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Three weeks to find £25 000: the NHS doctors remortgaging to pay punitive pension tax bills

BMJ 2019; 364 doi: (Published 05 March 2019) Cite this as: BMJ 2019;364:l998
  1. Stephen Armstrong, freelance journalist1,
  2. Antony R Goldstone, consultant radiologist and clinical director2
  1. 1London
  2. 2Castle Hill Hospital, Cottingham, East Yorkshire
  1. Correspondence to: S Armstrong stephen.armstrong{at}

Unexpected tax demands are forcing doctors to borrow money, and they are considering cutting hours and retiring—with potentially serious consequences for services. Stephen Armstrong and Antony R Goldstone report

Continuing uncertainty over recent pension tax changes may mean senior doctors opting out of the NHS pension scheme, reducing their hours worked, or seeking early retirement, as The BMJ reported in January.1

These fears compound findings from a freedom of information request by the Health Service Journal last year.2 It discovered that 245 561 staff had opted out of the NHS pension scheme in the past three years: about 16% of the scheme’s working members, says the pensions firm Royal London.3

Andrea Sproates, head of the independent financial advisers Chase de Vere Medical, told The BMJ, “We are encountering increasing numbers of doctors opting out of the NHS pension scheme at all ages. These may be older members who are considering retiring early or reducing NHS or private practice hours, or younger members who are considering leaving because of affordability concerns.

“We have also seen doctors taking out loans or even remortgaging to pay pension tax bills. Many of these doctors have been unable to avoid these bills and in some instances didn’t expect them, because the tax liability is often an unknown quantity and so is very difficult to plan for.”

A BMA survey published this year4 found that that six in 10 NHS consultants (2446 of 4089 respondents) intended to retire before or at age 60, while over a third (36%) expected to reduce the days they work in the NHS by as much as half—and pension rules were the second biggest reason.

Unexpected £25 000 bill

Since the recent 31 January 2019 deadline for 2017-18 income tax The BMJ has spoken to senior NHS doctors and found many …

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