{"id":46201,"date":"2019-12-05T11:12:00","date_gmt":"2019-12-05T10:12:00","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=46201"},"modified":"2019-12-18T15:52:01","modified_gmt":"2019-12-18T14:52:01","slug":"the-annual-allowance-tax-charge-at-christmas-is-it-cause-for-festive-cheer","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/12\/05\/the-annual-allowance-tax-charge-at-christmas-is-it-cause-for-festive-cheer\/","title":{"rendered":"The annual allowance tax charge at Christmas: is it cause for festive cheer?"},"content":{"rendered":"

It is unusual for the festive season to see the government bearing gifts for the NHS, and this is doubly so when we\u2019re blessed by the double joys of both Christmas and a General Election. Nevertheless, the health secretary\u2019s <\/a><\/span>announcement that doctors\u2019 annual allowance tax charges for 2019\/2020 will be waived means doctors must now decide whether he\u2019s really playing Santa Claus, or whether this is\u2014as most previous announcements have been\u2014Scrooge in heavy disguise.<\/span><\/p>\n

The problems these charges have caused for the NHS have been enormous: <\/span>half of GPs in some areas cutting their work<\/span><\/a>, <\/span>thousands of consultants reducing hours<\/span><\/a>, and many early retirements because of the charges. An NHS already at breaking point after a decade of austerity could not cope with that, so the obvious question for me as a GP is: will this help staffing now and in future?<\/span><\/p>\n

For hospitals, this is easy: staff can now be paid for extra hours out of the pots of money hospitals have to reduce waiting lists and so on, and they won\u2019t be taxed a multiple of that income as a result. GPs don\u2019t work like that\u2014as in so many areas, we are seemingly invisible to the government when it comes to winter pressures. If you look at <\/span>NHS England\u2019s \u201cWinter resilience\u201d pages<\/span><\/a>, they talk about A&E pressures, transfer targets, and occasionally urgent care centres, but not about your local GP surgery. GP partnerships are not going to look at the AA announcement and rush out to hire more locums over winter, because that just costs those partnerships money while the government continues to treat us as an unlimited free resource.<\/span><\/p>\n

Even if GP practices had access to winter pressure funding, there aren\u2019t the staff there to do the work: despite Hancock\u2019s predecessor promising an extra 5,000 GPs by January, <\/span>we continue to lose whole-time-equivalent GPs year-on-year<\/span><\/a>. Of course we expect targets to be set and missed, but to see the broken promise of 5,000 GPs simply replaced by another promise, this time of 6,000 more, does not lend itself to GPs trusting Hancock when he says the pension charges will go.<\/span><\/p>\n

There are technical issues, too. The \u201csolution\u201d only applies for the current financial year, and, <\/span>as Hancock admitted in a letter to Simon Stevens, may \u201cconstitute tax avoidance\u201d<\/span><\/a>. Even if GPs can find short-term paid work over the winter, they still incur a tax charge which increases by more than inflation every year until they retire. At retirement, they rely on:<\/span><\/p>\n