Dr Tony Goldstone Profile picture
Jul 17, 2022 26 tweets 11 min read Read on X
1/26 V Important 🧵 on this weeks debate in the House of Commons tabled by @DrDanPoulter

Highlights & my analysis. Pls read to end & share/RT👇. Vital we resolve this to fix *retention* & backlog

Part 1/2 - Dr Poulter (Pt 2/2 Minister response soon)
2/26 Really important points from @Dr_PhilippaW

1️⃣ vital issue needing 4 nation solutions @BMACymru @BMAScotland @BMA_NI
2️⃣AA is the wrong tax for the wrong group of people & its destroying the NHS
3/26 A further intervention from Northern Ireland's @JimShannonMP again pointing out the 4 nation problem and large rise in retirements in the NHS since April (my prediction - unless this fixed very urgently, retirements will increase +++ in 22/23)
4/26 Similarly Dame @NiaGriffithMP again pointing out that Wales too affected by the same retention issue. And @DrDanPoulter pointing out this isnt the same issue as previously discussed due to the unique position in the current tax year due to inflation
5/26 Crucial point from @DrDanPoulter on the "just use scheme pays" argument used by government
1️⃣ Eye Wateringly expensive currently as inflation+2.4% so >>10%
6/26 2️⃣ Unfair 22/23 as being billed thousands of pounds in tax for "pseudogrowth" in their pensions which never materializes

So whats the impact on the NHS
- Waiting lists continue to rise 6.48m waiting for treatment 📈 (and rising)
7/26 - care backlog for general practice, with 401,115 patients waiting for treatment
8/26 So on staffing...
-England needs additional 46,300 full-time doctors OECD EU average
- Over 100,000 posts in secondary care are vacant, >8,000 medical
- The NHS needs to keep the staff it has simply to keep the current level of service running.
9/26 - Pension tax > financially unviable 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 & introducing a tax unregistered scheme for those senior NHS workers
10/26 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.
11/26 Next Jonathan Edwards points out a similar issue with judges was solved with a tax unregistered scheme which "critically, breaks the link between working more hours and the additional tax bill, as well as ensuring that the right amount of tax is paid.". Poulter agrees
12/26 Now to LTA. Government froze the LTA in 2021. Back then inflation was 0.4%, with 2% long term prediction. A survey of 8000 Gps/con. 72% said LTA freeze⬆️likely retire early; 61% ⬆️ likely work fewer hours.

That would surely be worse now as LTA rapidly falls with inflation
13/26 Next @AmyCallaghanSNP intervenes - >100 of her constituents contacted her re this issue. "This really significant issue needs to be noticed & action needs to be taken, but not like the action that was taken with the taper, which did not affect enough doctors. "
14/26 OK pay attention now. This is the technical bit - but essential nonetheless.

- AA "completely unsuited" to defined-benefit schemes such as that in the NHS
- should be scrapped in defined-benefit schemes. That view has been supported by Treasury advisers & @OTS_UK
15/26 Next Dr. Poulter turns to the 3 reasons inflation is crucifying retention

(1) Doesn’t pay to stay
16/26 (1) - Doesn’t pay to stay - my thoughts
17/26 (2) - CPI disconnect S235
18/26 (2) - Finance Act S234
19/26 (2) - Finance Act - My thoughts
20/26 (3) - The lifetime allowance & inflation
22/26 (1) - Solutions #FixTheFinanceAct #CPIdisconnect #FixNegativePIAs - My thoughts
23/26 (2) AA Compensation scheme
24/26 (3) #Taxunregistered - fair to taxpayers and doctors. Already delivered to judges.
25/26 AA charges arising from the defects in the Finance Act are *manifestly unfair*. It is clear to any reasonable person that the intention of the Act was to measure growth *above inflation*. It is doing nothing of the sort. Hence @TheBMA asks
26/26 The unintended consequences of rapidly increasing inflation could be dire for the NHS. Please fix this. It needs *urgent* action. @NHSMillion @TheBMA

Please share widely / watch the debate☝️ / RT

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More from @goldstone_tony

Jan 23
1/ NEW & V IMPORTANT update from @nhs_pensions on pension savings statements for 23/24
•@nhs_pensions have self reported to the regulator
•what do YOU need to do for Self Assessment (31/1)
•What compensation might be due
•Next steps

Summary 🧵please read & share/RT Image
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2/ So firstly after @BMA_Pensions wrote to the NHSBSA CEO this is the first time they have openly confirmed in this letter that thay have reported this issue to The Pensions Regulator (our complaint in the quoted tweet below) 👇

Image
3/ So importantly WHEN are YOU expected to get your 23/24 PSS which you need for your self assessment 31st Jan 2025 (8 days away)

Well they expect to START issuing them by February 27th 2025

@nhs_pensions have asked @BMA_Pensions to be involved in assurance after the errorsImage
Read 14 tweets
Dec 26, 2024
1/ V. Important 🧵 if you are CONSULANT in England. This week I used my FREE modeller to identify & correct an error in #AnnualAllowance for 24/25 which I suspect may be a common error. It will save me over £2,600 from my AA liability, buckle up & see if you are affected
Ps RT Image
2/ As many of you will know Twitter/X is now really difficult to see the information you want to see from the people you follow so please help by RT, but also sending your colleagues on whatsap / FB groups if you think this will help them Image
3/ In preparation go onto ESR, download Mar '24, May '24 + Nov '24 payslips & 23/24 TRS (+/- 22/23 TRS) - and then I will talk you through IF you are also affected by this "misallocated arrears" error, tell you how to model the impact of this, and how to correct thisImage
Read 21 tweets
Dec 12, 2024
1/ THOUGHT FOR THE DAY: Whilst I'm grateful for the changes to LTA/AA, the AA and the dreaded #taper still remain. And here's your regular reminder why its PARTICULARLY unfair, and stupid, in the NHS (from @BMA_Pensions @TheBMA evidence to DDRB).

Short 🧵pls read & share Image
2/ We are all in CARE now, so should all be paying generally the same employEE contributions.

But we aren't - and its worst - by a garden mile - in the NHS per this chart showing the ratio of conts from the highest earners : lowest earners in the public sector 👇Image
3/ So unlike in the private sector where there is no difference in cost for higher vs lower owners other than tax relief, we go through this ridiculously unfair step in the NHS - far worse than anywhere in the public sector - that strips away our higher rate reliefImage
Read 5 tweets
Dec 10, 2024
1/ very important and NEW: @nhs_pensions have overnight issues guidance on 23/24 tax year where they have failed to send you a pensions savings statement on time (which was their legal duty)

nhsbsa.nhs.uk/public-service…Image
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2/ the bottom line is they expect you ESTIMATE your carry forward and PIA and any charge in the normal timescale ie by Jan 31st 2025 …. Which is going to be extremely difficult ….. Image
Image
3/ after you estimate you will have until Jan 26 to correct your estimation based on the real figures Image
Image
Read 13 tweets
Oct 30, 2024
1/ Well after intense media speculation re: budget (speculation incl. reduction of tax free lump sum to £100k; flat rate relief at 30 or 20%; lifetime allowance re-introduction & pension "flexibility" [i.e. balance between pay & pension] .. speculation can now END....
Pls RT 🧵 Image
2/ Its now time for @RachelReevesMP to deliver her first budget ... I'll be live tweeting anything significant with a focus on #pensions and #pensiontax (if there is indeed anything!)

So keep following! Appologies for any typos/errors read to end for any corrections & docs Image
3/ So following #PMQs there is a statement that the contents of some of the budget has been made public before the budget and expresses dissapointment that this has happened Image
Read 27 tweets
Oct 17, 2024
1/ Longtime followers may remember this update from 4.5 years ago. Id met the then head of @nhs_pensions and the senior leadership team. They made lots of promises to improve things around Annual Allowance that BADLY needed improvement....

Pls read, share and RT
2/ Chief among those promises was to have an end to waiting till October for a PSS. Indeed no more brown envelopes. 85% of people would get their "digital brown envelope" by June (starting in 2020) 👇

3/ And furthermore for those that dont get automatic PSS (then around 85%), 15% would be able to see in this portal, from June 2020 why they DONT have a PSS i.e. you need manual calculations, or they cant issue one as they are awaiting info from employer

Read 14 tweets

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