Witney GP: "Nobody supports the NHS changes"

Senior GP in David Cameron's own constituency tells New Statesman "things are going to fail, hospita

In an exchange over the government's controversial health reforms at Prime Minister's Questions last Wednesday, David Cameron cited "a supportive GP . . . who hails from Doncaster [Ed Miliband's constituency]".

In this week's New Statesman (on newsstands tomorrow), Sophie Elmhirst travels to David Cameron's own Witney constituency in West Oxfordshire, where a senior partner of a local GP practice tells her:

"I would say very few GPs are happy with [the NHS reform] at all . . . Not a question of supporting it, it's a question of going along with it."

"In my practice, nobody supports the changes . . . people think there should be more clinical involvement in commissioning. But I don't think many people think that GPs are the right people to commission. They need input into it - but if we wanted to be managers we would have trained to be managers, not doctors. "

The GP adds:

"Most GPs are incredibly worried about conflict of interest. How can you be a patient's advocate and look after the money? A lot of people think the whole thing's designed to fail so they can bring private providers in. It's the one big bit of the economy that hasn't got private money in it."

Of the effects to patients from the health service overhaul, the Witney GP says:

"The public have just got no idea what's hitting them . . . Things are going to fail, hospitals will close, because the money's not going to be there. Things will get taken over. And if you're going to have to make a profit out of it, you're not going to have the same service."

In the same report, Elmhirst speaks to Dr Paul Roblin, the chief executive of Berkshire, Buckinghamshire & Oxfordshire Local Medical Council, which covers Cameron's Witney constituency. Speaking about the health and social care bill, currently working its way through the House of Lords, Roblin, a retired GP, says:

"It's a major change which is quite experimental at a time when the NHS is trying hard to save money. The timing doesn't seem to be good. Among GPs there's a huge spectrum of enthusiasm from those that think commissioning will work to those who think that think it's another fad in the NHS and will soon pass."

"There is a large bulk in middle just watching events, and waiting to see what happens. [They are] slightly perturbed - they didn't go into medicine to do that sort of thing [commissioning] and it's a distraction from actually seeing patients."

"Many GPs are fed up with continual NHS restructuring.... The actual job... takes a back seat for many years while the restructuring is taking place. It's a very wasteful process."

Roblin issues a personal message to the prime minister:

"Produce an environment where people within the NHS can concentrate on what really matters which is patient care rather than structural reorganisation. Because continual change is draining and wasteful. They describe it as modernisation. I think they should stop using that political euphemism."

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Stability is essential to solve the pension problem

The new chancellor must ensure we have a period of stability for pension policymaking in order for everyone to acclimatise to a new era of personal responsibility in retirement, says 

There was a time when retirement seemed to take care of itself. It was normal to work, retire and then receive the state pension plus a company final salary pension, often a fairly generous figure, which also paid out to a spouse or partner on death.

That normality simply doesn’t exist for most people in 2016. There is much less certainty on what retirement looks like. The genesis of these experiences also starts much earlier. As final salary schemes fall out of favour, the UK is reaching a tipping point where savings in ‘defined contribution’ pension schemes become the most prevalent form of traditional retirement saving.

Saving for a ‘pension’ can mean a multitude of different things and the way your savings are organised can make a big difference to whether or not you are able to do what you planned in your later life – and also how your money is treated once you die.

George Osborne established a place for himself in the canon of personal savings policy through the introduction of ‘freedom and choice’ in pensions in 2015. This changed the rules dramatically, and gave pension income a level of public interest it had never seen before. Effectively the policymakers changed the rules, left the ring and took the ropes with them as we entered a new era of personal responsibility in retirement.

But what difference has that made? Have people changed their plans as a result, and what does 'normal' for retirement income look like now?

Old Mutual Wealth has just released. with YouGov, its third detailed survey of how people in the UK are planning their income needs in retirement. What is becoming clear is that 'normal' looks nothing like it did before. People have adjusted and are operating according to a new normal.

In the new normal, people are reliant on multiple sources of income in retirement, including actively using their home, as more people anticipate downsizing to provide some income. 24 per cent of future retirees have said they would consider releasing value from their home in one way or another.

In the new normal, working beyond your state pension age is no longer seen as drudgery. With increasing longevity, the appeal of keeping busy with work has grown. Almost one-third of future retirees are expecting work to provide some of their income in retirement, with just under half suggesting one of the reasons for doing so would be to maintain social interaction.

The new normal means less binary decision-making. Each choice an individual makes along the way becomes critical, and the answers themselves are less obvious. How do you best invest your savings? Where is the best place for a rainy day fund? How do you want to take income in the future and what happens to your assets when you die?

 An abundance of choices to provide answers to the above questions is good, but too much choice can paralyse decision-making. The new normal requires a plan earlier in life.

All the while, policymakers have continued to give people plenty of things to think about. In the past 12 months alone, the previous chancellor deliberated over whether – and how – to cut pension tax relief for higher earners. The ‘pensions-ISA’ system was mooted as the culmination of a project to hand savers complete control over their retirement savings, while also providing a welcome boost to Treasury coffers in the short term.

During her time as pensions minister, Baroness Altmann voiced her support for the current system of taxing pension income, rather than contributions, indicating a split between the DWP and HM Treasury on the matter. Baroness Altmann’s replacement at the DWP is Richard Harrington. It remains to be seen how much influence he will have and on what side of the camp he sits regarding taxing pensions.

Meanwhile, Philip Hammond has entered the Treasury while our new Prime Minister calls for greater unity. Following a tumultuous time for pensions, a change in tone towards greater unity and cross-department collaboration would be very welcome.

In order for everyone to acclimatise properly to the new normal, the new chancellor should commit to a return to a longer-term, strategic approach to pensions policymaking, enabling all parties, from regulators and providers to customers, to make decisions with confidence that the landscape will not continue to shift as fundamentally as it has in recent times.

Steven Levin is CEO of investment platforms at Old Mutual Wealth.

To view all of Old Mutual Wealth’s retirement reports, visit: www.oldmutualwealth.co.uk/ products-and-investments/ pensions/pensions2015/