The Prosperity Institute has argued that financial penalties punishing doctors for working more hours should be removed to free up NHS capacity, as a two-day strike over pay and conditions approaches.
Nick White, a surgeon who works with the think tank, warned the strike beginning on November 25 would be a “disaster for the NHS’s permanent capacity crisis”. He said: “Strikes mean appointments cancelled, wait times increased, and sickness untreated.”
Tax rules blamed for reduced workforce
The think tank claims tax rules mean there are “fewer doctors at work in the NHS than there otherwise could be”. It says factors including the tapering of the income tax personal allowance above £100,000 and limits on tax-free pension savings mean there is “simply no financial incentive” for doctors to put in extra hours, with many choosing to go part-time or do no overtime.
Mr White said: “Scrapping or reforming these tax laws would make extra work profitable for consultants, releasing much-needed capacity into the NHS.”
BMA highlights 'cliff edges' in the system
Dr Vishal Sharma, who chairs the pensions committee of the British Medical Association (BMA), the doctors’ trade union, said: “Cliff edges in the benefit and taxation systems can leave some doctors earning less by working more. For those affected, cutting their hours may be the only certain way to avoid breaching restrictive thresholds.”
The BMA has urged the Treasury to remove financial disincentives to taking on extra hours, including reviewing the £100,000 childcare threshold, so doctors can spend more time with patients without being penalised.
Consultants' pay and government response
Consultants gained a 3.5% pay increase this year, but the BMA argues their wages have fallen by a quarter in the past 17 years post-inflation. In the long-term, the Prosperity Institute wants to see tax relief for private medical insurance.
“Right now, however, we need to make work pay,” Mr White said. “Consultants may already earn more than most people, but they are highly skilled workers whose services are in great demand. When they work more, we all benefit.”
Health and Social Care Secretary Yvette Cooper said: “The Government is working with staff across the NHS to prepare for winter, improve care for patients and make our health service better for the whole workforce. NHS England and the Department have been in constructive discussions with the BMA, so it is very disappointing to see the BMA committee choosing this response rather than continuing with that dialogue.”
She added: “With colleagues across the NHS, I am determined to support staff and patients through the tough winter period. I hope the BMA will stay united with us in that effort, and not take irresponsible action that would place our health service under even greater pressure at this crucial time.”
