NHS Doctors: Retirement (Hansard, 13 December 2000)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, although the retirement age for NHS staff is normally 65, flexibility in the system already allows trusts and health authorities to employ doctors up to the age of 70. From the age of 70 doctors may continue to be employed, subject to the needs of the service and to quality assurance.

§ Lord Janner of Braunstone
My Lords, does my noble friend agree that, at a time when so many parts of this country are gravely in need of doctors, it is ludicrous and an anomaly to force doctors into retirement at the age of 70 if they are still skilled and competent? He referred to the exceptions to the rule but he left one out: in exceptional circumstances doctors are allowed to practise after the age of 70 for only two months out of nine. Surely if a doctor is fit to serve for two months out of nine, he or she is fit to serve for the whole nine months. Has it occurred to my noble friend what the effect of the application of such a rule in this place would be and how, for seven months out of nine, this place would be half empty?

§ Lord Hunt of Kings Heath
My Lords, that, indeed, would be a tragedy. My noble friend is half right in that practitioners over the age of 70 can be employed if, as he said, the period of employment is for not more than two months in any nine-month period; if there is a pressing need for the employment and it cannot be filled through a regular appointment; if a breakdown in service would result if the appointment were not made; and if the authority is satisfied that the practitioner is suitably qualified and is fit both mentally and physically to undertake the duties of the post. However, a practitioner over the age of 70 may be employed for more than two months subject to quality assurance and subject to a variation order under the direction of the Secretary of State which may set aside any of the conditions that I have mentioned. It is very much in the hands of the individual employer to apply to the Secretary of State for such an order.

§ Lord Walton of Detchant
My Lords, in asking a supplementary question, I declare an interest as it is 356 almost nine years since I received a letter from the Oxford Health Authority thanking me for my services but saying that, now that I have reached the age of 70, I could visit the hospital for social but not clinical reasons. Does the noble Lord agree that the issue concerns not so much chronological as biological age? Is it not reasonable to consider that annual extensions of clinical contracts might be awarded to doctors where the employing authority and the doctor wish it? As the noble Lord, Lord Janner, said, we are very short of doctors and some, I am afraid, are retiring early because of pressure of work and stress.

§ Lord Hunt of Kings Heath
My Lords, I agree that we need a flexible approach. Some doctors will retire early because, as the noble Lord suggested, they may feel that the time has come to end their career. Equally, flexibility in the system is required to allow doctors to continue to work when they wish to do so. A sensible arrangement is in place which allows doctors to work up to the age of 70 and to work beyond it subject to the conditions that I have set out. I believe it is right that the local employer should decide whether to apply for a variation order if it wishes a doctor who can contribute to the service to continue to do so beyond the age of 70.

§ Lord Elton
My Lords, what would the noble Lord consider the biological age of the noble Lord, Lord Walton of Detchant, to be?

§ Lord Hunt of Kings Heath
My Lords, haN, ing been subject to his penetrating questions over the past two years, I would say that it is a very young age indeed.

§ Lord Clement-Jones
My Lords, does the Minister agree that the problem concerns not so much the retirement of GPs at the age of 70 as early retirements, which are now becoming so common in the health service? In July, the Government published guidance on flexible retirement, but it was purely guidance. Should not financial incentives be available to try to persuade doctors to stay in the service and to enhance their pensions in so doing?

§ Lord Hunt of Kings Heath
My Lords, 1 understand that in recent years the average retirement age for doctors has risen. However, I accept that we need to consider the financial arrangements which relate to doctors. In particular we need to ensure that their pension rights are not affected unduly if they wish to continue in either full or part-time work. As part of the flexible retirement packages that we are developing, and as the noble Lord suggested, we are trying to ensure that pensions become more flexible. We have developed some schemes which enable staff who are approaching retirement to move to part-time work without suffering a reduction in their pension benefits or to move to new roles which, even though they may be lower paid, preserve the pension entitlements from the higher level posts. Therefore, I believe that we are making progress in that area.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that in some countries, such as Australia, general practitioners often continue to practise well into their 80s? However, that is dependent on their being of sound health and up-to-date on new developments in the medical field. Do provisions exist in this country for doctors who are over the age of 70 and who wish to continue in general practice to be updated on current medical treatment?

§ Lord Hunt of Kings Heath
My Lords, when the Secretary of State considers a request from an individual employer to make a variation order, the Secretary of State must satisfy himself that the doctor is an appropriate person for whom the variation order can be made. It is also worth making the point that we are introducing appraisals for all NHS doctors, including locums, starting in April next year. That accords with the kind of system to which the noble Baroness referred.

§ Lord Mackie of Benshie
My Lords, will the number of new doctors overcome the difficulty and what have the Government done about that?

§ Lord Hunt of Kings Heath
My Lords, I am glad to say that the number of doctors in the NHS has increased by over 4,000 since 1997, which is encouraging progress indeed. In addition, we announced in the NHS plan that we seek an increase of 7,500 more consultants and 2,000 more GPs. In addition, we have seen already a considerable increase in the number of medical training places, which will enable us, over the next few years, to increase our capacity. So there is no doubt that the present situation is one of real pressure on staff. There is no doubt that the health service has suffered over the years from a capacity constraint. I believe that with the increase in the number of training places and the movements that we are making in terms of flexible working, we shall be able to increase capacity in the way that we have suggested.

§ Lord McColl of Dulwich
My Lords, has the Minister considered the possibility of raising the age for consultants from 65 to 70, because that would relieve many of the problems?

§ Lord Hunt of Kings Heath
My Lords, it is perfectly acceptable for consultants to continue working in the health service up to the age of 70. There is no problem about that at all, if the employing authority deems that to be acceptable. As part of our general direction and encouragement to the NHS to improve its recruitment and retention practices, we have encouraged it to be much more flexible in the way that it employs staff. I certainly would encourage all NHS employers to consider employing people over the age of 65 where they consider them to be able to offer a good resource and service to the public.