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National Health Service: Pensions

Volume 798: debated on Monday 10 June 2019


Asked by

To ask Her Majesty's Government what steps they are taking to review the tax rules relating to National Health Service pensions; and whether they intend to have a public consultation on the issue.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as a trustee of the Parliamentary Contributory Pension Fund.

My Lords, I am aware of concerns raised by NHS doctors about the impact of annual allowance tax charges. Although there are no plans to have a public consultation on the tax rules, on 3 June the Secretary of State for Health and Social Care announced his intention to consult on introducing a new pension flexibility for high-earning NHS clinicians affected by annual allowance tax charges.

The Answer that my noble friend has just given is most welcome, but it is perhaps a little tardy in the sense that this problem has existed for some time. The people who suffer are NHS patients, as consultants do not feel able to take on extra work. Is it not time that there was a total review of NHS pensions, as a whole lot of anomalies have developed over time? I now declare a second interest, as my wife is a retired GP. Prior to 1988, there was equality of contributions for men and women and equality for the beneficiaries, whether they were widows or widowers. However, for 24 years, despite having paid equal amounts, the future beneficiaries of female doctors—their husbands or partners—have had no benefit. Against that background—there are other examples—instead of a short-term review, is it not time that the NHS looked at all the anomalies that have arisen over time and tried to put them right?

My Lords, in the interval between my noble friend tabling his Question and today, the Government made a significant announcement on 3 June aimed at addressing the very problem that he addresses in his Question, and no doubt he can claim some credit for that chain of events. On the point about the impact on patients, between 2018 and 2019 57% of GPs who retired took early retirement. Some consultants are unwilling to take on extra sessions because of the impact on their pensions, and that has an impact on the quality of service that we can provide. On his more detailed question, I understand the sense of injustice that he feels about the circumstances that he has described. I will see whether the consultation that begins at the end of the month can be stretched to include the broader review that he has just proposed.

My Lords, are not the Government being more than a little tardy in response to this situation? After all, they introduced the pension arrangements in 2015 and it is clear that they made a right mess of them in some respects. In addition to the range of people whom the noble Lord, Lord Naseby, spoke about a moment ago, both ends of the medical profession—younger doctors and consultants—are greatly aggrieved at the provision of pensions under the 2015 legislation. I just wonder why the Minister can say with equanimity that we are getting round to a consultation.

It is important that noble Lords understand the background to the changes. One of the most expensive tax reliefs is pension tax relief. It costs £50 billion per year—roughly half the budget of the NHS. Two-thirds of that goes to additional, or higher-rate, taxpayers. The reforms introduced over the last two Parliaments were aimed at targeting the relief more effectively and saving £6 billion that could be redirected towards other priorities. Less than 1% of taxpayers will be affected by the taper of £40,000 that was introduced, and more than 95% of those approaching pension age will not be affected by the lifetime allowance.

My Lords, I declare an interest as a past president of the BMA, and as someone with an NHS pension whose husband does not stand to gain particularly by my death; so be it. Do the Government recognise the seriousness of the situation, given the open letter from the BMA to the Prime Minister published in the Financial Times today? The 50:50 suggestion that came from the Secretary of State is not the solution to the problem. Clinical services are already being severely jeopardised by consultants who drop their additional sessions; waiting lists are therefore already rising and those facing retirement have decided to carry on with leaving the NHS, thereby worsening our workforce problems.

We join the noble Baroness’s husband in wishing her a very long life. So far as the issue she raises is concerned, the BMA asked us to introduce this flexibility earlier this year. The chair of the BMA council said:

“This is a step in the right direction”.

The Secretary of State is willing to discuss other models for pension flexibility; we very much hope that, if we make these changes, high-earning clinicians will be able to attend to more patients while saving for their retirements without incurring significant tax charges.

My Lords, senior officers in the armed services face the same problem. I raise this because I know that the Minister will follow up on it. One showed me his tax returns: a £5,000 increase in income led to an additional tax payment—in just the first year—of just under £17,000. This is driving away not only senior officers but especially the high-fliers who, with early promotion, get into this conundrum very early in their careers.

My Lords, the Armed Forces Pension Scheme continues to be one of the best available defined-benefit occupational schemes. Service personnel on the AFPS are not required to contribute towards their pension throughout their career. However, we continue to monitor the differences between the various schemes to ensure that they are fair and provide appropriate support to the workforce.

My Lords, does my noble friend the Minister not recognise that this is not a problem confined to the NHS or indeed the armed services? It arises because the former Chancellor of the Exchequer, George Osborne, reduced the size of the pension pot from £1.8 million to £1 million over a short period of time. As a result, if people with final salary pension schemes reach the age of 55 and do not retire but continue, they are taxed at an outrageous 55%. The remedy lies in the Treasury undoing the mess that it created in the first place.

There are a number of contenders for the leadership of our great party at the moment. If my noble friend feels this is a cause which will gain currency in my party, no doubt he will pursue it with one of those candidates. However, I return to what I said a few moments ago. The changes we made were progressive, to ensure there was not an inequity in the tax relief benefit.