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NHS Pension Scheme

Volume 660: debated on Tuesday 21 May 2019

4. What assessment his Department has made of the effect of the annual tapered allowance on members of the NHS pension fund. (911004)

5. What assessment the Government have made of the effect of the annual tapered allowance on the (a) recruitment and (b) retention of doctors in (i) hospitals, (ii) primary care and (iii) the armed forces. (911005)

6. What recent discussions he has had with Cabinet colleagues on the NHS pension scheme tapered annual allowance. (911006)

The NHS pension scheme and other public service schemes are among the most generous pension schemes available in this country today. The tapered annual allowance is focused on the highest-earning pension savers to ensure that the tax relief that they receive is not disproportionate to that of other savers. However, I do accept that there is some evidence that the annual allowance charge is having an impact on the retention of high-earning clinicians in the NHS. I am in discussion with my right hon. Friend the Health Secretary about how to provide additional pension flexibility for NHS doctors affected by the annual allowance tax charge, and he will make an announcement as soon as possible.

I am grateful to the Chancellor for that answer, and particularly to the Government for accepting that the taper contributes to capacity gaps and retention issues in the NHS. Given that the costs of increased waiting times, delayed diagnosis and knowledge gaps far outweigh the tax revenue generated, would not the sensible and fiscally responsible thing be just to scrap the taper altogether?

I understand my hon. Friend’s point. However, the overall reforms to pensions allowances that were made in the previous two Parliaments and include the tapered annual allowance are necessary to deliver a fair system and to protect the public finances. These measures affect only the highest-earning pension savers and are expected to raise £6 billion a year. But, as I said, we are monitoring the response of high earners in the NHS, and I expect that my right hon. Friend the Health Secretary will be able to make an announcement soon.

A number of hospital consultants who live in my constituency have written to me to express their concern at the implications of the tapered annual allowance. With GP numbers continuing to fall, ongoing shortages across consultant specialties and armed forces doctors currently experiencing a 23% workforce shortfall, how is the Chancellor going to help doctors and patients by resolving the unintended consequences caused by the annual tapered allowance and lifetime annual allowance that are leading to doctors who would otherwise be happily continuing to work having to leave the profession to avoid disproportionate and unfair tax bills?

I think I have answered that question, but it is good to hear Labour MPs focusing on the disincentive effect of high taxation, particularly on professionals in our public services. Someone has to be earning £150,000 a year before the tapered annual allowance affects them. I would suggest that perhaps Labour Members who do understand the detrimental effect of very high marginal tax rates on professionals in our public services make those representations to their right hon. Friend the shadow Chancellor, who is intending to raise tax for everybody earning more than £80,000 a year.

One of the constituents I have in Barrachnie is a consultant who has told me that there are concerns about recruitment and retention. Given that a recent survey shows that 40% of doctors have retired early as a result of pension tax changes, I would urge the Chancellor to look again at this and make as strong a case as possible to the Health Secretary so that he can make sure that we have the staff in the NHS to serve our communities.

As I have already said, both the Treasury and the Health Department wish to address this problem. We have to find a mechanism that does it in a way that is fair and appropriate. The right way to do it is through increasing flexibilities within the NHS and, potentially, other public sector schemes. My right hon. Friend the Health Secretary will make an announcement as soon as possible.

Yesterday I met representatives of Alliance Health Group who were making representations because a number of very experienced surgeons are leaving the NHS due to the problems with the pension. I just wondered how representations would have been made to the Treasury on behalf of consultant groups.

The British Medical Association has been vocal, I think is probably the right word, in making the case around the disincentive effect of annual allowance charges, in particular, but also lifetime allowance charges. The Health Secretary and I have been discussing this for some time, and I think we are close to reaching a conclusion.

The workforce shortfall is the greatest challenge facing the NHS. What discussions has the Chancellor had with the Health Secretary about the combined impact of these changes together with the disastrous consequences for the NHS workforce that would follow a no-deal or WTO Brexit?

As the hon. Lady says, recruitment and retention is one of the big challenges facing the NHS. Clearly, anything that were to impede the NHS’s access to overseas workers coming into the UK to serve in our health service would have an impact on that. But I have also recognised and acknowledged today that the operation of the pension annual allowance charge does have a significant effect—particularly, it seems, on partners in GP practices.