Supporting nhs consultant doctors industrial action

[Lapland123]

I hope this has public support. Consultants have seen the largest pay erosion in public services- now 35 % pay erosion since 2010.

Add the pension debacle, where we are asked for real money now for a theoretical glitch in how pensions are calculated. The ‘real money ‘ bill now can be 6+ months of your take home pay annually. Yes, really.

Vacancies exist in multiple specialties and the day to day job is more and more difficult in the context of vacancies throughout the nhs

I hope we have support for industrial action due to this government’s disgraceful erosion of our pay though we are working harder than ever

the more immediate one is the Annual allowance as that results in a yearly huge tax bill that negates the last 6 months I’ve worked and prevents me from paying my bills and mortgage

I'm tired of this argument. You only pay what anyone else earning those figures earns.

The lifetime allowance applies to any career where the person has exceeded the LA.

My DH was over the LTA and kept working. As do many people on high salaries and good pensions.

Why are consultants implying they are the only ones facing this tax?

Remind me how many billions this govt have pissed away giving dodgy PPE contracts to their mates and on Liz Truss' little experiment with the economy?

That is true. But it only defeats your argument, as it proves there is a bigger debt. We can't turn back the clock.

People are very keen to advocate pay rises yet ignore the fact i t means a bigger tax bill for everyone, mainly middle income earners.

Tell me you haven't read the thread without telling me you haven't read the thread

The lifetime allowance affects everyone
The annual allowance fiasco is specific to the NHS.

How can you be tired of the argument if you haven’t read any of the explanations about the pension tax? It is not the same as paying what is owed. Doctors are not preparing to strike because they think should be allowed to avoid paying tax, FFS!

@AIBUYESYES I'm tired of this argument. You only pay what anyone else earning those figures earns.

We are not in agreement.

The consultant is paying what anyone else pays who earns those figures AND has a defined benefit pension AND it is a final salary pension AND they are denied any flexibility to change their pension accruals in order to stay out of the unfair tax trap. There is a very limited group of people facing these circumstances, and it includes many NHS consultants.

Most other people on these earnings levels will have a DC pension, or flexibility to adjust their pension accruals, or both, so that they can make use of the allowable pension tax reliefs without falling afoul of rules that seem designed to penalise people who try to game the system by claiming excessive tax relief through pension-related income deferral.

The mechanics to fix this are not that complicated, and there are several ways to do it that would not give consultants (and other public sector workers who are on DB final salary schemes and have relatively high pay) any unfair tax advantage, but would only remove the unfair tax disadvantage. What is needed is the political will to give this the necessary attention, choose and develop a solution, and pass it into law.

If the only way to get that done is for the consultants to strike, then I support the strike, because the alternative would be a steady exodus of consultants who leave the NHS or at least reduce their hours after getting stung by unfair tax bills, which would cause more deaths than a few days of strike, provided that striking does impel the government to fix this problem.

I will check that out as that's not my understanding of it and I have seen other arguments disputing what you say. You are also carefully ignoring the fact that the pension limit being discussed is over £1M.

www.england.nhs.uk/looking-after-our-people/the-programme-and-resources/pensions-and-flexible-working-in-your-later-career/understanding-the-lifetime-allowance/

@YankeeDad

This doesn't seem to support your argument.

It says that high earners [NHS and other careers] can opt out of paying more into the pension pot to overcome paying more tax.

@AIBUYESYES I ignored the £1 million limit because it is irrelevant. The real problem stems from the is the annual allowance of £40k for pension contributions, even deemed contributions, which also applies.

If the actuarial value of the pension pot increases from £400k to £480k in a given year, then there is a deemed contribution of £80k. £40k of that is therefore in excess of the annual allowance, and hence subject to immediate taxation at a rate that is likely to be 45%. So £18k in tax. Due immediately. Bang.

In contrast, a private sector worker who starts the year with a DC pension pot of £400k that increases to £440k thanks to market action, and then increases to £480 thanks to £40k in new contributions, so precisely the same value uplift, faces no excess tax charge, because the market action is not taxed.

That is despite the fact that the market action on the DC pot is a real increase in real money (just tax sheltered), whereas the £480k for the NHS consultant is an actuarial estimate of present value. It could end up being worth less or more.

Note, I am ignoring the effects of inflation here in order to simplify, but on balance that does not help very much, and if anything it could make things worse.

I acknowledge that a private sector worker with a DB pension could theoretically face the same problem, but any decently run company would allow its DB pension plan members ways to avoid this pension trap by reducing their accruals, perhaps reducing extra taxable cash income instead, which would be taxed fairly at the normal rate, but only once, unlike the NHS deemed pension contribution which ends up getting unfairly taxed twice at full whack to the extent it goes over £40k.

Just as an aside, £40k sounds like a huge sum, but the way it is calculated, if your annual pension entitlement goes up by £2.5k then it gets treated like £40k in income in that year. However, if you later convert that to a lump sum, however, it is suddenly only worth £30k before tax. Go figure.

Not striking and allowing the government to continue to run down the NHS will cost more lives.

Sigh. The LTA has got nothing to do with the main pensions issue, which relates to the AA and the way that the NHS Pension DB rules interact with inflation.

You've got a really strong opinion on something that you don't understand at all.

Consultants: this thread should be an illustration at to why the opinion of the general public doesn't really matter. It's like playing chess with pigeons.

Consultants: this thread should be an illustration at to why the opinion of the general public doesn't really matter. It's like playing chess with pigeons.

👏👏

If I had a fiver for every person on this thread who has vehemently disagreed on a point that they clearly don't understand.........

But all this misinformation, misunderstanding but insistence of correct knowledge will be used to manipulate the public against the medical profession, whilst completely ignoring the professionals in finance/pension (independent from the consultants) who try to explain why the pension tax is punitive.
We are all being played.

Clapping to that!

Doesn't matter. They'll still come to see you when they need you.

My solicitor charges (in my view) quite a lot. I don't particularly like him. But he's a bloody good solicitor and I check anything contractual with him. I suspect he doesn't give a shit whether I like him or not.

For another example, the media has done a good job of turning people against GPs. So we're doing more consultations than a few years ago (now a million a day, albeit F2F slightly reduced at 70pc v 80pc, but with even fewer GPs). But still people still claim on here that GPs are not working at all even though demand (not supply) is actually the bigger problem.

So people don't like us... But oddly enough both NHS and private clinics are full.

You should stop caring what the general public think. Many simply aren't bright enough to understand the issues (sorry but true). And a big chunk of those that could, can't be bothered. Who cares? I certainly don't (apart from it's fun to correct people on MN).

You are right, it also affects Band 7 nurses/HCPs moving from part time to full time, and nurses/HCPs being promoted into Band 7 and 8. I know at least one ANP hit by this during the pandemic, as she increased her hours to cover while our registrars were redeployed to ICU.

It affects anyone on the 1995 pension scheme (so anybody who started work in the NHS pre-2008).

Interesting turn of discussion. Agree there are some strong opinions about issues they are entirely ignorant about. That’s despite clear explanations here.

Perhaps all that actually matters then is that industrial action is voted for and we proceed unless the government take action. Forget media and some public ignorance.

Heartened however to see a lot of people understanding and supporting.

As a final point, it won’t be us consultants who miss out when we move to private- we’ll without a doubt have better terms conditions and pay there.

The losers in this will be any of you who can’t afford private healthcare.

Being a peadiatric cardiology consultant is a pretty niche job, which requires a particular set of skills that few possess. We had hoped that our dd would be with the same consultant (who has saved her life a few times) until she was ready to move to an adult hospital. The consultant retired early, having grown increasingly fed up with the NHS. We wish him well, but that repeated across the organisation is a huge problem. Please @Lapland123 and any other NHS staff on here understand that we value you highly. It was lovely to see one of the nurses and HCAs who looked after her when she was a few days old, on our latest hospital visit 14 years later.

I am of the view that the most useful way to deal with the politics of envy is to vote with your feet. These are people who can't do the job and deliberately misunderstand what's happening, just like those who mouth out when clinic is delayed which according to them is due to the consultant having a long lunch, when we've been in theatre before they got out of bed and had missed lunch just so clinic would not be further delayed, and then they hold everyone else up demanding some unnecessary procedure usually conjured up from some dicey social media source. These ridiculous demands occur increasingly often across most specialties, especially on post-secondary referrals.

I absolutely don't object at all to those who feel they have to strike, ie. if they choose not to reduce their NHS work for a sustainable work life balance. Either way why continue to indulge those entitled patients who think they're doing us a favour under-paying for work that apparently they "could do" (rofl, I believe, is the appropriate response)? Of course there are still some patients who are so well put together that treating them feels like a bit of a perk, and sadly they'll suffer due to the ignorant jealous people who can only see the headline salary for a job that they have no skill or ability, nor ever will have, to do.

What do you think will happen when healthcare staff leave the profession or the country because the conditions and pay are no longer acceptable?

how much would you like to be paid to have people’s lives on your hands? Have you looked up suicide rates for doctors? Do you think it’s an easy job, that a “calling” (as so many seem to think justify not being rewarded or treated decently at work) doesn’t deserve fair remuneration?

thinking isn’t that hard, surely

I’m not in a medical profession, but support the right to strike if professionals aren’t being paid fairly for the jobs that they are doing.

being a consultant is an extremely high skilled role, those on this thread comparing the role to that of being a bin man or a ship assistant at their local supermarket need some kind of reality check. I’m sorry but these roles are unskilled, require little training and can be done by anyone (whether they would want to is another question that is besides the point). A doctor is a highly skilled high stress role, requires years of training and deserves higher reward than a lot of other professions.

to the individual who said that consultants are holding the government to ransom for a suitcase of cash, how is this any different than the government holding consultants to ransom utilising moral guilt trips so that they don’t have to pay what the profession is worth. Good will only goes so far.

the 35% pay rise in my view is highly unlikely (probably fair, but unlikely) but agree that the middle ground should be to put something in place for the AA pension position, if anything this will probably improve retention and mean that skilled individuals aren’t retiring early. Let’s be honest, vocation or job, nobody works for reward that is not commensurate with their skills, and not should they.

@edwinbear there‘s a thread going “why do people keep voting the tortes (sic) in again and again”
please post this there too!!

I tried to read this thread but had to stop halfway after someone compared NHS consultants to their cousin working at Aldi, a few said they should purely work for the love of the job as it’s a vocation and some dude, I think it was @Jazz12 found it utterly perplexing that doctors can’t cough up 40K per year to pay their tax bill. Despite them all being Tories who all have a “thriving” private practice 😂
Oh also that the foreigns have no problem working for low wages so that’s the answer - make the brown people do the job for half the price

Feeling very relieved that none of those guys are operating on me any time soon

I'm going to restate what a pp posted as it seems to really indicate the annual allowance issue :

"If the actuarial value of the pension pot increases from £400k to £480k in a given year, then there is a deemed contribution of £80k. £40k of that is therefore in excess of the annual allowance, and hence subject to immediate taxation at a rate that is likely to be 45%. So £18k in tax. Due immediately. Bang.

In contrast, a private sector worker who starts the year with a DC pension pot of £400k that increases to £440k thanks to market action, and then increases to £480 thanks to £40k in new contributions, so precisely the same value uplift, faces no excess tax charge, because the market action is not taxed."

Your being taxed on hypothetical gains (I'm assuming due to the current rate of inflation your bills will be even higher this year, however there is no guarantee that when you are pensioners and drawing your NHS pension that they will experience such a high rate of inflation again). It is not money you are currently accessing but estimated future potential money (you may not live long ). Also looking at "scheme pays" that appears to be run as an equity release scheme on your pension pot (inflation + 2.4% interest per year and that is subjected to compund growth!!!).

When actuaries are calculating what your increase in pension pot is projected to be should they be deducting e.g. what the original pension pot would have increased by if it was tracking eg FTSE 100 etc. Difficult as FTSE 100 probably went down at various times eg Covid. I'm not saying under current tax laws you should not be taxed if exceeding 40000 a year but how that excess is calculated and how it is collected/when collected. Most importantly I think it should be looked into why there is the need in tax pension relief to have both an annual and lifetime allowance. If only lifetime allowance existed high earners would be limited on their tax relief and could no when to exit a pension scheme more easily. Towards the end of their working lives more people may be encouraged to invest more in to pensions. Ps this is ramblings and sure others and myself as well will later think of multiple issues that are wrong with my theory.

The harsh reality is that as a nation, we can't afford to be paying anyone any more money at all. Currently we are £27.4bn pounds in debt - overdrawn if you like. That's the highest debt figure since records began in 1993.
As a nation, the private sector (the profit sector if you will) does not generate enough income, or profit, to fund the public sector (the cost centre). If the UK were a Plc, we'd be bankrupt, as our spending is greater than our income.
I'd fully support the UK becoming a bit more more overdrawn to fund reasonable pay rises for lower paid workers, but becoming more overdrawn to pay people on £100k a 35% pay rise? That needs to wait until our bank account looks a bit healthier.

Well the real question is whether you can afford not to pay. Due to the very high barriers to entry, it's a seller's market worldwide. The NHS is the cheapest market you get to buy healthcare in, so pay up or pay more privately (oh we can easily give you that increased private sector income you're looking for, however the cost of complex cases, a very small part of which is consultant fees, doesn't sit well even with those with large pockets).

Perhaps the outcome sought is to reduce NHS services by stealth, pushing consultants to work in the private sector? I guess you're betting that you won't be a complex case costing six/seven figures from your personal bank account or insurance company after which you'll never get insured again, so happy betting! Also the private sector gets to choose whether to take you on, so happy betting you can find someone who can be arsed to take on a complex case risking their own career when they can choose lower risk patients. None of this is to say that NHS improvements are not desirable, however we're just looking at underpaid consultants at the moment.