Is NHS IR35 misapplication impacting patient care?

Is NHS IR35 misapplication impacting patient care?

Could NHS IR35 misapplication be responsible for 10,000 excess deaths in first 7 weeks of 2018? IHPA suggests inquiries should be made.

It has emerged in written evidence from the Secretary General of the Independent Health Professionals’ Association (IHPA) that HRMC has been knowingly misleading both the Government and the public in how its application of IR35 has and is continuing to impact the NHS.  Additional oral evidence can be found here.

Evidence in the form of an email exchange obtained by a Freedom Of Information request (FOI) suggests that HMRC were fully aware of the impact the changes to the NHS Loan Charge would make, despite denying that there would be any tangible negative effects at all. These Loan Charges are being reviewed further tomorrow afternoon, after which we’ll have more developments.

The IHPA represent over 3000 self-employed doctors, nurses and allied health professionals, both within and out of the NHS. Dr. Iain Campbell, Secretary General and author of said letter, uncovered an email conversation between Mark Frampton, HMRC’s dedicated IR35 lead and Martin Innes, Senior Operational Agency Data and Intelligence Lead for NHS Improvement. This email conversation discussed the issue of unlawful IR35 blanket determinations, specifically that people were being denied self-employed status (regardless of their true employment status) and therefore being forced into ‘disguised remuneration’ umbrella schemes. While HMRC has publicly denied that this will impact the NHS, negative effects are acknowledged throughout the internal email exchange unearthed by Dr. Campbell.

Umbrella schemes and blanketing staff: HMRC covering up the truth?

The following is a brief summary of the points made within Dr. Campbell’s letter to HMRC:

  • HMRC mislead the government in regards to the realistic implications of the Loan Charge on the NHS.
  • HMRC attempted to avoid disclosing particular emails in which the above was discussed without citing an exemption. The email was only uncovered because the same request was submitted to NHS Improvement who supplied the full correspondence.
  • HMRC are driving medical professionals into loan schemes as a result of the April 2017 IR35 reforms.
  • HMRC is embroiled in a campaign of deliberate misrepresentation to deny doctors, nurses and AHPs in the public sector self-employed status, regardless of if that is indeed their correct status.
  • There is evidence of unminuted webinars by Mark Frampton and NHS Trusts of which the goal was finding all medical professionals inside IR35.
    Stephen Barclay MP and Mel Stride MP have both denied any purposeful misleading of the Government.
  • There has been a reported drop of 20,000 self-employed doctors in the UK and a drop of 11,000 doctors in total in the UK since the April 2017 IR35 Public Sector changes.
  • Nick Hulme, CEO of Colchester Hospital, banned staff from speaking up on short staffing issues. Their corporate risk register includes comments that they’re down 100 additional nursing shifts per week.
  • IHPA not aware of a single NHS trust in the UK which is applying the public sector IR35 reforms correctly, ‘blanketing’ staff instead of affording individual assessments with required reasonable care. This is a common trend in HMRC’s CEST tool.
  • Speculation as to whether the impact felt by IR35 in the NHS could’ve contributed to 10,000 excess deaths unrelated to weather, influenza or ageing population in the first 7 weeks of 2018.

All of the above raises serious concerns as to the integrity and transparency of HMRC who are clearly avoiding any public acknowledgement of the extensive evidence of the issues caused so far since the Public Sector IR35 reform.

NHS Loan Charges to effect 1000s of medical professionals

In the emails, Frampton disclosed: “We have heard reports that some doctors are also being sold the sort of tax avoidance schemes we thought everyone knew were closed down years ago. HMRC are very concerned that some doctors are being sold ‘contractor loan’ or similar complex avoidance schemes without them understanding that there is already legislation in place that catches these schemes.”

In addition to potentially encouraging non-compliance among employers, this email alone demonstrates that HMRC was aware that the IR35 reform was inciting disguised remuneration at a time when it was championing the legislation’s supposed success in improving public sector compliance.

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