PATIENTS in Gwent are among many thousands across Wales to have had operations, outpatient appointments and diagnostic tests cancelled or delayed as a result of consultants scaling back on doing extra work amid concerns over tax penalties on pensions.

And despite a solution being put in place in England and Wales late last year to try to encourage them into doing extra work, it has had little effect to date in Gwent, according to Aneurin Bevan University Health Board.

And that is "not good news" for patients, particularly those referred with orthopaedic problems, according to the health board's director of finance and performance Glyn Jones.

By the end of December, 826 orthopaedic patients in Gwent had been waiting more than 36 weeks since referral, up 20 per cent in just one month.

"A solution [to the pensions and tax issue] has been put in place - effectively the NHS and Welsh Government will cover potential tax liabilities linked to pensions and clinicians doing extra work," said Mr Jones.

"This will run to the end of this financial year, and is intended to encourage staff to come and do extra work."

Unfortunately, in Gwent's hospitals, there has not been "any material shift to date" in the situation, he added.

Orthopaedics accounts for the majority of patients in Gwent who have waited more than 36 weeks for treatment since referral, and Mr Jones said the health board must "think of other ways of increasing capacity, particularly into next year", to address the mounting waiting list.

That is likely to mean asking some patients to travel to other hospitals - NHS or private, in England or elsewhere in Wales - to minimise delays and deal with backlogs. But as well as being an expensive option, there is no guarantee sufficient capacity will be found elsewhere to ensure all patients can be treated quickly.

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The issue of tax penalties on pensions for NHS consultants has rumbled on for months and continues to heap pressure on a service struggling to cope with rising demand, and in the midst of another testing winter.

Health minister Vaughan Gething says the issue has caused, and continues to cause, "undeniable harm" to the NHS across the UK, and has written a strongly worded letter to Matt Hancock, the UK Government's Secretary of State for Health and Social Care on the issue.

He is urging that a long term solution be found, as the temporary solution adopted in Wales is only a "sticking plaster", with an "opportunistic" move to tackle the issue by the UK Government in the midst of the General Election campaign leaving the Welsh Government in a "totally unacceptable" position.

"The Welsh Government fundamentally disagrees with the solution which has been implemented in England. The tax issue should be resolved by the Treasury, not left to the health budgets of each of the four UK Governments to absorb," writes Mr Gething.

"However, we were left with no option but to also consider putting in place the same temporary solution while the UK Government is consulting on changes from April 2020."

Mr Gething said health boards in Wales reported losing around 3,200 sessions - for surgery, outpatients and tests - from April-December 2019, which has affected nearly 27,000 outpatients.