HCSA calls for Treasury tax reform as research casts doubt on flexibilities plan

Download the HCSA Pension Flexibilities Consultation Submission

New research by HCSA - The Hospital Doctors' Union casts significant doubt on the ability of proposed "pension flexibilities” to remedy the impact of pensions taxation on the medical staffing crisis and its consequences for patient care.

HCSA reveals the findings in its submission to the Department of Health and Social Care consultation on pension flexibilities, which closed last week.

In its submission, published today, HCSA argues:

  • No amount of flexibility within the current scheme will succeed in conclusively resolving the current crisis
  • Understaffing is a key underlying cause of the crisis and this must be recognised
  • The unintended consequences of pension tax rules will continue to impact hospital doctors’ behaviour and choices until the Treasury revisits its reforms to lifetime and annual allowances
  • Any hospital doctor who makes use of flexibilities should, however, have as a matter of national policy access to repayment via salaries of employer contributions saved

 HCSA research found that just one in seven doctors said they would definitely use the complex framework of pension "workarounds" - including cutting back on contributions - once they are introduced.

The research also suggested many NHS Trusts are lagging behind in a pledge to ramp up education for doctors: three-quarters of hospital doctors said they had not received any guidance from their Trust on pensions taxation.

The findings also highlight the widespread impact, with more than a third of hospital doctors saying they had cut back on hours or given up senior roles to avoid passing pensions tax thresholds, and over half of these gaps remaining unfilled.

HCSA President Dr Claudia Paoloni said: “We have said all along that flexibilities will not resolve the issues we are seeing on the ground, and now we have evidence from hospital doctors that back up this view.

“Whoever wins the election next month is going to have to act fast to at least partially reverse the growing paralysis which is contributing to rising waiting times the length and breadth of Britain.

“Understaffing is at the root of this crisis, and we know that for many hospital doctors pensions taxation has proven to be the last straw – they feel they have been flogging themselves to bridge the gaps in care created by vacancies and have been rewarded with tax bills running into tens of thousands.

“The truth is that even with tax changes not all of these will now be coaxed back into working overtime – they have reassessed their work-life balance and chosen life.

“But for those who wish to, these flexibilities will not resolve the fundamental problem: that keeping under the £110,000 annual allowance taper threshold is the easiest way to limit their exposure to huge tax bills.

“The answer very clearly lies with the Treasury, the scrapping of the taper and reform of the tax system. Without that, these well-meaning proposals are set to fail.”