The NHS is at risk of losing 'large swathes of expertise from the NHS's most experienced doctors at a time when the overstretched service needs it most', a letter from BMA chair Dr Chaand Nagpaul to the prime minister warns.
GPonline reported last month that one in three GPs had been forced to cut back on work or refuse shifts to avoid taxes that can mean they lose money for working more. The BMA has warned that even GPs in their 30s have been advised by accountants to reduce their working hours to avoid incurring annual allowance tax charges.
London GP Dr Nagpaul warns that the government has taken too long to acknowledge the impact of pension taxes on the NHS workforce - and calls on Mrs May to put pressure on chancellor Philip Hammond to meet with the BMA immediately.
NHS workforce crisis
He writes: 'Every delay brings forward the likelihood of a crippling workforce crisis and patient care suffering.'
The letter comes just days after the goverment backed plans to introduce a 'partial pension' option - a mechanism mooted in the five-year GP contract agreement earlier this year that would allow NHS scheme members to halve the rate at which their pensions grow by halving their contributions.
However, Dr Nagpaul's letter reiterates the BMA stance that this 50:50 pension proposal 'will categorically not solve the problem'.
The letter says: 'This option will not only result in doctors receiving a lower pension, but also does not remove the perverse incentive for doctors to reduce the work they do for the NHS. This is particularly the case if there is no recycling of employers’ pension contributions back to the employees.'
Dr Nagpaul warns that the 'true solution lies in pension taxation reforms'. He argues in the letter to Mrs May that current arrangements give GPs no control over the amount they pay into pensions each year. Because tax relief is already capped by the 'lifetime allowance' limit, annual and tapered allowance mechanisms that are 'significantly damaging the ability to maintain safe, sufficient patient care' are unnecessary and 'must be scrapped urgently'.
The letter warns that defence medical service are also being hit hard by the impact of pension taxes, highlighting that 'unless a solution is found it will lead to severe shortages and put at risk the abilty to deploy.
Both the BMA and leading accountants have called for 'radical' steps to stop punitive charges on pensions driving doctors out of the NHS workforce.