BMA leaders have written 'several times' to chancellor Phillip Hammond highlighting the damaging impact of pension tax charges on the NHS workforce - and have warned that punitive pension taxes threaten a 'massive loss of capacity within the NHS'.
The association has now published its latest letter, saying it has been forced to take this step because the government 'has neither listened to us or advanced any proposals of its own to address the urgent issues we highlight, or even to acknowledge the solutions we recommend'.
GPonline reported earlier this year that numbers of GPs taking early retirement had tripled in a decade as taxes on pensions forced doctors to reduce their working hours, retire early or quit the health service.
The BMA's GP committee warned last month that even GPs in their 30s were being advised by accountants to limit their working hours to avoid hitting annual allowance thresholds that trigger tax charges.
Meanwhile, as part of the five-year GP contract agreement unveiled earlier this year the BMA and NHS England agreed to make an unprecedented joint approach to the government to call for a rethink on pension tax charges. The two organisations proposed a 'partial pension' option that would allow doctors to reduce their pension contributions, slowing the rate at which their pension pot grows to avoid triggering tax charges.
The BMA letter says that modelling of the impact of pension changes by its consultants committee shows that 'separate changes made to the annual allowance and the NHS pension scheme have converged, creating a perfect storm that is essentially forcing the most experienced doctors to retire, reduce their workload, abandon leadership positions and stop covering vacancies'.
Consultants committee chair Dr Rob Harwood said: 'It cannot be right that doctors working extra hours to reduce waiting lists or cover rota gaps are then hit with additional tax bills greater than the value of the extra hours worked.
'Given the refusal of both the Government and NHS employers to take steps to rectify or mitigate this, it is now our responsibility to inform our members that current regulations, particularly the annual allowance and tapered annual allowance, are disproportionately and unfairly impacting them.
'Unless action is taken, our only option is to reduce the amount of time we work for the NHS, which will through no fault of our own, be detrimental to our patients and to the country’s health service – exactly what the BMA has been trying to avoid.'
The letters warns that the 'window of opportunity' for the government to address the problem is closing fast and calls on the chancellor to prioritise reform of pensions taxation immediately.
The letter warns: 'If a workforce problem is allowed to develop, particularly one of the magnitude that we predict will result unless there is significant action on pension taxation, it may be impossible to rectify.'
A Treasury spokesperson said: 'We want people to save into a pension, which is why we allow the majority of savers to make contributions tax-free.
'And doctors, like all NHS staff, benefit from one of the best available defined benefit occupational pensions schemes. But we do have to get the balance right between encouraging saving and managing government finances, which is why we restrict the tax relief available for the highest earners.
'We are aware of concerns raised by NHS staff and the Treasury is discussing the issue with the DHSC.'