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Doctors: Retirement Age
2.45 p.m.
Lord Brooke of Alverthorpe asked Her Majesty's Government:
- What plans they have to allow doctors to remain in National Health Service employment beyond the age of 65.
Baroness Andrews: My Lords, the retirement age for hospital doctors is 65. Flexibility in the system already allows for their employment after the age of 70, after which they may continue to be employed subject to the needs of the service and quality assurance. General practitioners, as self-employed, independent contractors, are removed from the medical list at the age of 70, although they can continue to practise beyond that.
Lord Brooke of Alverthorpe: My Lords, I am grateful to my noble friend for that Answer. Is she aware that as the NHS seeks to boost its numbers and to recruit doctors from overseas, many doctors at home, who are fully fit, efficient and meet the requisite clinical standards, are not aware of the options she has described? Will she take every step to ensure that they are made aware of the opportunities open to them to continue in employment in the NHS beyond the age of 65?
Baroness Andrews: My Lords, my noble friend is right, we are anxious to make as much use as possible of the excellent skills of doctors approaching retirement age. The NHS is trying very hard to become a good employer. The flexible retirement initiative was launched in July 2000. It was designed specifically to enable staff to work more flexibly towards and beyond retirement. That could include extended part-time working, exchanging a senior role for a junior role, working over the winter, and so on. These and other
options are set out in the publication, Improving Working Lives for Doctors, which has been sent to no fewer than 10,000 doctors.
Lord Clement-Jones: My Lords, is it not the case, as the Audit Commission confirmed, that we have a potential retirement time-bomb on our hands in regard to general practitioners? Is the giving of options sufficient? Is not it absolutely vital that the department fashions some real financial incentives to ensure that general practitioners stay in post, particularly single practitioners in London?
Baroness Andrews: My Lords, it is true that the Audit Commission drew attention to a shortage of GPs. One of the practical options being put in place is the "golden hello" for new GPs and for retaining GPs coming back. An extra £5,000 will be added to that to create an incentive for GPs to work in inner city areas.
Baroness Greengross: My Lords, more and more GPs are retiring early for all kinds of reasons—inflexibility of work, too much pressure, and so on. The noble Lord, Lord Clement-Jones, made a very important point. Does the Minister agree that we need a comprehensive approach to keep doctors in work? They are highly qualified and we need them, both before and after the current retirement age.
Baroness Andrews: My Lords, the noble Baroness's point in regard to a comprehensive package is very important. That is why Improving Working Lives for Doctors is such an important document. It sets out a clear range of options for people approaching retirement. There is a myth about doctors retiring early in the sense that the retirement age for doctors has remained constant at 62 years for the past seven years. But we want all doctors to work to their fulfilment. As part of our drive to retain GPs we have launched the delayed retirement scheme under which GPs over 60 can delay their retirement and receive an additional £2,000 a year up to £10,000. That package was closely and successfully negotiated with the BMA.
Lord Renton: My Lords, would it help the noble Baroness to know that I knew a surgeon and family doctor who performed his last operation at the age of 78? He was my father.
Baroness Andrews: My Lords, this House is not the place to argue for early retirement under any circumstances. I take the noble Lord's point: there are some magnificent doctors aged over 70 who are still practising. The problem of capacity has to be addressed. An appraisal system for GPs will be introduced this year which is identical to that for hospital doctors. We are addressing competence through appraisal and through revalidation.
Lord Rea: My Lords, does my noble friend agree that a particular problem will be created in certain deprived areas where primary care has been kept afloat for the past 30 or 40 years by doctors trained in South
Asia who are almost simultaneously coming up to retirement age? What packages are being designed to retain doctors in deprived inner-city areas?
Baroness Andrews: My Lords, we are conscious that there is a problem in regard to the retirement of doctors in single practices. As my noble friend says, that relates particularly to Asian doctors. I mentioned the "golden hello" payment and additional payments to doctors. We are spending £55 million on improving premises. In London, where there is a particular problem, we are looking at the potential introduction of doctors from overseas in a pilot scheme across London, which may well help the situation.
Lord Phillips of Sudbury: My Lords, enlarging on the noble Baroness's replies to the very relevant questions of my noble friend Lord Clement-Jones and that of noble Baroness, Lady Greengross, does she accept that at the root of a great deal of disaffection on the part of doctors—whether GPs or hospital doctors—and their wish to get out of service as soon as they can, is their complete frustration with NHS and hospital bureaucracy and with the endless reorganisation in the health service? These affect their working lives and remove a great deal of pleasure and fulfilment, making them want to leave the service.
Baroness Andrews: Yes, my Lords, it a real problem, and the Government have addressed it. Two reports have addressed bureaucracy: one in June 2001 and one in March this year. Clearly, doctors feel very strongly about it. A number of measures have been set out to reduce red tape which have the potential to unlock 10.3 million appointments. They will address issues such as repeat prescriptions and requests for non-medical information. We hope that these will be followed up as quickly as possible.
Asylum Seekers
2.52 p.m.
Lord Chadlington asked Her Majesty's Government:
- What progress they have made towards meeting Home Office targets on the removal of asylum seekers whose cases have been rejected.
The Parliamentary Under-Secretary of State, Home Office (Lord Filkin): My Lords, the number of failed asylum seekers removed from the United Kingdom has increased year on year from 6,990 in 1998 to some 9,185 excluding dependants in 2001. The number removed in the financial year 2001–02 including dependants was 11,515. The target in the Spending Review 2002 PSA is the same as that in the Spending Review 2000 PSA:
- "enforcing the immigration laws more effectively by removing a greater proportion of failed asylum seekers".
Lord Chadlington: My Lords, I thank the Minister for that reply. Can he tell the House precisely how many bogus asylum seekers will be deported in the next 12 months?
Lord Filkin: My Lords, the House would be amazed if I could give an accurate figure. It will depend on a number of factors. First, there must be a safe place to which people can be removed; so the country from which they have fled has to be normalised. We hope that Afghanistan will increasingly move into that category. Secondly, there must be effective documentation so that, when a person is removed by means of a charter flight—a method of travel that is increasingly used—he or she is accepted on arrival. Thirdly, we must be able to identify the failed asylum seekers, which is why we are increasing contact management and building up a detention estate.
Lord Judd: My Lords, does my noble friend agree that, in the midst of all our other preoccupations about immigration and asylum policy, the objective which is perhaps most important is that every single asylum seeker who should have asylum in this country is accorded it with the minimum of delay? Will not history judge us by our record in that respect?
Lord Filkin: My Lords, I agree that one of the standards by which we shall be judged is the care and humanity that we apply to those making genuine asylum claims. There is good progress. As to new asylum claims, the vast majority of initial decisions are now given within two months. But history will judge us also by how we manage the challenge—faced by many countries—of large numbers of people seeking to use asylum routes for understandable, but not acceptable, economic migration.
The Lord Bishop of Portsmouth: My Lords, does that mean that the targets referred to by the Minister are not realistic in the circumstances?
Lord Filkin: My Lords, the original target—which remains the current target—of removing some 30,000 failed asylum seekers a year is right. If one looks at the rate of acceptance in asylum cases, as a proportion of those applying, over time we should be seeking to remove about 30,000 a year. But we shall arrive at that point only when the other measures are in place—when it is safe to do so, when there is documentation, when transportation means are in place, and when we have the strength and ability to identify and detain failed asylum seekers. The commitment is there. The debate is about how rapidly we can arrive at it.
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