A TOP doctor says he will be forced to cut his hours as a paediatrician in rural Scotland unless action is taken to stop senior clinicians being hit by huge pension tax bills.

Speaking to the Herald ahead of his appointment today as the new chair of BMA Scotland's consultants' committee, Dr Graeme Eunson said one of his colleagues at Borders General Hospital in Melrose had been hit with a £140,000 tax bill following promotion.

He added that others were shunning extra work or taking early retirement to avoid scenarios where their tax liability exceeded their earnings.

The problem has occurred as a result of tax changes rolled out under David Cameron's government which were intended to avoid the super-rich benefitting from tax relief.

HeraldScotland: Camley's Cartoon: Doctors shunning extra hoursCamley's Cartoon: Doctors shunning extra hours

However, the complex way the charges are calculated means that many doctors on salaries of £110,000 or more have ended up being asked to pay more in taxes than they have received in overtime pay, with some forced to re-mortgage their homes or take out loans just to cover their tax bills.

READ MORE: SNP health secretary back move to end pensions 'tax trap'

Following Boris Johnson's appointment as Prime Minister, the Treasury announced that the system would be overhauled to give doctors greater flexibility around pensions saving. However, it is unlikely to take effect until 2020, and critics say more comprehensive tax reform is needed.

In his own case, Dr Eunson, a 45-year-old consultant paediatrician who lives in Selkirk, said he expects to receive a "significant tax bill" this year.

He said he currently faces a "bizarre situation" where he would be able to substantially increase his take-home salary in future by working fewer hours.

"In 10 years' time I should hit the top of the constant pay scale, which would be a gross salary of £139,000. That's a huge amount but, if nothing changes, 77 per cent of that is going to go straight back in tax and pension contributions, so my actual take-home pay would be £31,000.

"Yet if I cut my hours and drop down to only working 36 hours a week - which would reduce my gross salary by £14,000 - I would actually take home £30,000 more. It's a perverse situation where working harder actually punishes you.

"It's taken people by surprise. In our own hospital, one of the doctors says he has had a tax bill of £140,000 because of his pension going up when he took on a significant senior clinical position. His tax bill actually exceeds his gross salary.

"Within my own department, people at my seniority level or above are starting to seriously look at what they're doing. In our department, any time we had gaps in the rota or vacancies coming up previously we would step in and take on extra sessions. Now people are saying they'll do the extra work, but they'll have to take that time back because they can't afford to be paid more."

READ MORE: Pensions survey exposes 'disaster' facing NHS Scotland

It comes as the final results of a BMA Scotland survey asking medics what action they were taking to avoid or mitigate pension charges found that 40% of consultants are now declining extra work funded specifically to cut waiting times. In addition, four in ten GPs said they are turning down out-of-hours work and 22% of doctors are taking early retirement.

In total, 593 doctors responded. More than a third (35%) said the situation will damage urgent and emergency care provision and "leave front-end services uncovered", with a quarter warning that staffing shortages would trigger the collapse of a particular service.

Among the feedback from doctors was a comment that "stories of clinicians leaving to work abroad are becoming common".

Statistics show that NHS Scotland is short of 514 consultants, putting the vacancy rate at a record-breaking 8.8%.

Dr Eunson, who previously chaired BMA Scotland's junior doctors' committee from 2004 to 2007, said the workforce was already feeling the effects of Brexit.

"In my wife's department, they had someone who was lined up to take a post in June - he was an EU national as was his wife. But due to the uncertainty over whether both of them could continue working in the UK, when they got a firm job offer in another country they took it.

"That was in radiology - the one speciality that we are the most desperate for."

READ MORE: A pensions age of 75 is no way to solve our economic woes 

Dr Eunson, who is originally from Thurso and studied medicine at Edinburgh University, said consultant shortages were also partly driven by younger doctors increasingly postponing specialist training.

"Currently only about a third of doctors finishing their foundation years go straight into speciality training," said Dr Eunson. "That was certainly not the case when I was training - people got on the career path pretty quickly.

"Some go abroad. I suspect a lot of them do come back eventually, but we're seeing diminishing numbers of people coming through Scottish training and into consultant careers.

"It's not just that they're taking longer to get there, they do seem to be disappearing. Exactly why that is is not 100% clear."

A Scottish Government spokesperson said: “It is very disappointing that the UK government imposed these changes on hard working health staff without consultation or thought on the impact on doctors or patients.

“The Health Secretary has written to the Chancellor urging a quick resolution to avoid loss of expertise and called for an urgent review.

“We welcome the BMA findings and we continue to work in partnership with the BMA and other partners to improve the working lives of doctors, including further improving flexibilities around the pension scheme.

“We will continue to work with stakeholders, including the BMA and employers on the impact on doctors’ working hours and Out of Hours Services.”