Image copyright Peter Byrne/pa

Doctors in Northern Ireland have warned health services could be put under extra pressure due to "punitive, unexpected pension tax bills".

The British Medical Association (BMA) said the move has caused doctors to consider cutting working hours and taking early retirement.

Pension rules introduced in 2016 mean that consultants are penalised if they breach their pension savings allowance.

The Department of Health said it is closely monitoring the situation.

Across the UK the pension changes and the nature of NHS pensions, have meant consultants and others earning more than £110,000 a year risk large, unexpected tax bills when their income increases.

"Concerns about potential impacts on service provision have been raised with us by trusts and the BMA," a spokesperson said.

"Taxation - including pension taxation - is a reserved matter and decisions on tax relief on pension contributions are taken by the Treasury.

"Department of Health officials are in close contact with counterparts in England and Wales on this issue."

The BMA is a trade union which represents and negotiates on behalf of doctors and medical students in the UK.

Image caption Dr Anne Carson says the tax means doctors are essentially working extra for nothing

'Unable to do extra work'

Anne Carson, chair of BMA Northern Ireland's consultant committee, said matters are "grim".

Dr Carson, a radiologist, has reduced her clinical hours from about 60 to about 30 per week.

In an interview with BBC News NI, she said she was now considering retiring if the situation is not resolved within two years.

"Consultants are reducing hours, they are retiring early, they are unable to do the extra work," she said.

"Waiting lists are increasing and will continue to increase in the next 18 months as understanding of this hits and the bills come."

Image caption To combat waiting list backlogs, doctors were relied upon for working additional hours in weekend clinics

Dr Carson said it is not about avoiding paying taxes.

"Consultants are already taxed on their pay," she said.

"This is about the punitive tax there is for taking on additional work, for example covering for colleagues, covering maternity leave, taking on management work or waiting list initiatives."

However, BMA Northern Ireland said patients are already being affected as waiting lists are not being tackled to the same degree as before.

In order to tackle the backlog in orthopaedic waiting lists, the Department of Health set up weekend clinics, but they often relied on some doctors working additional hours.

Image copyright PA Image caption A BMA survey found 45% of consultants intended to reduce their working hours because of the taxation

Dr Carson said doctors want to help.

"We are committed to addressing the issues around waiting lists and transformation in Northern Ireland, but due to the way the tax system is set up it essentially means that we would be doing that additional work for free."

A BMA survey of 1,600 consultants was carried out online over June and July.

Of the 214 who responded, 19% had already cut their working hours in order to address the issue.

Forty five percent of respondents said they intended to reduce their working hours in the next few years because of the issue.

The government is consulting on plans to make the system more flexible including allowing doctors to reduce their pension contributions.

While doctors are well paid, the work they take on at the weekend is in addition to what can be a stressful week's work.