The government has once again shown its contempt for NHS staff

Average NHS workers have had a 10 per cent real terms pay cut since this government came to power in 2010.

Matt Dykes is senior policy officer for public services at TUC

This is turning into a terrible week for the NHS. Following the Commons vote for the hospital closure clause on Tuesday, the government today once again showed its contempt for NHS staff with a derisory response to the recommendations of the NHS Pay Review Body.

With characteristic disregard for evidence-based policy, secretary of state for health Jeremy Hunt announced this morning that the government would reject the carefully considered recommendations of the independent NHS Pay Review Body and opt to impose a pay freeze for the majority of NHS staff covered within the Agenda for Change agreement (nearly all staff excluding doctors and dentists).

While the PRB called for a consolidated 1 per cent increase for all staff, the government have decided that a non-consolidated 1 per cent raise would be awarded only to those staff not eligible for an increase through incremental pay progression.

This means that well over 50 per cent of staff and up to 70 per cent of nurses and midwives will receive no cost of living pay award this year. Hunt also announced that this approach would be replicated next year.

This will have a huge impact on morale among the NHS workforce that is already shaken by the combination of five years of pay restraint, top-down restructuring, hostile press briefings and outsourcing. Average NHS workers have had a 10 per cent real terms pay cut since this government came to power in 2010.

The Pay Review Body report specifically addressed this point, raising fears about the potential impact on patients, when it stated:

“In particular, we recognise the connection between quality patient care and the morale and motivation of the staff delivering that care. Our conclusion was that government statements have led staff to expect a pay settlement this year of around 1 per cent. If these expectations were to be dashed, patients would be impacted through declining staff morale and engagement.”

This is a further insult at a time when David Cameron is talking up the benefits everyone is supposedly enjoying from economic recovery. While it’s true that pay prospects are improving more broadly, the public sector worker is once again being shackled with real terms pay cuts.

Of course, both Jeremy Hunt and chief secretary to the treasury Danny Alexander have been spinning it that all staff will be receiving the promised pay rise as many will continue to benefit from pay progression.

But as the PRB itself acknowledges, this is a separate issue. Pay progression is merely a staggered way that workers progress to a given rate for the job, it is based on the accumulation of skills and experience and, since April 2013, has been explicitly linked to appraisal and competency.

As such, pay progression in the NHS is the fairest, most transparent and most cost effective way of managing performance and productivity in such a large and complex service and mirrors similar schemes employed in private sector firms like Fords, BAE Systems, E.ON and HSBC.

That the government are so keen to spin it otherwise demonstrates their contempt not only for NHS workers deprived of a pay award this year but also the collectively agreed terms and conditions within the NHS, reflected in their equal disregard for the process of the Pay Review Body whose recommendations they so readily dismissed.

Jeremy Hunt contends that pay restraint will save jobs and achieve savings that will be recycled into front line care. But five years of pay restraint hasn’t stopped this government making over 7,000 key clinical staff redundant since it came to power.

And while it is true that holding back pay has been one of the few ways that the NHS has come close to finding some of the £20bn ‘efficiency savings’ required by the ‘Nicholson Challenge’, serious questions remain about how much of this has been recycled into front line services. As John Appleby of the Kings Fund put it:

“Presumably, we are saving admin costs not because we like to save admin costs but because we face the need to provide more hips and do more. It is about spending that money on something else. My point about the reporting, in a sense, is that we do not quite know where the money has gone.”

Ultimately pay restraint is unsustainable in the NHS and it is not just health unions making this point.

The Commons Health Select Committee states that the “future of the health and care system cannot be built on an open-ended pay freeze”, the Kings Fund tell us that the ability to achieve sustainable savings through pay restraint is “limited” and cannot be a “substitute for achieving long term productivity gains” and, in the Health Service Journal (HSJ) recently, Dean Royles from NHS Employers acknowledged that the time had come to find a way out of prolonged pay restraint.

This government has never been a good listener when it comes to the NHS and Hunt’s insistence on pushing through pay caps into 2015/16 shows he is deaf to informed opinion. We may well have reached the tipping point on NHS staff morale; we’re fast approaching the stage where we hit recruitment and retention crises.

If the government has the remotest interest in finding a sustainable future for the NHS, we need them to stop making the NHS workforce bear the brunt of its ceaseless austerity drive.

9 Responses to “The government has once again shown its contempt for NHS staff”

  1. Paul

    “If the government has the remotest interest in finding a sustainable future for the NHS…”
    There’s your problem.

  2. nodbod

    “We must take the hard decisions..” No, Dinny Dave. The hard decision would be to give them 2% and then do it without cutting elsewhere. What you did, Dave me old mate, was to take the easiest possible decision you could. Dressing it up in a posh frock and inferring that we are all in it together and we can’t afford any more is horse feathers and you well know it. And how much are MPs going to be awarded after an “independent” review? 11% wasn’t it? Good one, my old son. Next time there’s a big disaster (like flooding or some such) you’ll be the first one I phone to help out.

  3. JD

    Pure Tories. Denigrate and under-fund a service until privatisation seems like the least-worst option. It is in fact the first-worst option.

    In the run up to the 2015 election the wider public need to be informed, again and again and again, about who has let the NHS down. This is vile coalition of the unwilling needs to be consigned to the dustbin of history.

    Labour need to get their act together too in this. Setting themselves up as the natural defenders of the NHS (it was their policy after all) would be, in crude terms, a vote-winner. But in practical terms, for many millions of people in this country, it would be a potential life-saver.

    “The NHS will not exist within five years of a Conservative victory” said Oliver Letwin. This quote should be on literature for the election. It’s not scaremongering if it’s really the plan.

  4. JD

    I’m not what you’d call much of a patriot. But what this coalition and their media acolytes are doing to the NHS is treasonous. And it’s theft when they sell parts off because it doesn’t belong to them, it belongs to us.

    Dopey Dave is very fond of promising referendums. How about, if he’s so confident in his wrecking-ball policies with the health service, he puts his reforms to a vote so the people that actually fund and use the service can decide?

    Actually Hang on a minute. The last referendum on the Tories, the 2010 election, didn’t go all that well for old Dave did it. And the cheek of him is that when a piece of ‘good’ economic news comes along (good mostly for his mates) he expects us to not just forget four years of misery that came before it but be grateful for them!

    Roll on 2015. Lemme at ’em!!

  5. JC

    Shouldn’t we first ask the question “What is the primary purpose of the NHS; is it to look after its staff or its patients?”

  6. Matt Dykes

    Evidence would suggest that, in health and social care (and many other areas of human activity), the two are largely synonymous. Well treated, engaged and rewarded staff deliver better outcomes for patients. So to think you can simply prioritise one at the expense of the other, is a false dichotomy.

  7. JC

    You can only have one primary purpose.. That’s what the word means. Are you suggesting patient care is not it?

  8. Shlola22

    Obviously the primary purpose JC is to uphold and maintain the health and well being of the nation. In order to do this however you need to ensure several things….just one of these being ensuring its staff are valued and treated fairly. When staff feel undervalued, stressed and overworked the issue of staff retention takes hold….when this happens wards are either understaffed or recruitment drives abroad take place…..English trained nurses are sought after and looked after in many other areas of the world. Yes, I believe jobs of nurses like myself who have emigrated to a better place will be filled…..not by English nurses tho. It’s all about quality not quantity. Therefore looking after staff ensures that patient care isn’t compromised!!!! Hope this helps 😉

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