The pay review body report published in March 2012 has accepted the second year of the government’s public sector pay freeze, along with recommendations to implement regional pay for nurses and NHS staff.
It outlines the case for making pay more market-facing in local areas and, let’s be quite clear on this issue, regional pay is not about enhancing the pay of nurses but a cynical move to dismantle national pay and national bargaining. So how could this impact on nurses across the UK?
Evidence extracted from pay surveys in the private sector points to lower levels of pay in the North of England in comparison with the South, with significant differences between the South West and the North West. If this was implemented across the NHS then a nurse in Blackburn could be earning a lot less than her counterpart in Bristol. This surely would undermine the whole infrastructure of Agenda for Change and create damaging competition between employers. It is likely that rates of pay would be maintained and perhaps enhanced in the form of high cost area supplements in “hotspots” such as London and Bristol, at the expense of other areas. This would mean nurses elsewhere facing the potential of continuing pay freezes or, even worse, a series of cuts in pay.
Regional pay cuts will deal a fierce blow in the hard-pressed communities already hit by job losses and cutbacks. Pay inequality will be a real issue - the foundations of Agenda for Change and national bargaining will be rocked to the core. The reason nurses covered by the Agenda for Change national pay agreement are currently paid the same in Blackburn and Bristol is the commitment to equality and equal pay for equal work. Pay drift would rapidly be followed by job drift with nurses migrating to the higher-paid localities. The impact on service provision and the delivery of healthcare in lower-paid and deprived areas would be huge.
Medical and dental staff are unlikely to be included in these proposals so, again, it is the nursing profession that will bear the brunt of this attack on pay and conditions.
There is also the question of how NHS employers would negotiate regional pay and whether they have the capacity to manage such a process. Some have already expressed concern at increased administration burdens that might be placed on the service. We firmly believe the NHS could be destabilised by local pay as the service struggles to deal with cuts, restructuring and the impact of the Health and Social Care Act.
There is no indication that governments in Scotland, Wales and Northern Ireland would embrace market-facing pay; as such acute recruitment and retention problems could emerge in English regions bordering Scotland and Wales, with the devolved countries potentially retaining higher levels of pay.
Unite has always opposed local pay bargaining in the NHS. Previous attempts to implement such a strategy proved disastrous across the board and took many years to unravel. There are existing mechanisms for dealing with the cost of living encapsulated within Agenda for Change. These include allowances and recruitment and retention premia, which are agreed through the national framework. There is no requirement to introduce regional pay with ill-defined regions and zones; Unite sees this proposal as yet another “quick fix” for the government to raise revenue from hard-pressed nurses to repay the national budget deficit.
Enough is enough, the proposals for regional pay must be vigorously opposed. One option is to contact your MP and ask how they would react if regional pay was imposed on members of parliament.
Fiona Farmer is national officer, Unite the Union.