The British Medical Association (BMA) has criticised the government for not listening to, or advancing, proposals it has suggested to address the “perfect pensions storm” facing the National Health Service (NHS).

Commenting on the latest in a series of letters addressed to Chancellor Philip Hammond stated, BMA chair, consultant committee, Dr Rob Harwood said: “Having written to the Chancellor several times on this matter, we are disappointed 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.”

The latest letter warns the Chancellor that unless action is taken to address the issues “doctors will be left with no option but to reduce their working hours even further thereby exacerbating an already acute workforce crisis and seriously jeopardising the sustainability of the NHS”. The BMA believes that the concerns it has raised are “not fully appreciated” within the Treasury.

The BMA has warned the Treasury that the current pension and tax rules are creating a “perfect storm”. It explained that the BMA has been working to model the impact of the current tax regime, and its impact on consultants in the NHS pension schemes.

“The results of this modelling are truly shocking; it transpires 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.

“We firmly believe that the effects of these seemingly separate changes, were not appreciated when they were introduced and the resultant effects on the NHS workforce were unintended. It is clear, however, that the solution to this impending problem lies entirely with government agencies – Treasury, HMRC, Department of Health and Social Care, the Devolved Nations’ Governments and with NHS Employers. We recognise that this issue is partly a UK-level reserved matter (pensions tax policy) but is also partly devolved to the Devolved Nations in terms of consultant pay and conditions.”

Commenting, Dr Harwood said that given the refusal of both the government and NHS employers to take steps to rectify or mitigate this, it is now the BMA’s responsibility to inform members that current regulations, particularly the annual allowance and tapered annual allowance, are “disproportionately and unfairly impacting them”.

“The BMA has always sought constructive dialogue with the government and NHS employers and has taken every opportunity of making clear the grave threat faced by the health service to those who have both the power and responsibility to effect change. The government’s window of opportunity is closing fast, and we urge the Chancellor a final time to make reform of pensions taxation an immediate priority. Action is needed now, before doctors are compelled, by these punitive rules, to reduce their working hours or quit the health service. Doctors are facing the very real prospect of effectively working for no pay and that is untenable.”

“We believe that there needs to be a fundamental review of current pensions taxation legislation. While we understand that this is unlikely to happen quickly, we remain deeply concerned that once this information is more widely known, there will be a massive loss of capacity within the NHS.”

BMA members have also sent over 1600 letters to MPs on the inequity of current pensions rules, but the responses received so far reveal a “worrying refusal to acknowledge the reality faced by individual doctors and the wider NHS”.

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