Denman et al's paper Reference Denman, Oyebode and Greening1 was thought-provoking and of vital importance given the current difficulties in recruiting to psychiatry training schemes. However, it is our opinion that the authors made a significant omission in not assessing the effect that Mental Health Officer (MHO) status has had on applications to training schemes.
Certain members of staff who were members of the National Health Service pension scheme before 6 March 1995 were eligible for MHO status. 2 This enabled them to take retirement aged 55 with no reduction in pension benefits. MHO status was withdrawn in March 1995.
Financial incentives have become almost a taboo subject, but one which we feel should be revisited. MHO status recognises that, owing to the particular stresses in the specialty, early retirement may be desirable or necessary for some doctors. This offered a significant financial and lifestyle boost to those afforded it.
The crisis in recruitment to psychiatry training posts is well described. It is exacerbated by the effect MHO status has on retention of experienced psychiatrists. Retirement aged 55 – instead of 60 or 65 – only worsens the workforce crisis. The recent reduction in lifetime allowance from £1.25 million to £1 million will make it financially unattractive to those with MHO status to carry on working past 55, even if they wished to do so.
It is highly unlikely that MHO status would ever have been the sole reason to choose psychiatry. However, it formed a significant incentive that directly contributed to the attractiveness of the specialty. It is worth considering what impact its withdrawal is having and comparing the benefits of MHO status to the salary premiums which have been offered in the new junior doctor contracts.
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