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

Jul 23
1/ Pleasing to wake up this morning to news that - FINALLY - were hearing about the NHS in the leadership contest for our next PM. Similarly pleasing to see the word crisis. As for the NHS, crisis is very much where we are. Some tips @RishiSunak

Pls RT

bbc.co.uk/news/uk-politi…
2/ Lets look in a bit more detail. "From day one of being in office I'm going to put us on a crisis footing." - OK as above - this is a welcome step. Snr NHS leaders have been reluctant to use the word "crisis" when asked in recent weeks by @Jeremy_Hunt

Image
3/ Now onto the detail. @RishiSunak "promise to accelerate NHS targets to cut waiting lists". Great, but the problem is not a lack of targets. We have targets we are not acheiving. These are predicted to get *very* much worse, perhaps reaching 14.6m👇

Read 14 tweets
Jul 22
“Despite what the Government says, this is not a pay rise, but a more than 6pc real-terms pay cut, & this will have a significant impact on final salary pensions” said @Vish_Sharm @BMA_Pensions

telegraph.co.uk/pensions-retir…
A consultant could be worse off by £124,000 over the course of their retirement by delaying retirement for a single year"
"Clearly it's not fair or reasonable to expect workers to continue working, having given a lifetime of service, to receive a considerably lower pension,"
( & that doesnt include the £11-19k AA tax charge the consultant would need to pay due to #CPIdisconnect & #NegPIAs)

There would be an exodus of the country’s most skilled doctors. “It will be an absolute car crash if the Government continues to ignore this problem said @gdcuk
Read 4 tweets
Jul 16
Good article @bmj_latest @ingridtorjesen

bmj.com/content/378/bm…

@DrDanPoulter MP "“punitive & unfair interplay between longstanding government pension taxation policies and the NHS pension scheme” for forcing many senior doctors to consider taking these “drastic steps.”
He warned that, with inflation at more than 9% this year, the penalties faced by doctors will be much higher, so the rules needed to be looked at “urgently, or we will see a reduction in the NHS workforce at the very time we can least afford it.
Responding the minister said any changes would affect "all pension savers"

However this is not correct as S235 of Finance Act only affects DB pension savers
Read 5 tweets
Jul 14
Link to last nights debate on Hansard. Again thanks to @DrDanPoulter and others who supported

hansard.parliament.uk/Commons/2022-0…

Some very initial thoughts, full thread weekend
Initial thoughts on some of Ministers responses.

This👇 is completely wrong. S235 of the Finance Act only references DB pensions schemes, so would not affect "all pension savers".

The "certainty" argument is nonsense. Aligning CPI would give valued public sectors "certainty" Image
This is also completely wrong. All active members now have a 2015 component. Its a question of how much CARE pension they have.

For GPs ALL of their pension (1995 pract / 2015 CARE)

For hospital docs is 2015 CARE, and for most of them they will need CARE since 2015. A big deal Image
Read 8 tweets
Jul 13
1/ BREAKING NEWS: Ahead of this evenings debate @RCPhysicians ask government to "The temporary measures put in place for the 2019/20 tax year to enable additional work before the pandemic were an acceptable solution [AA compensatin scheme]. ImageImage
2/We recommend that this temporary measure is extended over the next 2 to 3 years until more formal changes to legislation are achieved. The increase in activity needed to overcome the backlog will be impossible without such a step.
3/ MP @drlukeevans had only yesterday challened Matt Styles & other NHS leaders @NHSEngland about "mandation" of such policies in @CommonsHealth eunquiry into retention

Read 10 tweets
Jul 11
1/23 V. important pension tax🧵 Alert ! Some of the arguments used by government not to fix pensions taxation & why they don't stack up (but may appear in Wednesday's debate). A long thread but spend the time to watch the videos. Pls read to end & share/RT👇
2/23 Argument 1 - Tax relief is one of the most expensive reliefs

Part A (well it is if you get it)
3/23 Argument 1 - Tax relief is one of the most expensive reliefs

Part B (well it is if you get it)
Read 23 tweets

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