Health and social care secretary Matt Hancock promised earlier this year to create the 'most flexible NHS pensions ever', amid a workforce crisis that has seen thousands of doctors forced to reduce their working hours to avoid punitive tax charges.
The BMA has warned that charges doctors face if their pensions grow faster than limits under the annual allowance mechanism can leave them effectively paying out more than they earn for taking on additional shifts.
Around three quarters of GPs have reduced their working hours or plan to do so to avoid charges on pension contributions, BMA research has shown - in a crisis undermining the entire NHS medical workforce.
NHS pensions
In its formal response to a government consultation on proposed flexibilities under the NHS pension scheme that would allow doctors to slow the growth of their pensions by reducing contributions, the BMA calls the proposals a 'sticking plaster solution'.
The changes will not solve the current pension crisis facing the health service, the BMA warns - and will represent a 'real-terms pay cut' unless employer contributions are recycled automatically rather than lost to doctors who choose to reduce their personal contributions.
Sharp criticism of the government's pension proposals comes just weeks after the Office for Tax Simplification (OTS), which provides independent advice to ministers on tax, highlighted major concern over the impact of tax penalties on the NHS workforce.
An OTS report welcomed an 'encouraging' government announcement earlier this year that the Treasury would review annual allowance tapering rules - and proposed scrapping the annual allowance mechanism altogether for defined benefit models such as the NHS pension scheme.
GP workforce
Health and social care secretary Matt Hancock has suggested that plans for pension flexibilities could be scrapped if the Treasury does choose to overhaul the annual allowance mechanism - suggesting the government may share at least in part the BMA analysis that flexibilities will have a limited impact.
BMA pensions committee chair Dr Paul Youngs hit out at the 'perverse' tax charges forcing doctors to turn down shifts they were willing to work.
'Doctors are being forced to turn down vital extra shifts caring for patients in our under-pressure hospitals and GP surgeries because they would be literally paying to go to work,' he said.
'Doctors are trapped in a dilemma between wanting to care for patients and not wanting to end up financially worse off.
'While the proposals in this consultation from the DHSC offer short-term mitigations, they are merely a sticking plaster that fail to address the crux of the problem. Only by scrapping the damaging annual and tapered annual allowance will the government stem the flow of doctors refusing additional work or considering leaving the profession over the issue. This lies with the Treasury.'
Dr Youngs added: 'Any flexibilities without insisting that employers fully recycle their contributions back to the employee is worthless. During their career, a doctor’s pension forms a vital part of their reward package, and we cannot support what is effectively a pay cut for our colleagues.
'We urge the government to get a grip on this issue immediately. As we approach Brexit day and the onset of winter – themselves presenting their own threats to the NHS and its patients – we cannot afford to be without the skills and expertise of our most experienced doctors.'