The British Medical Association (BMA) Scotland’s Consultant Committee chair, Dr Graeme Eunson, has warned that NHS Scotland is facing an “exodus” of consultants due to pay, workload and pension tax issues.

In a blog, Eunson stated that unless urgent action was taken, the potential resulting exodus of consultants would “seriously undermine” the NHS’s ability to provide care and train the doctors of the future.

A recent survey of doctors by the committee following this year’s pay award found that 70 per cent of consultants, excluding those that were not too young, were planning to take voluntary early retirement.

Eunson said that “perhaps most frustratingly” the committee has seen little movement from the UK or Scottish governments to deal with the pension tax charges that are “driving people out of the workforce” before they are ready to retire.

“It is not rocket science to understand that doctors who are tired and exhausted and then fearing they will be whacked by a massive pension tax bill, which they could avoid by either retiring or working less, are going to choose that option,” he wrote.

“While some of the worst cases of ‘paying to go to work’ were ameliorated by budget changes in March 2020 this remains one of the most pressing problems which consultant’s report to us. And it is a major threat to the future of the workforce.”

Eunson called on the Scottish government to reintroduce and expand a recycling of employer contributions scheme with immediate effect and maintaining it on an ongoing basis.

“This is particularly the case as the scheme is available in England and Wales, but not in Scotland,” he stated.

“Indeed, the Welsh government has taken the positive step of writing to NHS boards there encouraging them to pursue this option.”

The committee believes that reintroducing the scheme would send out a “strong and unequivocal message” that the Scottish government wants its senior doctors to remain in the workforce as long as possible.

Although it would not be a fix-all solution, Eunson noted, it would offer a “powerful incentive” for consultants to delay retirement.

"The NHS in Scotland desperately needs its senior staff in these leadership roles to ensure the clinical voice is at the heart of the NHS recovery plans,” he wrote.

“It’s on that basis that I’ve written to the Cabinet Secretary for Health Humza Yousaf to make this argument as plainly and as clearly as possible.

“We have had some positive discussions on it already, and I hope he will listen and the government of which he is part will act.”

A Scottish government spokesperson commented: “The Cabinet Secretary for Health and Social Care meets regularly with the BMA where all issues related to the medical workforce are discussed.

“We recognise the challenges health and social care services are experiencing. That is why we have announced a record £300m of new investment in measures to help services deal with system pressures over winter.

“To ensure our health and social care staff can continue to be able to best care for us, we need to make sure we continue to care for them by looking after their wellbeing this winter. This is why we are investing an additional £4 million in staff wellbeing measures, in addition to the £8m made available through the NHS Recovery Plan.

“As well as direct workforce investment, we are introducing measures to maximise capacity in our hospitals, reduce delayed discharges and improve social care pay. These measures will ensure patients are cared for in the right setting within their community and alleviate pressures on frontline health services.”

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