First Standing Committee on Delegated Legislation
Monday 8 May 2000
Dr. Ashok Kumar
National Health Service (Pension Scheme and Compensation for Premature Retirement) Amendment Regulations 2000
Mr. Philip Hammond (Runnymede and Weybridge): I beg to move,
That the Committee has considered the National Health Service (Pension Scheme and Compensation for Premature Retirement) Amendment Regulations 2000 (S.I. 2000, No. 605).
May I start by welcoming you, Dr. Kumar, to the Chair, and congratulating you on your elevation to the Chairmen's Panel. I hope that we shall all enjoy the opportunity of working under your chairmanship on many future occasions.
The measure that we are considering is largely uncontroversial. It tackles the changing shape and structure of the national health service, in bringing primary care trusts and pilot schemes fully into the scope of the regulations. However, it was laid during considerable public interest and press speculation about the case of Dr. Harold Shipman and the pension entitlements of medical practitioners leaving the service for reasons other than reaching normal retirement age. We wanted further clarification from the Minister on those issues, and to probe further the arrangements for dealing with pensions and compensation for such people, including people who take what is euphemistically called retirement in the interests of the efficient operation of the service, and those who retire following obvious misconduct such as Dr. Shipman's.
As so often happens, other issues came to light during our examination of the regulations. Although they are perhaps not worthy of a debate in their own right, it makes sense to raise them now that a debate has been arranged. A common refrain used by me in Committees considering delegated legislation is that I understand, from rulings or advice given by Committee Chairmen, that it is the relevant Minister's responsibility to ensure that the appropriate materials are circulated to Committee members, or made available to them through the Vote Office, to enable them to scrutinise the measures in question. I regret that neither the National Health Service (Compensation for Premature Retirement) Regulations 1981 nor the National Health Service Pension Scheme Regulations 1995 are available in the Vote Office. Will the Minister and the other responsible persons note that when we debate a statutory instrument that refers to other measures it would be helpful if those were made available in a timely fashion in the Vote Office? Fortunately, I have obtained them elsewhere.
I turn to the issues that arise from the Shipman case. The Government have, rightly, concentrated on dealing with the tiny minority of medical practitioners who do not act in the best interests of their patients or bring the service into disrepute for some other reason. On 1 February, 2000, the Secretary of State told the House that
the powers that I have as Secretary of State allow me to remove pension entitlements from those recipients who have seriously damaged public confidence in the NHS. I am today giving notice that I am considering removing Harold Shipman's pension entitlements.--[Official Report, 1 February 2000; Vol. 343, c. 909.]
That statement was not totally accurate. Regulation T6 of the 1995 regulations states that
Subject to paragraph (2), the Secretary of State may direct that all or part of any rights to benefits...in respect of a member be forfeited if the member is convicted of any of the following offences...
(a) an offence in connection with employment...which is certified by the Secretary of State to have been gravely injurious to the State or to be liable to lead to serious loss of confidence in the public service;
(b) an offence of treason;
(c) one or more offences under the Official Secrets Acts 1911 to 1989.
Curiously, paragraph (2) goes on to say:
A guaranteed minimum pension may be forfeited only if paragraph (b) or (c) applies.
In other words, a practitioner will only forfeit his guaranteed minimum pension if he has been found guilty of treason or an offence under the Official Secrets Acts, but not, apparently, if he has been murdering his patients. In what circumstances is a guaranteed minimum pension payable? To whom is such a pension payable? Which classes of practitioner or clinician would receive such a pension? Should we not examine the regulation, to ensure that there is no loophole that sends a contrary message to that which the Secretary of State intended when he made his statement on 1 February?
What has the Secretary of State done about Dr. Shipman's pension entitlements? Is Dr. Shipman in receipt of any NHS pension? There is much public interest in the matter. The Secretary of State may have done nothing, simply because of the procedure that must be followed in the quasi-judicial exercise of his discretionary powers. If that is the case, should we not amend the regulations that deal with the possible loss of pension benefits, given that we have the amended regulations before us? The Secretary of State should not just have the discretion to remove some or all of them, but, in cases in which a practitioner has been found guilty of a serious abuse of trust and has committed a criminal offence that carries a sentence of imprisonment, should be able to ensure that the loss of pension rights is automatic--not at his discretion.
How often does the Secretary of State use the power that regulation T6 gives him? What is the extent of the problem? The Shipman case had a high profile, but I am aware of several other cases, with a much lower profile and--I hasten to add--involving much less serious situations, in which practitioners have retired following allegations of misconduct. To what extent does the Secretary of State use the power that is vested in him under that regulation?
During the debate on 1 February 2000, my right hon. and learned Friend the Member for Sleaford and North Hykeham (Mr. Hogg) raised with the Secretary of State the important issue of the position of the innocent spouse of a practitioner whose pension entitlements are removed. Is not it time to make specific provision for the spouses of members of the scheme whose pensions are rightly removed as a result of actions that are seriously damaging to the interests of the service? I am pleading for the introduction of a concise and possibly automatic process rather than of a discretionary process that could involve the Secretary of State in long-winded reviews of cases and which might also result in the payment of a pension to somebody who has committed crimes such as those perpetrated by Dr. Shipman. We must wait for the Minister to explain whether the process could do so. The great majority of the public would not want that to happen, and I suspect from the Secretary of State's tone in making the statement that he, too, would find such circumstances thoroughly unacceptable.
How many people retire from the health service
in the interests of the efficiency of the service?
Would that euphemism cover people who retired following involvement in gross and obvious misconduct such as that of Dr. Shipman? If so, how many of the total number of people who retire
in the interests of the efficiency of the service
will have abused their positions within it? I am sure that the numbers will be small, but I know that the Minister, like the Secretary of State, will acknowledge the vital public interest that is at stake.
As I said earlier, although we have been forced to consider the regulations in detail because we wanted to raise specific issues, a number of other questions have also arisen. I hope that the Minister can answer them; indeed, I suspect that he can, as I see that he has a comprehensive brief. I am not a pensions expert and the regulations are nothing if not opaque, so I am grateful to whoever drafted the explanatory note, which was extremely helpful and illuminating, although that is not always so.
Regulation 5 amends regulation E3 and provides that the certificate issued by the Secretary of State in respect of retirements
in the interests of the efficiency of the service
can be issued only with the agreement of the employing authority. Does that provision merely formalise current national health service practice? I suspect that it does. As it is the Government's stated intention that incompetent as well as malevolent practitioners will be weeded out--provided that it is done fairly, we support that objective--we must conclude that the provision, which allows for early retirement
in the interests of the efficiency of the service,
is likely to be used more frequently in future. Does the Minister think that it is entirely consistent with his Government's policy that the authority that will have to bear the on-going pension or compensation costs of early retirement should also need to acquiesce to such retirement? There are increasing concerns about single-handed general practice in that respect. Is the proposed procedure appropriate, or should the retirements or terminations of employment in question be independently reviewed?
Regulation 13--again, I am grateful for the explanatory note, which has given me a sporting chance of understanding it--also concerns me. Until 31March 2000, a person who returned to employment in the national health service after having retired and drawn a pension would have his or her total emoluments--the pension plus the salary--reduced to an amount that did not exceed the salary. Someone could not retire from the service, draw a pension, re-enter the service, draw a full salary and continue to receive the pension. However, as of 1 April, that will not be so. The pension and salary will be paid without reduction. A doctor can retire, rejoin the service and receive the pension and salary.
I am not going to dismiss such a possibility out of hand as patently absurd. Doctors who retire early might find that their circumstances have changed and that they are able to rejoin the service. Given the shortage of doctors, it would be ridiculous to put hurdles in the way to disincentivise people. My hon. Friend the Member for Woodspring (Dr. Fox) has proposed a targeted scheme in which retired general practitioners with many years' experience are encouraged to return to service in inner cities or deprived areas for relatively short periods without losing their pension entitlements. That would allow them to bring the benefits of their experience into play. Is the Minister satisfied that he is not opening the door to abuse?
At the same time, will the Minister consider a separate issue? It is not possible for people who legitimately return to employment in the NHS after they have retired, perhaps because the state of their health has changed, to rejoin the NHS pension scheme. Someone who retired early with a relatively low pension entitlement and who returns to employment in the NHS cannot rejoin the scheme and build up full pension entitlements to the normal retirement age. If the purpose of the proposal is to encourage people who are able to do so to return to the NHS in appropriate circumstances, would it not be better to offer them the option of ceasing to draw the pension to which they are entitled and allowing them to rejoin the scheme, so that they could build up a more substantial or full pension for when they finally retire?
In what circumstances do people return to the NHS after having retired from it? Does the Minister intend to target a particular group for recruitment back into the NHS? It is a legitimate false start for people to retire because of ill health and to return if their health improves, but, without wanting to paint the world black and white, a distinction may be drawn between that and the possibility of structured abuse as a result of the changes. Will the Minister give the Committee an idea of what numbers were involved until 31 March under the old system in the suspension of all or part of pensions on re-employment in the national health service?
Since we are discussing pensions and the NHS, I would like to take the opportunity to question the Minister on two other areas. What arrangements are available for members of the scheme who leave the NHS and continue employment elsewhere to transfer their accumulated entitlements from the NHS fund to another fund? My understanding is that that is possible, but that the process is hedged by many caveats. Such transfer is complex and difficult to achieve.
I understand that the Minister's instinctive reaction is that he does not want to encourage people to leave the NHS, but experience across the spectrum of activity in our society suggests that the more flexible one makes a system, the more one encourages people to do what one wants them to do. Creating artificial rigidities such as exchange controls and high marginal tax rates might be superficially attractive, but they have been shown not to achieve in practice the benefits that they were set out to achieve. I would be grateful if the Minister told us, first, of the current situation and, secondly, whether the Government have plans to address the inflexibilities on transferring out.
Will the Minister tell us anything about the impact that the Government's rethinking of their policy on retirement age might have on the national health service? I am thinking especially of nurses. Many nurses are entitled to retire at the age of 55; a considerable number of them retire at that age. I do not know whether the recent comment in the press merits the title of speculation or whether it is more solid. It was to the effect that the Government were revisiting the issue of retirement at the age of 55, that they were minded to the view that that should be discouraged and that it would be in the public interest if people tended to work longer.
I do not, on the whole, disagree with that judgment, but there would be considerable concern if the Government intended to move in that direction with regard to the nursing profession. They are not only the Government of the nation but, in the last resort, the employer of the NHS. To achieve a wider policy objective, they might seek to change arrangements in the health service ahead of legislative or other changes using not legislative procedures but the Secretary of State's powers as the health service's ultimate manager. It would be helpful if the Minister told us how he saw the debate on retirement at the age of 55 in the context of current arrangements in the NHS.
As I said at the outset, the original purpose of laying the prayer was to probe the Government on issues arising from the Dr. Shipman case. I hope that members of the Committee will have found useful the raising of a couple of other issues worthy of a second look, and find it useful to hear what the Minister has to say on them. My questions on Dr. Shipman and the payment of pensions to medical practitioners in similar circumstances covered an issue of wide interest to the public. I hope that the Minister will be able to clarify what has been happening in the Shipman case and to state the Government's wider view--for the benefit of members of the Committee, the listening public and those outside the House.