South and East Wales Branch
Welsh Ambulance Services NHS Trust.
Branch 11353
5 Pant Yr Hebog
Broadlands
Bridgend
CF31 5DF
Tel 07808 632089
Email tonychatfield@worldonline.co.uk
31st March 2004
Dear Mike,
I would like to thank you for your invite to the review seminar on the 8th march in London. We found the day
very informative, and hope that it will be something we can build on for the future.
As time passes, I realised that a lot of information was exchanged on the day, and with some thought and
discussion since, there may be further opportunity to have input on Values & Aims.
So many points were raised on the day, and perhaps some were missed or not put forward. Some may have a
greater importance than others, and some may have already been raised. In light of this I would like to list a
few that may or may not have been raised in the four questions on the day.
Choice & Flexibility

Critical Illness Cover. This has to be a key additional benefit in modern society. A form of cover in the
event of being incapacitated, may be an attractive option. Also an increase in death benefit scheme
allowance, already allowed by the scheme, which should be offered now, to staff who wish to receive it.

A Phased Start to the scheme. Mortgage companies provide reduced induction’s to their product to allow
for an element of flexibility for the individual. Perhaps we should view their examples. This in turn
allows members to prioritise financially and perhaps allow them to spend finance elsewhere. This may be
particularly beneficial for first time buyers, or young people starting a family, or buying a property, who
perhaps cannot afford a full commitment to pension scheme in the first instance.
Equality

There are no real comments that we can make here, as the recommendations may be either a legal or
statute requirement.
Working On

Limits and conditions should be set, concerning occupational health checks and competency.

Phased Retirement. Perhaps it would be less of a culture shock for individuals to retire slowly, rather than
the immediate cessation of employment. It would also allow for expertise/experience to remain in the
workplace, whilst allowing the individual to ‘bow out gracefully’. Perhaps re-deployment may be an
alternative, or the ability to freeze the maximum allowed to be paid into the scheme, and the possibility to
continue working (full-time or reduced hours) whilst the fund continued to mature, or be received.
Recruitment & Retention

A secure pension scheme has to be one of today’s societies biggest selling points

Better promotion and communication of the benefits needs to be advertised. Informed staff don’t then
assume!
The above list is not exhaustive, and may have already been raised
Please find attached a copy of a document with quotations from Mr Andrew Forster, a member of staff from
your own organisation, where you will note that the highlighted sections clearly indicate a need for special
requrements for Ambulance staff. (Appendix 1)
I also attach a copy of a letter (appendix 2), sent to Ministers, specific to the review of the pension scheme in
relation to Ambulance staff. As mentioned on the day, an urgent review of the scheme for Ambulance staff is
required in order to improve working lives. The high percentile of ambulance staff retiring on ill health has to
be reviewed if any individuals, who retire, are to have any quality of life or reasonable health for their
retirement.
In light of this we would like to formally object to any attempt to increase the retirement age for Ambulance
staff, and request the reduction of retirement age, without abatement to 55. This may be achieved with the
introduction of a 60ths scheme, or even to afford ambulance staff the former MHO status.
We would continue to value any opportunity for us to be part of the consultation/review process of the NHS
pension Scheme, and any discussion regarding the fair retirement of Ambulance staff. Please do not hesitate
to contact Mr Dave Galligan, UNISON representative on the pension review body or myself should you
require any further information.
Yours in anticipation
Tony Chatfield
Mr Tony Chatfield
Branch Secretary
UNISON 11353
Welsh Ambulance Service
Appendix 1
Cast aside
The government's review of public sector staff retirements on ill-health
grounds could give the NHS a fresh incentive to overhaul retirement and
pension options, writes Patrick Butler
It will be news to most NHS employees that thousands of their colleagues are 'faking'
illness in order to win a cushy early retirement at public expense - but the readers of
certain newspapers will have acquired that impression.
The occasion of this tabloid knee-jerking was Treasury chief secretary Alan Milburn's
announcement this month of a review into why 25,000 public sector staff retire on illhealth grounds every year, at an annual cost of more than £1bn.
But is the NHS full of fraudulent shirkers? There is no strong evidence of this - unlike
in the Metropolitan Police, where it has been officially admitted that large numbers of
officers facing disciplinary charges retire on medical grounds.
Statistics show that the NHS, proportionally, is not the worst offender: according to
the Treasury, 33 per cent of NHS retirements were illness-related, compared with
local government (50 per cent), the fire service (73 per cent), civil service (22 per
cent), teaching (25 per cent) and the armed forces (6 per cent).
There is little evidence that the NHS uses ill-health retirement to 'ease out' difficult or
badly performing staff. 'Managing a release on the grounds of ill-health happens
occasionally, but I suspect the vast majority are genuine,' says NHS Confederation
human resources spokesman Andrew Foster.
Indeed, the real scandal appears to be how NHS staff are forced into ill-health
retirement by employers' neglect (direct or indirect), or the iniquity of the pensions
scheme. Figures supplied by the Royal College of Nursing show that for the three
years to 1997-98, the proportion of those going on grounds of ill-health among
nurses taking retirement has risen from 80 per cent to 84 per cent. Many of these
have back injuries caused by lack of correct lifting equipment or poor training.
In the ambulance service, only one in 100 frontline staff reaches retirement
age. It is estimated that 75-80 per cent of frontline retirements are on ill-health
grounds - well over twice the NHS average. They leave because of
musculoskeletal injuries and, increasingly, stress.
Part of the problem is that although careers of frontline staff are expected to
last around 30 years (in line with the fire and police services, whose pension
arrangements reflect this), NHS pension arrangements assume a 40-year
career.
According to one senior ambulance officer, this means that paramedics in their
50s struggle on beyond their physical capabilities, wear themselves out, and
are forced into ill-health retirement. 'Proper early retirement would help these
people to retire with dignity, instead of hanging on until their health breaks
down,' he says.
There are also reported cases of NHS employers allegedly persuading staff to retire
with the unscrupulous promise that ill-health retirement will be forthcoming, only for
the NHS pensions agency to refuse the application, leaving the applicant jobless and
pensionless.
Guinette Davies, nurse adviser to the RCN's work-injured nurses group, says that in
one such case, a nurse in her 40s with 20 years' NHS service has been left jobless,
poor (she exists on benefits as she cannot receive her pension until aged 60) and
depressed.
Ill-health retirement is not just confined to frontline staff. According to the Treasury,
'the rate of ill-health retirements among NHS male administrators in their 30s and
40s rose four-fold between 1969 and 1994, before dropping off in the late 1990s'.
Mr Foster suggests that stress may be even more of a factor for women managers,
particularly if they are juggling work and family. Much white collar ill-health is stressrelated, he suspects, and it is not surprising given the demanding management
agenda.
There are many options the NHS can explore to reduce ill-health. The ambulance
service is keen on the idea of a dedicated occupational health service. Both the RCN
and the ambulance service want more scope for redeploying staff into other areas.
The Treasury review may give the NHS a fresh incentive to consider these options.
This will inevitably require a cash injection, Mr Foster says, but it will pay dividends
by improving employees' health and prolonging careers. 'The hatchet-faced financial
directors of the world will have to accept there's a payback from this kind of
investment.'
The Treasury review: terms of reference
* To review factors leading to ill-health retirement, including why incidence is much
higher in some parts of the public sector and in some employing authorities than
others.
* To identify best practice both in the management of pension scheme provisions
and the operation of relevant human resource policies.
* To make recommendations to ministers on the implementation of measures to
spread best practice and to ensure the appropriate use of ill-health retirement
benefits.
* The review will report 'by early 2000'.
Back
© 2000 Emap Healthcare Ltd
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Appendix 2
South and East Wales Branch
Welsh Ambulance Services NHS Trust.
Branch 11353
Dear Minister,
Firstly may I take this opportunity to thank you for reading this letter. Recently we had the privilidge
of being invited to provide input at the Pensions Green Paper Consultation exercise, Holiday Inn,
London Kensington on the 7th May 2003. I hope that our input on the proposals for the Green Paper
have been of benefit.
Secondly, I am writing concerning the proposals that are underway regarding pensions, and the green
paper from the DWP, that is currently under consultation.
I note that in section 6.5 of the green paper, there is a reference to public service pension proposals.
The proposals highlighted in point 66 states: “There will continue to be some occupations such as armed forces, fire service and police where the
need for a recognised physical capacity justifies the award of a normal pension at a lower age…”
I wish to point out that once again we find ambulance staff omitted from this list. For many years we
have campaigned for earlier retirement (55 years) for our profession, and for very good reasons: 
Ambulance staff suffer one of the worst post retirement longevity periods.

Ambulance staff have one of the worst ill health retirement rates in the NHS. On average 3 to 4
people working in the NHS retire annually on the ground of ill health per 1000 staff. Ambulance
staff have a rate between 17 to 30 ill health retirements per 1000 per annum in comparison.
That’s 4 to 6 times the number of ill heath retirements compared with other NHS workers. It is
usually caused by Physical injury such as musculo-skeletal injuries, but mental stress problems of
a post-traumatic nature are on the increase.

The government has allowed our colleagues in other emergency services, retire at an earlier age,
for many years. It is deemed virtually unacceptable for a fireman/police officer aged over 55 years
to be in active service. It is however not uncommon to find Front line ambulance personnel
(Paramedics and Technicians) working till full retirement age (65). These members of staff could
be carrying one of our own relatives down several flights of stairs, or dealing with you at a serious
road traffic accident, often in dangerous circumstances, in an attempt to save a patient’s life. An
Ambulance person, who visits one patient, may have to lift that patient plus equipment up to 12
times between incident and handover at clinical care. Multiply that by an average of 8 calls a day
and that could equate to 96 lifts per shift, upto, equivalent or greater that that persons own body
weight. Multiply this by 40 years of service, and you arrive at some alarming figures. I don’t
know how this compares to the other services, but I don’t believe that a fireman would lift up to
96 people in a day!*

The NHS confederation of human resources figures indicate that only one in 100 frontline
Ambulance staff actually reaches retirement age.

In 1997, the National Ambulance Service Retirement Age Working Party submitted a report,
together with the ASA (Ambulance Services Association) to the Department of Health (then the
Ministry of Health). This report recommended ability for staff to retire at 55 years with no loss of
benefits. It also advised changes to the pension system for Ambulance staff, to allow the
retirement at an earlier age.

The 1997 report also recommended modification of the NHS Pension scheme, in recognition of
“the shorter life expectancy of front line ambulance staff, so as to enable such staff to retire on
half pay on completion of 30 years’ contributing service, and to retire without any actuarial
reduction of their benefits at age 55”

The report was updated with additional evidence in June 1998, and submitted to the DOH. It
concluded that “It appears as a matter of fact, that it is unlikely that a member of frontline A&E
(ambulance) staff, can be expected to sustain more that 20-25 years active service, particularly if
also over the age of 50-54. This confirms and further supports the findings of the previous report
(Nov ’97) on the Ambulance Services Retirement Policy recommendations.”

The treasury review of ill health retirements in the public sector (July 2000) indicated that the
NHSPA should have a target of 4 ill health retirements per 1000 staff. This target could be met as
part of the government’s initiative of “Improving working Lives”. The target date for this figure is
2005. Realistically, those figures are close to the average now for general NHS staff, with the
exception for frontline Ambulance personnel, who account for four to six times that figure as a
minimum. It is therefore clear, that to be successful in reaching the 4 per 1000 figure for
ambulance staff would probably have to be done as a complete review of their scheme.

As a result of potential change to any scheme, the entire career structure would probably have to
be reviewed. A new structure would allow staff to remain in the workforce longer, though
contributions may have to be increased for the scheme to be sustainable. It may also have to be
considered for staff to be able to continue in their post if they should wish. This could be subject
to a medical, or other conditions, and would eliviate any risk of any claims regarding age
discrimination.

I note that one of the purposes of the green paper is to eliviate age discrimination. I would
therefore ask for age parity with the other services, regarding length of service and retirement. I
am also aware, as no doubt, you are too, that there is a working party to discuss the earlier
retirement of Ambulance personnel as a special case. I believe that this working party is in line
with the government’s policy on “Improving Working Lives”. I can only hope for a positive
outcome.

It may be of benefit to you to contact the NHS Pensions agency at Fleetwood, where Mr Paul
Robinson has been tasked to lead the review as part of the “Improving working live initiative”.
He may be able to provide you with additional information, with view of considering us as a
special case for earlier retirement.
I would therefore like to seek your support and assurance, in campaigning for the early retirement for
Ambulance Personnel, without loss of benefits, and allow us access to the specialist group of
occupations of physical capacity. This would allow them to enjoy a longer retirement, be more family
friendly, and possibly use their experiences and advanced skills elsewhere in the workforce.
I do hope that you can assist us in our endeavour, Please contact me at the above address or our
national Pensions officer, Mr Glyn Jenkins, based at Unison Offices, Mabledon Place, London WC1.
Thank You,
Yours Sincerely,
Tony Chatfield
Mr Tony Chatfield
Branch Officer
On Behalf of UNISON Branch 11353
Welsh Ambulance Services NHS Trust South & East Region
*Figures available if required
All Data and Evidence Available on request