Doctors’ pensions tax issue now having a real impact on patient care

The College recognises the vital importance of raising the issues in the Academy’s joint letter to the Chancellor of the Exchequer and the Secretary of State for Health & Social Care, on the impact of current pension regulations on service provision. As well as contributing to the Academy’s work on this, and further to the letter Professor Ravi Mahajan, President of the Royal College of Anaesthetists said:

“Our senior members tell us that the current pension scheme has made it harder for them to take on additional work commitments to help alleviate workforce pressures. Staffing concerns in the NHS are ongoing and a reduction in the number of hours that consultant anaesthetists are able to work because of the pensions taxation issue, is only going to increase the problem.  I know that clinicians of all grades put the safety and timely treatment of patients first and they are keen to see the situation does not further impact on the delivery of care.  We welcome the government’s decision to review the current pension scheme and we urge them to hear the concerns raised by doctors and work urgently to make sure this issue is resolved.”  

Doctors’ pensions tax issue now having a real impact on patient care

The Academy of Medical Royal Colleges has written to the Chancellor of the Exchequer and the Secretary of State for Health calling on them to urgently address the pensions tax issue that is causing many of the UK’s most senior doctors to reduce their overtime or leave the NHS altogether.

The letter follows an audit of the Academy’s members which asked them to give real-life examples of the impact the tax changes are having on patient care because fewer doctors means even longer delays for patients needing both urgent and elective care. With the NHS short of 11,000 doctors already, many hospitals rely on senior doctors working overtime to plug rota gaps and reduce waiting lists. Responses from the Academy’s members included:

• radiologists at Nottingham University Hospitals NHS Trust reported that because of staff working reduced hours the number of CT/MRI scans the hospital can do has dropped from 1200 a month in January to 600 in July
• at the Royal Cornwall Hospitals NHS Trust three senior paediatricians have been forced to cut their hours to avoid punitive tax rates which has meant 720 patient appointments have been lost this year
• at Guy’s and St Thomas’ NHS Foundation Trust, in London, seven out of 35 intensive care consultants have reduced their working week which has led to one Intensive Care Unit being mothballed for nearly five months.

The pensions tax crisis has been simmering since new rules were introduced in 2016, but has hit doctors and other high earning state employees such as judges and civil servants hard this year, because the tax allowances which could be ‘carried over’ in previous years have now, in effect, been ‘maxed-out’. It is widely understood to be Treasury that is blocking any changes to the rules, which in some extreme cases mean doctors are paying more in tax than they are actually earning.

Professor Carrie MacEwen, Chair of the Academy of Medical Royal Colleges said: "This is self-evidently a ludicrous situation which is having a direct impact on the care patients are receiving and staff across the NHS. Fewer doctors means the ones that can afford to stay and work are getting burned out, so everyone is impacted. All this will take to fix is a bit of creativity when it comes to the rules and less intransigence on the part of Treasury."