NHS Pensions: Taxation

Andrew Selous Excerpts

Monday 8th July 2019 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)(Urgent Question]

To ask the Chief Secretary to the Treasury to make a statement on the implications for patients of the taxation of NHS pensions.

[The Chief Secretary to the Treasury (Elizabeth Truss)]

The Government keep public sector pay and pensions policy under constant review in the context of the wider public finances. For the majority of savers, pension contributions are tax-free. The annual allowance is a fiscal measure that operates across all registered pension schemes in both the public and private sectors, alongside the lifetime allowance. The measure is kept under review by the Government to ensure that the benefit of tax relief on pension schemes remains affordable.

Some senior clinicians face pension tax charges owing to the increase in the value of their pension accrual. I understand that the Secretary of State for Health and Social Care is currently engaged in discussions with senior representatives of the British Medical Association. The Government are taking this issue very seriously, and that is the right place for those discussions to be held. However, the House will recognise that the same tax rules must apply identically to everyone in the same situation, regardless of their employer. It is simply not possible for the tax rules applying to senior clinicians in the NHS to be different from those that apply everywhere else.

I understand that the Secretary of State for Health and Social Care is to publish a consultation on proposals for a new 50:50 scheme providing pension flexibility for clinicians in the NHS. The scheme will give senior clinicians in England and Wales more choice in respect of their pension accrual, and will thus control tax charges. Since last autumn, all members of the NHS scheme on the taper have been able to elect for the pension scheme to pay any tax charges now, and so avoid any impacts on take-home pay, in return for an actuarially fair reduction in their pensions.

I recognise the concerns that have been raised, and I assure the House that the Government will continue to monitor the impact of pensions policies on public service delivery.

[Andrew Selous]

The unforeseen consequences of recent pensions legislation, initially supported in all parts of the House, are now resulting in very worrying consequences for the NHS as hospital doctors who have regularly worked weekend overtime to get waiting lists down are understandably refusing to continue to do so because they are being made worse off as a result. Can we imagine a conversation between couples along the lines of, “So you are leaving me and the children again this weekend to go voluntarily to work to make our family worse off?” It is not going to happen, is it? The same applies for GPs, many of whom are now doing fewer sessions each week than they want to and their patients desperately need in order not to be made worse off by breaching their annual pension allowance.

We do not have conscription for healthcare staff; we cannot force them to do weekend overtime or more sessions than they want to, and it is not surprising that they choose not to if they are being made worse off as a result. For example, in The Guardian this morning we learned of one senior anaesthetist who worked 27 Saturdays last year in order to reduce waiting lists and has now said he cannot afford to work any extra Saturday shifts this year because it would give him a large tax bill he cannot afford to pay.

Very few doctors have earnings that exceed the adjusted income threshold of £150,000, but due to the inclusion of hypothetical pension growth as income, doctors are being affected by tapering. This is different from what the Chancellor said in Treasury questions on 21 May when he said that someone has to be earning over £150,000 a year before the tapered annual allowance affects them. Taxable income and adjusted income are very different as regards pensions taxation.

The Government should also be aware that members of the imposed 2015 pension scheme had no option but to become a member of multiple schemes including the GP CARE—career average revalued earnings—scheme and as a result incur significantly higher annual allowance tax bills than those members who are protected members in only the final salary scheme. This means that all full-time consultants who are a member of more than one NHS pension scheme will be affected by the tapered annual allowance and will need to reconsider how much work they do for the NHS to mitigate these tax charges. Furthermore, this punitive pensions tax penalty means that doctors are not just working less but are retiring earlier than they would like to in order to avoid significant additional tax charges. In a survey of more than 2,400 consultants, more than half cited pensions taxation as a reason for their decision to retire early.

I therefore have five questions for the Chief Secretary. As the 50:50 pensions accrual option proposed does not remove the unintended consequences that are forcing doctors to reduce the work they do, can this be included in the consultation so that this issue is raised? Once the scope of the consultation has been extended to cover this essential aspect, can it then be launched as quickly as possible? Can the consultation be brief as the issues are well-known and well-rehearsed, and can the Government then respond quickly to it and if necessary legislate given that there is likely to be cross-party support for these important measures to protect the NHS? Can timely pensions statements be provided to all NHS staff who are affected by these measures? Finally, can the Government confirm that they understand the urgency and importance of this issue and that they will act without delay to prevent a deteriorating situation from getting even more acute?

[Elizabeth Truss]

The answer to my hon. Friend’s first question is that the Health Secretary is currently in discussions with the British Medical Association and other health representatives about precisely what can be done, and of course the consultation will come out shortly. Some of the issues he mentioned in terms of legislation will clearly be a matter for the new Prime Minister and Administration, but the fact that my hon. Friend has raised this urgent question today will draw to people’s attention the urgency of this issue and one would expect it to be considered very early on by a new Administration. The point I was trying to make earlier is that there is a fundamental distinction between how we deal with the issues in the NHS, on which the Health Secretary is leading, and the broader issue of our pension system, which is there to encourage people to save. That has to be considered in a holistic manner so we cannot just design it around one workforce. It has to be designed to work for everybody in both the public and private sectors. That takes time of course, and we are working through some of the conclusions of the reforms that took place a few years ago.