NHS Pensions and Staffing — House of Commons, 2022-07-13
Topic: Health
Daniel Leonard James Poulter (Conservative, Centre-right): I thank the hon. Lady for her support, and she is absolutely right to highlight that this issue affects all of the United Kingdom This year in particular, due to certain factors related to inflation, we are facing a real challenge that is created by the pension penalties that exist under the current legislation. That needs to be looked at urgently, or we will see a reduction in the NHS workforce at the very time we can least afford it, while we are tackling the covid crisis "Scheme pays", which is effectively a loan against a pension, is often suggested by the Government as a way for doctors to pay their pension tax bills. However, it attracts an interest rate of CPI plus 2.4%. So in the current climate, with inflation being at over 9%, "scheme pays" is prohibitively expensive and can result in a significant reduction in the total value of the pension, particularly for younger NHS workers in their 30s and 40s. Many doctors and nurses are left with little option but to pay the tax from their post-tax income instead, take out bank loans or, in some cases, increase the size of their mortgages. As I shall explain later, due to rising inflation, senior workers are being billed thousands of pounds in tax for pseudo growth in their pensions which never materialises as inflation continues to rise What is the impact on the NHS? The NHS is at a care and staffing precipice. GP workforce numbers are falling, while hospital consultant numbers are not increasing rapidly enough to keep up with demand. Many staff are also feeling burned out and demoralised due to workload and rising instances of abuse. In addition, the secondary care backlog in our hospitals for both urgent and elective operations, as well as for cancer care, is at an unprecedented level, with 6.48 million people currently waiting for treatment. Return referrals to GPs have also seen an 87% increase and a care backlog for general practice, with 401,115 patients waiting for treatment as of November 2021. Those circumstances, coupled with low levels of hospital beds, mean that staff and patients alike are feeling the impact We can all agree that the NHS needs more staff. England would need the equivalent of an additional 46,300 full-time doctors simply to put the NHS on an equivalent standard to today’s OECD EU average of 3.7 doctors per 1,000 people. However, as of March 2022, over 100,000 posts in secondary care are vacant, more than 8,000 of which are medical posts. The NHS needs to keep the staff it has simply to keep the current level of service running. In the year between June 2021 and May 2022, the NHS lost 323 GP partners and 462 salaried and locum GPs. That means the number of fully qualified GPs decreased by a net 785 full-time equivalent GPs in just under one year That trend is exacerbated by the fact that despite there being 1,737 fewer fully qualified GPs today than there were in 2015, each practice has on average over 2,000 more patients than in 2015. So, there are fewer GPs but each with more patients to care for, and many more patients now have complex care needs to manage Pension rules are making it financially unviable for some senior doctors and nurses to either stay in the NHS or work the number of hours they would like to. By tackling the NHS pension crisis through amending the Finance Act 2004 and introducing a tax unregistered scheme for those senior NHS workers, we could help to keep those much-needed doctors and other frontline clinical staff in the NHS for longer, and we would be supporting patients to get the care they need. Without those changes to the pension rules, more staff will leave and the care backlog together with waiting times are likely to continue to rise.