JUST when you think the problems facing our NHS can’t get any worse, along comes a curve ball that shows they absolutely can.

Thanks to a change to pension rules introduced in 2016 senior consultants across the NHS are shunning the extra shifts that keep the health service running for fear it will land them with unmanageable tax bills. The rules were brought in to limit the extent to which pension-related tax breaks favour the wealthy, with those who benefit from high earnings being asked to pay a bit extra to the Treasury to take account of the higher pension contributions they can afford. So far, so fair. The problem is, due to the labyrinthine way in which the charges are calculated they are resulting in many doctors seeing the pay they receive for doing extra work being wiped out.

Though no consultant is objecting to being taxed on their earnings, the effect this has had has been chilling, with many senior practitioners who regularly take on extra sessions to help clear waiting-list backlogs no longer volunteering for that work. Who can blame them? It’s one thing expecting higher earners to pay a higher proportion of their income as tax; it’s another thing entirely to expect them to work for free or – worse still – to have to pay for the privilege.

READ MORE: NHS faces staffing crisis over pension charge fears

It could not have come at a worse time, with the NHS in Scotland already running at a disadvantage due to the number of consultant vacancies across the service ballooning from under 200 in September 2009 to closer to 400 today. The impact has been stark, with public spending watchdog Audit Scotland noting last year that not one Scottish health board had been able to meet all its national waiting-time targets while just three had started treating cancer patients 62 days after referral as required.

Things have not improved since, with this newspaper last week reporting that one in three patients due to have hip replacement surgery are waiting longer than the 18 weeks promised by Holyrood while half the women who have cervical cancer detected as a result of routine screening are not starting treatment on time due to delays in diagnosis.

If ever there was a time when senior doctors’ overtime was needed it is now, so what’s the solution? The most obvious answer would be for the UK Government to overhaul the system of pension-related reliefs and allowances that have created the problem in the first place. As they exist for a reason, though – to bolster the overall tax take by ensuring those with the broadest shoulders carry the heaviest burden – the appetite for that is likely to be limited, especially as it would work in the favour of other high earners, such as bankers, whose work is not a matter of life and death.

Another option would be for the Scottish Government to follow the lead of some English NHS trusts by allowing health service employees to stop saving into their pension while continuing to receive employer contributions in their salaries. Yet while that would deal with the immediate problem of individuals inadvertently breaching their annual allowance, the long-term impact could be immeasurable, with the loss of contributions from countless high-earning members likely to undermine the future integrity of the NHS scheme.

In and of themselves these options are clearly unsatisfactory, but even if both these paths are gone down it would do little to get to the root cause of the problem. You see, the staffing crisis that will engulf the NHS if consultants continue to shun extra shifts has far more to do with the way our health service has been left to dwindle during an extended period of government-imposed austerity than with the way pensions or taxes operate.

READ MORE: NHS faces staffing crisis over pension charge fears

Indeed, these highly skilled, highly experienced individuals who – quite rightly – are highly paid for what they do are not being caught out because they are trying to earn ever-greater sums of money, but because they are trying to keep the service functioning. That their commitment is being repaid with disproportionate tax charges that will ultimately be funnelled back into that service is beyond insulting, but eradicating those charges will not eradicate the problem. Only finding the resources to fill the vacancies so that already highly paid individuals aren’t left to plug the gaps will do that.

Despite this, a temporary solution must be found and MPs will discuss the pension issue this morning in a Westminster Hall debate tabled by East Renfrewshire member Paul Masterton. He has urged the Government to act quickly to sort out an “unintended consequence of the UK’s complex pension regime” in order to “let these consultants get back to work”.

The chances of it doing so seem slim to non-existent, with the unsolvable conundrum that is Brexit continuing to suck up every second of time that would be better spent running rather than ruining the country. Having proven itself time and again incapable of cleaning up any mess of its own making, though, our Government appears more intent on fiddling with the minutiae of its own internal power struggles than doing anything to stop the UK's health service burning. That is an unforgivable dereliction of duty.