Chris Lancelot: Doctors aren't immune to the impact of a slump

What does the financial future hold for doctors as individuals?

In the short term the outlook is relatively good. The government has pledged to keep NHS spending constant for the next two years, so medical jobs are unlikely to be squeezed. (Sadly, this means that the unhelpful and expensive Darzi clinics won't be trimmed back either.)

The real problem for the profession will come in two to three years' time. Having maxed out UK plc's credit card on all the wrong things, the government is having to borrow ever more just to keep industry afloat. This money will have to be paid back. In two years' time the burden will fall entirely upon those still in work, who will be taxed up to the hilt to repay these loans.

Clearly, doctors are squarely in the frame for this: we will bear more than our fair share of the cost of the recession. Additionally, if inflation doesn't go through the roof then the value of the pound will fall. Either way our savings and investments will devalue, and all foreign purchases, including holidays, will become vastly more expensive.

As if this weren't enough, the UK also faces a demographic time bomb: an aging nation with a shrinking workforce. As well as repaying the government's borrowings, those still in work will also be taxed to pay for increasing numbers of pensioners.

In the long term, cash for the NHS inevitably risks being squeezed, and unless the DoH reduces the number of superfluous administrators there will be constant pressure to employ fewer, less qualified clinical staff, at reduced rates of pay.

Nevertheless, in a recession doctors and nurses generally keep their jobs. This good news also extends to our NHS pensions which, being state guaranteed and inflation-proofed, are still relatively secure - unlike pensions in the private sector which depend upon savings, shares or the viability of the company providing the pension.

Unfortunately, the level of security we enjoy will not apply to our patients, many of whom will be out of a job or suffering a significantly reduced pension. We doctors will be the lucky ones - although everything is relative, because the future will be tough for everyone. Batten down the hatches: this recession is going to last for a long time.

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