Chris Lancelot - Retirement could save a GP's sanity, with or without money

The only nine-to-five job I've ever held in medicine was as a psychiatric SHO in a therapeutic community.

I loved it - but discovered the hard way just how stressful it could be to do psychiatry well. By 5pm each day I was exhausted - yet, on paper, the post had seemed part-time by comparison with my previous work on the medical wards.

I discovered later that consultant psychiatrists were allowed to retire at 55. I wasn't surprised - they deserved it. This also resonated with the opinion of one of the early surgeons of the pre-anaesthetic era that no-one should continue operating after the age of 50. The intensity and pressure of the work (inflicting all that pain) would inevitably take its toll.

Even now, medicine is more than 'just a job'. Done well, it is stressful. It requires continual alertness, and never-ending decision-making in uncertain circumstances.

The stakes are always high: a single lapse of concentration can cause death or injury to a patient, never mind the ever-present fear of having to appear before the GMC or the High Court.

Even worse, these tensions are intensifying year upon year. There is ever more to learn, and therefore more to get wrong. Demands upon doctors are increasing, yet NHS resources are reducing; patients, managers and the public are much less forgiving than in the past. No wonder so many of our colleagues can't wait to retire, finding that the job they once loved has become utterly exhausting. Many can't even continue to the age of 60.

I am convinced that the real problem lurking behind the government's proposed pension changes isn't the money but the long-term strain of medical practice.

Do we seriously believe that the present generation of junior doctors will be capable of working full-time - 10 or 12 hours a day, five days a week - until they reach 68? Few will make it. Either they'll die in harness, so they won't even get to draw their pension; or else they will need to make alternative arrangements to enable them to retire at 60 and survive financially until their pension starts at 68.

For doctors, a change to the retirement age is about a lot more than just money.

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