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Original papers: Alex Mears, Tim Kendall, Cornelius Katona, Carole Pashley, and Sarah Pajak Retirement intentions of older consultant psychiatrists Psychiatr Bull 2004; 28: 130-132 [Abstract] [Full text] [PDF]

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Perverse Incentives

Michael Cooper   (6 April 2004)

Retaining MHO Status is not 'perverse'.

Navjot S. Ahluwalia   (20 April 2004)

Perverse Incentives 6 April 2004
Michael Cooper, Consultant Psychiatrist Rotherham District General Hospital Send letter to journal: Re: Perverse Incentives michael.cooper{at}rotherhampct.nhs.uk Michael Cooper	Whether or not the incentive to be able to retire early from what your survey confirms to be an overworked and undervalued profession is 'perverse' (Psychiatric Bulletin, April 2004, 28, 130-132) is a matter for debate. Nevertheless many psychiatrists will undoubtedly have taken it into account when choosing their career. More to the point, many Mental Health Officers will have made important financial planning decisions based upon a "guarantee by law" (A guide to the NHS pensions scheme NHSPA, 2001) that such an entitlement will remain in place. Given that there may be moves by the government to change the law and hence remove such a guarantee, do the authors not consider it unwise to describe what many consider to be one of the few 'perks' of psychiatry in such a way? Given the substantial financial incentives of non-NHS work, have the authors not considered the potentially disastrous consequences for an already strained profession that the removal of MHO status might lead to? Mike Cooper Consultant in General Adult Psychiatry Rotherham District General Hospital
Retaining MHO Status is not 'perverse'. 20 April 2004
Navjot S. Ahluwalia, Consultant Psychiatrist in Substance Misuse Rotherham Community Drug Team Send letter to journal: Re: Retaining MHO Status is not 'perverse'. Navjot.Ahluwalia{at}Rotherhampct.nhs.uk Navjot S. Ahluwalia	Mears et al (Psychiatric Bulletin April 2004. 28, 130-132) have produced a valuable paper but I believe reinterpretation of some of their findings is necesssary. As I am sure most readers are aware the entire NHS pension scheme is being 'reviewed'. This includes the MHO status which most workers in the psychiatric services still have as it was only removed as a priviledge in 1995. I have a deep sense of unease about the pensions 'review' and this paper can only add to my dismay. I had not realised that early retirement using MHO status was "perverse" as the authors put it. I believe those in the armed services and the Police Force have similar rights to such dreadful perversion. Some of us have managed the financial planning of our families on this disgusting incentive. Also the authors fail to note that those doctors with MHO status intended to retire at a mean age of 59.14 years versus 62.88 years for those without it. The difference is only 3.74 years, a long way from the potential maximum difference of 10 years as those with MHO status can retire without penalty from 55 onwards. It would be better to concentrate on the real factors in the study encouraging psychiatrists to retire such as heavy case-loads and feeling undervalued. Or perhaps it is easier for the Department of Health to save some pennies by removing the MHO status from perverts like me! I will bet my life that this is the part of the paper that will have them jumping for joy.