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 (attached) 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.

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

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The Academy of Medical Royal Colleges has written to the Chancellor of the Exchequer and the Secretary of State for Health (attached) 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, including members of our college, 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.”

Professor Jackie Taylor, President of the Royal College of Physicians and Surgeons of Glasgow said:  “If government values our experienced NHS staff they would commit to action now to reform this punitive and unfair process, and ensure that valuable staff are recognised for their contribution to our health service and patient care.”

A copy of the letter can be found online here.


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