A senior NHS official once told me that “workforce planning in the NHS is like astrology, but nowhere near as reliable”. Now that there is an emerging political consensus that the long-term solution to the NHS workforce crisis will require a better approach to planning, I am more optimistic about the future.
In the short term, the focus has to be on the retention of existing staff. The budget changes on pension rules may help, but the drain of NHS staff to other countries and the private sector is likely to continue unless action is taken. Your article (NHS doctors offered up to £5,000 to recruit colleagues for private hospitals, 17 March) highlights the threat from the private sector, which has long been subsidised by access to staff trained by the NHS at taxpayers’ expense.
Improving the working conditions of NHS staff is important, but legislation should be introduced to impose financial penalties on private sector healthcare organisations that recruit NHS staff, to level up the human resources playing field. The Labour party and the British Medical Association would be wise to take this issue into account, to ensure their members and the public are in no doubt that they support the NHS rather than the private sector.
John Hanley
Consultant haematologist
• Jeremy Hunt is correct to tackle the situation of NHS consultants with regard to their pensions (Report, 16 March). The present tax arrangements discourage consultants in the NHS from doing extra work. If they do, they are penalised with stinging tax bills. When I was a full-time consultant before 2006, if I took on extra commitments it benefited my salary and my pension. Now it benefits salary, but at the cost of an immediate high tax bill.
My son is an NHS consultant and he cannot afford to work more than his basic contract. He does not do private work, but the only way in which NHS consultants can boost their income is to take on private work in their spare time.
Hunt and Keir Starmer are correct: the pension situation of NHS consultants does need the measures that Hunt has given. This treatment has been given to judges ever since the punitive pension tax measures were brought in to safeguard their recruitment.
Robin Davies
Tregarth, Gwynedd
• Jeremy Hunt’s pension-pot tax break for the wealthy has been justified as an incentive to encourage senior doctors to return to the NHS. There has been some debate, though, over whether increasing the amount that can be saved tax-free to a pension will really have this effect.
As someone who has worked as a teacher most of my life, and thereby accrued a pension pot insufficient to sustain me in retirement just yet (I am still working in my mid-60s), I can confidently say that it would not work with me. I have a simple solution to encourage weary retired consultants back to the NHS: increase their salaries. This has the advantage that you can target the measure at those you want to return to, or remain in, work, and not at other wealthy individuals who we might wish would retire as soon as possible.
Jo Pike
London
• Another way of increasing the number of consultants working in the NHS is to pay a loyalty bonus for not doing private practice. This would also encourage doctors to work in specialties that don’t have lucrative private opportunities.
Dr Orest Mulka
Snarestone, Leicestershire
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