Streeting opens way for doctors to top up pay with pensions
The Health Secretary said he would discuss the policy to avert a new round of strikes that threaten to derail his landmark 10-year plan to fix the NHS.
The medics, now known as resident doctors, will walk out for five days later this month in an attempt to secure a 29 per cent pay rise – months after receiving a 22 per cent boost.
Downing Street on Tuesday said negotiations over pay were off the table, but Mr Streeting has suggested there could be a 'discussion' about forfeiting future state pensions in exchange for pay now.
Doctors are among the public sector workers eligible for lucrative, gold-plated pensions, costing the Treasury billions of pounds each month.
The Cabinet Office is understood to be considering proposals to increase pay in exchange for the Government making lower pension contributions, following an increase in workers opting out of employer pension schemes.
Mr Streeting said: 'We've got this situation where the pension pot is so big that consultants lobby us to change the tax rules.
'They're taxed so heavily on the pensions because they're that valuable that they say, 'I might as well not bother working, my pension's so valuable'.'
Speaking to LBC, he added: 'If the BMA want to come to me and say, 'Do you know what? Given that challenge, we would rather have a slightly less generous pension in order to have higher pay today', those are the sorts of issues you can get into in a discussion.'
NHS pensions include a threshold which restricts the amount of tax-free pension growth allowed each year.
It means doctors could be penalised for taking on extra work such as through initiatives to clear the backlog if they breach that amount, triggering a high rate increase in taxation that the BMA says would mean 'they are paying to work'.
While the impact on pay depends on the year compared to and the inflation measure used – the BMA uses the retail price index (RPI) instead of the industry-standard consumer price index (CPI) – there is less debate about the size of doctors' pensions.
They are often worth about 75 per cent of doctors' salaries in retirement and guaranteed to rise with inflation each year.
Doctors enjoy index-linked, taxpayer-funded, 'defined benefit' schemes, many of which pay a proportion of the recipient's final salary from the day they retire.
Under the NHS scheme, staff contribute between 5.2 per cent and 12.5 per cent of their salaries, while the state contributes 23.7 per cent each year, far outpacing most private sector arrangements.
As a result, the NHS is paying out nearly £1 billion a month in staff pensions, with almost 2,000 staff receiving pensions of over £100,000 annually – a figure that has more than doubled in a year – although this includes all staff, not just doctors.
Someone who started as a junior doctor eight years ago on a starting salary of about £27,000 will have already built up an annual pension of more than £8,000.
A first-year resident doctor today will earn a starting salary of around £39,000 as a result of recent pay rises.
The median pension claimed by GPs was £53,300 a year in 2023-24 and £40,090 for hospital doctors, according to a report by the government's pay review body on doctors and dentists.
The BMA's junior doctors' committee are demanding a 29.2 per cent increase to their base pay, despite having received 5.4 per cent on average this year – more than any other public sector worker for the second year in a row.
The union claims this is necessary because of real-terms cuts to doctors' pay dating back to 2008.
The walkout later this month could mean more than 200,000 appointments are cancelled, based on data from previous strikes.
The strike could endanger the success of Mr Streeting's 10-year plan to save the health service, which he announced last week with promises to 'bring down devastating hospital waiting lists'.
Figures published on Thursday revealed the NHS waiting list had fallen to 7.36 million, just 260,000 fewer than when Labour came into power.
Mr Streeting urged the BMA to abandon its walkout, saying that doctors' strikes 'ruin lives' and could lead to job cuts.
He said public support for the BMA has 'collapsed' and that strikes would jeopardise the NHS's 'fragile' recovery.
Ed Argar, the shadow health secretary, said Labour was paying the price for 'caving into union demands for above inflation pay rises without any conditions or strings attached'.
He said: 'Labour's weakness is sadly fuelling this crisis. If they don't get a grip now, a summer of discontent and strikes risks turning into a summer of chaos, and it will be patients that pay the price.'
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