I think an important part of this debate is a general feeling that Doctors, GP's in particular, are paid. Clearly they are paid well, GP's earn an average of 100K if the papers are to be believed (though I am a Gp and sadly fall rather short of this). But how much should they be paid? I don't know how much a bus driver gets paid - 25-30K? Tube drivers get 40 to 50K I believe? It's hard to get into medical school, you need to get high grades in some difficult subjects. Medical degress are also quite difficult, lots of lectures etc pretty much 9 to 5 for 5 or 6 years - compared with 10-20 hours of lectures per week for many degrees. Graduate pay is quite good admittedly, good job security and wages can rise to impressive levels if you're a hospital specialist and able to do private work on top of your NHS commitments but again there's lots of demanding and responsible work involved, lots of difficult and very expensive exams etc incredibly expensive annual indemnity fees, it's a stressful job compared with many other occupations.

So how much should Doctors be paid? Well? Do they deserve good pensions?

Sorry, re the final line above : I meant to say should doctors be paid well? Not: WELL? Not trying to hector anyone....

It's a good point. At the moment the two - pensions and pay - are inextricably link. Aside from a debate about whether the pay levels or fair, my colleague Jill Insley has suggested reforms could look at whether all of a doctor's pay should be pensionable, or whether the government could set a limit on how much of the salary was taken into account.

When I was working as a junior doctor out of hours getting paid 1/3 of time (NOT time and a third) the quid pro quo for that was the good pension.

When my pension was renegotiated in 2008 to make it sustainable and protect the taxpayer from the effects of NHS pensioners living longer - my contributions rose as did the normal pension age for the scheme, to 65.

When I am in my late 60's with the inevitable health problems that will bring to many of us, I will be faced with a choice of retiring early and losing a hefty chunk of pension or to continue working - in labour ward, the emergency department, theatre etc, potentially putting patients at risk from my frailty. What would you choose to do?

When my next door neighbour on an identical salary in the civil service pays half what I am being asked to pay for the same pension, I wonder, is this fair, particularly as I walk to my car at 3am to go in to attend an emergency...

When the government currently gains TWO BILLION per annum from the NHS pension scheme and cuts the income tax of the very wealthiest....

Can you understand why I am pissed off?

I have said it before but illsay it again.

How much do you think someone who studies for years, works very long hours, weekends/nights/Easter/Christmas/public holidays and needs to be available for emergencies any time of day ought to be paid. How much to you value your health and therefore the guardian of that health?

Perhaps another way to put to is this; pick an hourly rate you think is reasonable for doctors. Then multiply that by the number of hours a doctor actually works in a year (not the official number of hours on the contract as this understimates considerably) and I guarantee it comes out at more than we currently get paid. What does this mean? The current hourly rate, all those unpaid hours taken into account, is often less than the minimum wage.

This is not about doctors being millionaires, if we wanted that we could have chosen to do any other job in the world, it's about a decent wage which reflects a decent job, nothing more, nothing less.

a typical doctor's salary of £65,000

Polly I think you should fact check this for a start. Consultants can earn well over 100k just from the NHS, even before the moonlighting down the road for BUPA.

Rich want more. Poor have little voice. And the public who are already paying doctors a fabulous salary are now expected to continue with pensions we in the private sector can only dream about.

And hours are an irrelevance - junior doctors may have long hours at stages of their career but many in the private sector have long hours throughout their careers (and a pittance of a pension at the end).

Let them strike (impossible to get an appointment anyway these days).

Doctors should be paid well and should have good pensions. To suggest otherwise is ludicrous. Doctors have to engage in intensive education and training considerably beyond most other occupations. Medical expertise is specialised (even in wide knowledge ends of the profession) and the stakes, that is our stakes, in that expertise are extremely high. We need and want good doctors. Doctors are not overpaid. The salaries of doctors in the NHS are entirely reasonable. I find it extraordinary that this conversation is being conducted at all.

Hello, that salary was suggested by John Wright who said it was a typical GPs salary. I will check with the BMA. I realise consultants do earn more, but there will be lots of doctors, including doctors, with earnings that are dragging down the average.

How many life and death decisions do you have to make or how many people do you have to operate on in the middle of the night? I'm no longer a junior doctor but my hours are still extreme. In the last 10 days I worked 157 hours and I'll be paid for 48. The other night I was operating on an emergency patient who had a piece of dead bowel that needed to be removed, this was at 2am, after being at work since 7 the previous morning.i finished at 5, had a quick sleep and shower at the hospital and started a new day 2 hrs later at 7. I then had a full operating list that day during which I had 7 cases, plus ward round, plus on call, plus supervision of junior trainees and students. That night i didn't go home til midnight. Oh! And I had to give a presentation the next day. When do you think I last saw my friends or had a dinner out somewhere?

there's lots of demanding and responsible work involved

I'm a scientist, and it frequently annoys me that medics complain they have a difficult job (the "hardest job in the world" I have heard some say). I work very long hours, and get paid slightly above the average, for a job that is highly skilled, and takes years of 50-60 hour weeks to even get to the next level, i.e. a permanent job.

However, do I think I should be paid the same as a GP, and do I think their salaries and pensions are reasonable? The answer is no, i shouldn't be paid the same as I don't have patients lives in my hands. And it's on that basis that I would say yes the salaries and pensions are reasonable for the level of responsibility that you have. People should be more appreciative of not just what doctors do, but any public servant including teachers, nurses, policemen etc.

Sorry Hilary, didn't realise it wasn't Polly today.

You say at the top of the piece that the current scheme is a final salary scheme (not average career salary). Surely therefore the salary of a junior doctor is not therefore relevant - what matters is the typical salary of older, senior, doctors?

The doctors are just showing the most extraordinary lack of self-awareness regarding how this looks and in doing so are driving a wedge between themselves and those they treat.

The article estimates that you would need to save £1.5m over the course of your working life in order to be assured of a pension the same size as that which an average doctor will achieve.

Earning an average salary of £26k for a working life of 45 years, the man or woman in the street would earn £1.1m in total. But the doctors are defending their right to be able to save up more than that just for their pension. Over a shorter working life.

I'm a strong believer in the importance of having a strong public sector but given the position that private sector workers find themselves in, the doctors' aggressive negotiation to retain their extraordinary privileges, is cavalier. This attitude from some of the highest people in society risks under-mining the impressive and important relationship between the public and the NHS.

Well said and I'm big supporter of under appreciated scientist.

correction to last sentence: "highest people" should read "highest PAID people"

To expand on @PinkPearl's post DeimosP, maybe you'd like to tell us what you do, so we can compare and contrast your role with what a medic does?

... wages can rise to impressive levels if you're a hospital specialist and able to do private work on top of your NHS commitments...

So: full-time NHS consultants think that GP partners are better paid, and (salaried?) GPs think that consultants are better paid...

... here is a comment that I made earlier today:

... to earn the big bucks as a doctor you go into management or (and indeed often both) private practice. Working full-time with patients in the NHS and avoiding the distractions of private practice (universally inimical, in my experience, to doing your best for NHS patients) pays less well.

It's clear, at least in my part of the world, that doctors devoted to the NHS are the ones, with many reservations and not a little soul-searching, if not guilt, who are taking industrial action. It seems, to me, entirely predictable that those doctors supporting Andrew Lansley are those protected from the governments pension shenanigans. This is why he uses patients and other NHS workers in his argument: it is the striking doctors who care.

Indeed, it is the doctors who carry on as normal who are happily helping to dismantle the NHS in their own financial interest. Make no mistake, there is a deep political and ethical undercurrent that has persuaded a fundamentally conservative profession to take any action at all, and that undercurrent is the ongoing attack upon the NHS and all of its workers.

No. It's the politicians trying to drive the wedge james, and it appears you've fallen for it. I'll ask you this: how many of those earning the average salary of £26 make life and death decisions? Or even decisions that have long term health repercussions for people? Do you think that counts for nothing? It's called meritocracy.

The NHS pension scheme currently has a £2bn surplus but this is expected to return to a deficit by 2016. There are two main reasons for this surplus.

1) According to figures on the NHS Pensions website (www.nhsbsa.nhs.uk) in year 2009/10 NHS workers paid £2.5bn in pension contributions and this was topped up with £5.3bn from the tax payer.

2) The NHS pension is in surplus also because there has been a large increase in the number of NHS workers recently. While this means more pension contributions now, it also means larger pension payouts when these workers retire and since there is no NHS Pension 'Fund' it will mean a much higher cost to the treasury in the future.

I don't mind doctors being well paid and receiving a decent pension since they work hard but I do object to having to contribute so much to their pension scheme. On average, for every pound an NHS worker pays in contributions, the tax payer pays in 2 pounds. Compared to the majority of UK workers that just seems unfair.

I see what you mean - we need the average at retirement for the amount they are getting as pension to be correct. I will go back to John Wright and see if he knows what that is. The average, including junior doctors, is relevant for the contribution levels though. Thanks for pointing that out.

Its a very complex issue as it ultimately boils down to how much doctors are worth, which is laden with value judgements and very susceptible to personal bias.

One side issue is that of the public perception of doctors. People generally attend doctors with reluctance. It is a transaction that most would ideally avoid. People don't chose to see doctors based on a perception of high regard they generally do so out of necessity with the expectation that certain things such as competence, communication, confidentiality etc. are intrinsic to that interaction.

Although doctors do have fairly high regard among the public, I think that is a by-product of their work and not essential to it. If I were involved with these negotiations I wouldn't place too much value on the public regard argument, as it's basically irrelevant. There is a big difference to what people think of 'doctors' as a group, and what they think of the actual doctor who treats them.

How are teachers and doctors comparable? the latter earn far more than any teach could unless i'm missing something?

Doctors are not overpaid.

That is a matter of opinion, there can be no consensus on what Doctors should be paid so the argument is unimportant.

All we can discuss is what the market price for their services is, and since they are strongly unionised (in the form of the BMA) we can say they earn market price + economic rent, so objectively speaking they are 'overpaid'.

Absolutely correct.

What the BMA also doesn't admit is that in the decade to 2009/10, medics' contributions doubled (largely due to the increase in numbers and pay) but that over the same period, the taxpayers contribution increased sevenfold - and is still increasing rapidly.

www.nhsbsa.nhs.uk/Pensions/Documents/Pensions_FOI_Requests/Sinar_figures.pdf

Of course doctors should be paid well and receive a good pension - but their current demands seem somewhat out of kilter with reality. Very few workers are now on final salary pension schemes and as the article above estimates, you would need to save £1.5m over the course of your working life in order to be assured of a pension the same size as that which an average doctor will achieve.

There are few jobs nowadays where workers are not expected to regularly work longer than their contracted hours, and many people work in roles which require weekend and bank holiday shifts. Many workers, across a range of professions, are required to study long and hard as part of their careers. Admittedly doctors may be at the extreme end of this, but I'm not sure that this merits a pension which is subsidised quite so much by the tax payer.

A few years ago there was a study comparing life expectancy of top docs and surgeons and police who retired at 60 or 65.

Those who retired at 60 on average lived 15 more years, those who retired at 65 on average lived to 70!

What does this say? That working a demanding job after age 60 significantly shortens life expectancy. I wish I could reference these stats but I heard them in a lecture regarding life expectancy and pension planning!

So currently the government are asking for even more contribution while expecting to pay out less and still creaming the £2bn surplus off the top. If they are trying to plunder anyones pensions go for the bankers not the hard pressed docs who have to explain daily to sick patients why they cant receive excellent care.

And yes I feel health service workers should be compensated for the conditions in which they work across the board. see my blog here for more info http://showhowitsdone.blogspot.co.uk/2012/06/uk-doctors-on-strike.html

How much to you value your health and therefore the guardian of that health?

If this issue proves anything it is that first and foremost Doctors are an interest group which put themselves before public health or any such abstraction. If 'health' came first then they wouldn't be striking. I appreciate that many Doctors are not striking though and good for them.

Consider also that the BMA originally opposed the creation of the NHS and have obstructed the NHS over the years to their advantage.

This is not about doctors being millionaires, if we wanted that we could have chosen to do any other job in the world,

I find this arrogance quite often with Doctors that they believe they could just walk into another profession and be mega-rich, the implication is that they are saints for stooping so low as to magnanimously waste their intellects treating NHS chattel. Don't tell me you don't care about money (how noble!?) then strike for money...it's nonsensical.

The current hourly rate, all those unpaid hours taken into account, is often less than the minimum wage.

I really doubt that... I have absolutely no problem with doctors earning well, or striking to protect the deal they signed up for. But, taking the figure for a typical GP given in the article, it's actually impossible for that to work out at less than the minimum wage, even working 24 hours a day, 365 days a year.

My comments don't reflect some arrogant chest-beating about how great we are! They reflect the dedication we have. The point about chosing another job that would have made us rich is true. We CHOOSE to do this job because we love it. Hard to believe as it be might for you, we are not motivated by money. Not everyone is. If we didn't put our patients first we would clock off at 5 as we are theoretically meant to and let patients fend for themselves.

Do you know if that report is online anywhere? I'm off to check but can you remember who did the research?

You have to remember that GPs are consultants. They are at the top of their training path. There are many many more juniors out there for whom my comments are true.

So currently the government are asking for even more contribution while expecting to pay out less and still creaming the £2bn surplus off the top.

They are not "expecting to pay out less" - the taxpayer contribution is rapidly increasing and has increased over the last decade far more rapidly that that of NHS workers.

www.nhsbsa.nhs.uk/Pensions/Documents/Pensions_FOI_Requests/Sinar_figures.pdf

And if you think that there is a surplus then you don't understand pensions. To claim that there is a surplus just because current contributions exceed current outgoings is disingenuous as it entirely ignores the (much greater) build-up of future pension payment liabilities.

I think that science is criminally underpaid...one of the main reasons why the UK lost its pre-eminence in the world

Im a researcher and physician. The research aspect doesn't pay nearly as well as the physician aspect. Both are difficult and demanding in different ways. One thing that i do enjoy when i am doing my research, is that however long and arduous the hours i have to work, it invariably does not involve constantly changing shifts that just tire you out. 60 hours a week is a lot more difficult when yo uare doing it in shifts of 2pm-1am, then 8.30pm-8.30am then 9-5 constantly switching between them. This pattern of work not just tires you out, but reduces your life expectancy and increases morbidity (such as cancer). Shift workers need to paid to compensate for this.

I have never been to a good GP. Never helpful, most of the time cynical and always think they know best. It's like they resent seeing a patient. For that reason, I have no sympathy for them.

The point about chosing another job that would have made us rich is true.

No it's supremely arrogant especially as most Doctors have never existed outside of public sector institutions and have no idea about the cut and thrust of the private sector. Success in one field doesn't mean one is guaranteed success in another.

Rather than look at pensions, I would say the package as a whole is too generous - the pensions are the end product of overpaid doctors.

There are some exemplary doctors in the profession who may well deserve their package but there are too many lack lustre GP's just going through the motions and getting money for old rope.

It's nigh on impossible to get a GP to come out to visit a sick old person but come the vaccination season they are on the phone like tawdry salesmen touting for business. Their raison d'etre is to care for the infirm not to meet targets.

First of all let me qualify my response by my situation. I am a Civil Servant in a middle ranking role, my wife is a vet, relatives and friends are doctors, some of whom now work part-time simply because they earn enough.

We convert a lot today into a monetary value for worth, we often have family discussions over 'vocation' and definitions of worth. People seem to have lost a sense of duty over maximisation of financial benefits, I believe Doctors in general have been very fortunate in their agreed packages over the last 10? years.

Are Doctors worth a decent salary - absolutely. If we take the Civil Service Scale - the highest non Senior Civil Servants earn typically £55 - £65K. Typically these people are gifted, have post graduate degrees have various skills and intelligence at their roles and at management. These people devote a lot of time to their work, probably exceeding 45 - 50 hours per week minimum.

If you are in the public sector, if you believe in a certain amount of 'service' for the greater social good then I think the above is not an unreasonable comparitor. If you argue that Dr's are worth more (not specialists or consultants), then you are comparing them to the salary bands of Senior Civil Servants, or equivalent to the most senior military ranks. If the £100K salaries are correct - that bears no equivalent with the Civil Service that I know, except for our directors.

My wife by sense of alternative measure as a salaried vet - is unlikely to earn more than £40-£45K full time and has only a self-contributory pension because it is in the private sector and purely profit based, yet she had to train in similar ways to Doctors in the initial years. She has to do on-call, weekends and it costs us a lot as a family in terms of time and child-care.

So in conclusion, I believe they are extremely well paid, they are worth our respect and gratitude for looking after us - however that does not necessarily correlate to extraordinary pay in a public service. Private is a different matter in my opinion. Should they accept the change - yes.

I will be unlikely to earn £65K at the current rate of pay freezes let alone retire on it, my wife will be lucky if she has any retirement pot at all. I do believe there are two principles at stake, one - the focus on money as the sole arbitrator is wrong in principle. Two - I can understand the principle of striking when the government continues to move the goal posts - as we have observed within the Civil Service.

Really??

Every consultant I have seen has been head and shoulders above any GP I've seen.

Foxxxo - I absolutely agree that scientists are underpaid - and that you're almost certainly underappreciated for the work that you do. I wasn't complaining about the difficulty of my job, or complaining about my pay - I'd be mad to do that - I think I get paid pretty well. What I was complaining about is the Knee-jerk response of so many people to the headline figure of average GP/Hospital Specialist earnings. It sounds like a lot, and it is a lot, but it's not as much as your average banker, dentist, barrister, whatever gets. My point was this - how do you judge value. Thanks for your support incidentally.

And how do you think you would fare in my job? Why the aggression?

The point is when we had finished school, we had the grades that were a passport to any other degree course. If money had motivated us we could have chosen law or dentistry or various other pathways that ultimately would have lead to a much higher-paying career. Instead we made a different choice in the full knowledge it was not going to make us rich, and that's ok. All we want is a fair wage for the work we do.

I have no problem with Doctors being paid well - and since the astonishing 2004(?) GP contract, GPs would be best advised to maintain a discreet silence on the subject. But the reality is that we are all living longer, and that means we all have to work longer and contribute more to pensions.

Personally, I think that the only way of draining the poison from the Pensions argument is to make ALL public sector pensions Defined Contribution. That way the cost / value will be transparent to everyone, and the total remuneration package will either withstand scrutiny or it won't.

I guess I need to clarify the training pathway. Everyone starts out going through the junior doctor stuff. After a few years you choose to specialize. Either you can train to be a surgeon, physician or GP etc. Once you have complete your training in that specialty you are a consultant in that specific area. GPs thererfore are consultants in general practice and are on a par in terms of seniority with consultants in any other area. They will have completed all the post-graduate specialty exams from the Royal College of General Practitoners, just like a consultant surgeon has completed the equivalent from the Royal College of Surgeons.

Doctors have never existed outside of public sector institutions and have no idea about the cut and thrust of the private sector. Success in one field doesn't mean one is guaranteed success in another.

Firstly, of course success isnt guaranteed. But they would have had a damn good (statistically speaking) chance. The strongest predictor of degree class is raw A level scores (which also correlate strongly with IQ). the strongest predictors of employment and salary are family background which puts doctors at an advantage over others because of their chance of having an advantageous one, the type of degree, the class of degree and the institution. With straight As and A* and a string of extra-curricular, these students would have made damn good candidates for being on the top end of employable graduates - which with those grades would have got them into very strong institutions doing science type degrees and with a privileged family background, it is highly likely that they statistically speaking would outperform the 'average' A level student. Of course some wont make it, and some with less than stellar credentials will. But they, as a group, would have been successful in other fields.

And you have no idea about the 'cut and thrust' of medicine, the competitiveness necessary to succeed in medical training, never mind even being allowed to enter

Sure but perhaps aside from Dentistry having a degree is not necessarily a passport to money/success in contrast to how grades are a passport to a degree.

I just think you are presuming a lot about fields/careers you are ignorant of and also assuming the the future is predictable.

This is a typical argument I hear from many public sector people especially Teachers.

Having worked in the private sector I can tell you that the lack of job security, and the general ethos is very much in contradistinction to 'caring' professions and teaching (if you don't count teaching in that class).

Personally I wouldn't want to see a born lawyer as my GP. Intelligence is one thing but less tangible qualities such as empathy and being human is another.

Some good points but can I just clarify, only consultants or specialist at the top of their game in the last few years of work per-retirement would be on anything like 100k. Most others ear more like what your wife does and less than you.

Check whether that includes part timers or it is based on full time equivalents.

Are doctors' pensions too generous?

This is the wrong question, and its depressing and sad to see so many get into this tit for tat type discussion over other peoples pay and conditions.

This 'debate' is being generated falsely it is only because of the economic crisis and the State bailing out private banks that this is even up for discussion.

Who cares if doctors pensions are good? Shouldn't all pensions and old people enjoy a good quality of life? Is this really beyond us in the 21st Century? It will be under Capitalism.

And there's the rub, whinging about other workers pensions means we are not focussing on the fact there is wealth in our society, it's just all at the top.

The 1000 richest people in UK £155 Billion richer in the last 3 years, enough to pay off the deficit and still have £30 Billion left over.

Big business sitting on £750 Billion not having a clue what to invest in.

That's the problem not doctors or anyones elses pensions and please lets stop the rubbish about people living longer being a problem, really? Shall we start to kill everyone over 70 then like Logan's Run?

The way society is heading people will start to live shorter lives, not longer ones.

Divide and rule, divide and rule.

Trouble with that take on it is this- was there no other way to express unhappiness than to hit patient care?
And round here the GPs 'striking' are getting paid in full for the day because they are 'at work' though refusing to see patients. That doesn't help people's feelings much.

And you have no idea about the 'cut and thrust' of medicine, the competitiveness necessary to succeed in medical training, never mind even being allowed to enter

There is lots of politics and deception in the private sector, it's not some laid out road map to 'success' like medical school.

Look I'd actually agree with that and I understand that job security is something I am lucky to have.