have plenty of evidence to support it, that it is accepted practice that any measures, especially taken to liquidate a deficiency, are discontinued as soon as they are no longer necessary. While I am sure that some of the professions might have liked to see the continuation of this contribution, I do not think there was any fundamental disagreement with the Government Actuary on this point.

The hon. Member for North Angus and Mearns (Mr. Buchanan-Smith) brought up the Scottish aspect of this. I should like to tell him, on behalf of my hon. Friend the Joint Under-Secretary of State for Scotland, that the Government Actuary's report on the Scottish scheme is not yet to hand, but he certainly said that his preliminary investigation indicated that it would be reasonable to expect that the financial position of the Scottish scheme is likely to be such that the Regulations could include similar provisions to those proposed for the English scheme. It is in connection with that that the same provision is made for the discontinuance of employer's supplementary contribution.

A number of hon. Members repeated the plea made by the British Medical Association and the British Dental Association about the position of the older doctors. I would not deny that these doctors bore a great deal of the burden of the Service in its early and formative years. The hon. Member for Somerset, North suggested that they got no benefit out of these Regulations, but that is not quite true. They get the benefit of the back-dating of the 1¾ per cent. by, I think, four years. It is now back-dated to 1958, and I think that hitherto it was 1962. But they do, in common with other doctors, get an improvement as a result of the escalating formula.

The professions wanted this 1¾per cent. to be back-dated to 1948, but this proposal contains anomalies not only in relation to those who have already retired, who would derive no benefit from it all, but also for those who did not happen to be aged 45 when they entered the National Health Service at its inception. There are many other people, including nurses, who first became superannuate in 1948 and who, in consequence, will have lower pensions than they would have had if their whole careers had been in superannuable service. Had we been able to make the concession, therefore, it would have raised great anomalies.

Nevertheless, I examined the case very carefully. I sought the advice of the Government Actuary on the subject, and his advice indicates that the older practitioners already get full value for their contributions, and that they will derive benefit from the new formula. I discussed the matter with representatives of both Associations only last month. I told them that, whilst I had some sympathy with their case, I had to weigh it against the actuarial advice I had received, and had also to consider how far one could justify special treatment for older practitioners compared with older Health Service staffs, bearing in mind that the proposed new formula produces an acceptable result as between these staffs and practitioners in general. I had to tell them that, on balance, my conclusion was that it would not be right to make a further special concession for this group, and I understand that both the B.M.A. and the B.D.A. accept that position.

The hon. Gentleman's next point was about quarterly abatement. He asked whether we could not go that much farther and do it on an annual basis. Again, I examined the case very carefully, but we consider that the changes we have made will provide a very real improvement for both dentists and doctors, and I do not think that it would be possible to go further than that.

He then asked whether it was true that these provisions were only temporary. It is a fact that we have told the dentists that we are prepared to look at their position again when we have had further discussions with them, and when we can see what their future career earnings pattern is likely to be. That matter can be reconsidered later.

I would have hoped that hon. Members opposite would have welcomed the improvements we have made in transferability instead of chiding us for not going further—further, indeed, than any public service superannuation has ever been able to go. It is not practicable to have transferability with private pension schemes, which are not really in any way comparable with public service pension schemes. I entirely agree that maximum transferability is desirable and no doubt we will be able to go further from time to time, but we have gone as far as is reasonable and possible at the moment.

The hon. Member for Somerset, North then raised the question of the determination of appeals and suggested that it was not right that I should be the court of appeal against my own decision. I assure the House that powers to hold inquiries in cases where the facts are in dispute already exist and that these powers will be used when necessary. It is, perhaps, not unworthy of note that there has not yet been any need for such an inquiry since the Regulations were originally introduced. However, in accordance with an undertaking given to the B.M.A. and other staff interests, I have it in mind, when a suitable opportunity for legislation presents itself, to seek powers to cite a case for the opinion of the High Court on a point of law. This needs legislation. It cannot be done by amendment of the Regulations.

Mr. Dean

Can the right hon. Gentleman say when this legislation is likely to be introduced?

Mr. Robinson

The hon. Gentleman knows only too well that no Minister can say when such legislation will be brought forward. However, I can say that there are two possibilities and that we shall take whichever arises first to do this.

The hon. Member for Cheadle (Dr. Winstanley) asked if we could rearrange our ladder, our steps of escalation. I assure him that this was carefully and meticulously worked out to derive the maximum possible benefit in this connection from the amount of the surplus available. Considering the nature of the escalation that we have agreed, there was very little dispute between us and the professions and they agreed that this was the best way of doing it. I repeat that this is an actuarial scheme and that we must be governed by the amount of the surplus and the likely demands on the fund in future.

The hon. Lady the Member for Birmingham, Edgbaston (Mrs. Knight) wondered whether I thought that the Regulations were a panacea for all the difficulties facing the National Health Service. I certainly do not, and I hope that I did not present them in that light. Nevertheless, they represent significant improvements in the superannuation arrangements, not only for medical practitioners but for many other staffs in the Service. The hon. Lady asked if they provide sufficient encouragement to doctors to go on working. I believe that they do. After all, a doctor can increase his pension by going on working, and some of the improvements we have made in these amendments carry that process a little further.

A question not strictly related to the Regulations concerned the reduced pension that will result from the loss of income suffered by some National Health Service staffs, notably doctors, as a result of the incomes standstill and the deferment for six months of the Review Body award. I have looked into this matter and it has certainly been considered by the Government in a wider context than the medical profession. I assure the House that it would be impossible to make any arrangements, even if one could get over the practical difficulties—and they are formidable—of having notional superannuation payments on notional income which is not received. Even if we had been able to get over the practical difficulties, we should have thrown up far more injustices than those we were seeking to remedy.

One might be able to do this where loss of income was quantifiable; but there have been many staffs, in the National Health Service and outside, who have lost income where income was not quantifiable and, all in all, the Government decided that it would not be right to try to make any adjustment. However, I can confirm that the amounts of reduction of pensions for medical practitioners —and they are perhaps the ones most noticeably affected—are extremely small; far smaller than the hon. Lady appears to imagine.

I do not think that it would have been possible to make any adjustments which would not have thrown up greater injustices elsewhere, and I am grateful for the general response which has been given to these amendments tonight. They are amendments which make significant improvements and, to that extent, I hope that they will be useful in furthering those aspects of the National Health Service about which the hon. Lady spoke.

Question put and agreed to.

Resolved, That the National Health Service (Superannuation) (Amendment) Regulations, 1966, a draft of which was laid before this House on 8th November, be approved.

National Health Service (Superannuation) (Scotland) Amendment Regulations, 1966 [draft laid before the House, 8th November] approved.—[Mr. Millan.]