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Unions reject call to drop national NHS pay deals

The government should drop national pay agreements for NHS staff and allow each healthcare organisation to negotiate its own deal with employees, a report said today.

The report by the right-leaning think-tank Reform said the change would allow hospitals to reward good performance, introduce innovative working practices and improve care for patients by dealing with staff who are under-performing.

It would also allow trusts to take advantage of the expected surplus of doctors in the UK to “drive down pay” and review the hierarchy of medical ranks in hospitals, said the report.

Consultants should no longer be able to regard their position as a “job for life”, and immigration rules for doctors should be relaxed to give healthcare providers more freedom to recruit from abroad.

Nick Seddon, deputy director of Reform, said that the current pay arrangements were undermining the government’s goal of improving quality and efficiency in the NHS.

He called on health secretary Jeremy Hunt to reject the argument of the umbrella organisations NHS Employers, which wants to maintain national pay arrangements and extend the current pay freeze into a third year.

Pay freezes prevent employers from using their discretion to change working practices or incentivise good performance, warned the report, entitled Doctors and Nurses.

Mr Seddon said: “The current negotiations on NHS pay are a test for the new secretary of state.

“There is a glaring contradiction between his goal of a higher quality NHS and his Department’s support for national pay arrangements.”

Reform said ministers should offer their “full support” for NHS organisations challenging national pay bargaining, such as a group of 20 trusts in the South West which have formed their own consortium to consider breaking away from the national framework.

The report highlights health organisations in the UK, USA and India which have introduced performance-related pay incentives for staff.

It found that local pay agreements can help cut costs, by encouraging higher-quality care, which in turn reduces the expenses arising from medical error.

Unison criticised the “unhelpful timing” of the report. Negotiations are taking place between unions and NHS Employers today, aimed at reaching a national agreement on Agenda for Change.

Christina McAnea, Unison head of health, said: “Reform’s report is writing the wrong prescription for NHS pay.  

“It ignores the fact that Agenda for Change has a proven track record of delivering fairness and for keeping the industrial peace across the NHS. The agreement already contains the wherewithal for trusts to link progression with training and development which is instrumental in delivering better patient care.”

Royal College of Nursing chief executive and general secretary Peter Carter said the college “completely rejected” the vast majority of the Reform report.

He said: “Far from leading to a more efficient NHS, local pay would be a recipe for disaster, with damaging implications for local economies and the NHS. Agenda for Change, allied to national pay rates, is a transparent and fair system that also has the flexibility to adapt to changing circumstances.

“It means that in any part of the country, employers know they can recruit staff with the right skills and experience to give patients the care that they need.”

He added: “Local pay bargaining would actually increase inefficiency in the NHS. This is because trusts have to implement their own pay systems, forcing them into bureaucratic and expensive machinery with no economies of scale, which only takes money away from patient care.”


Readers' comments (4)

  • tinkerbell

    why aren't the unions now balloting their members for industrial action? Or have i just not received the ballot paper? What exactly are the unions doing for us members RIGHT NOW apart from talking and taking our union dues. We need action RIGHT NOW.

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  • Peter Carter can say what he likes but actions speak louder than words - get on with it unions - we can easily win this battle if we really want to!

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  • THANK YOU to my union and my managers for working so hard for me and my colleagues on our behalf, not forgetting politicians and traffic wardens and royal family, without who, our society would fall apart.

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  • Given the timing, it sounds suspiciously like a back-door request by the Government to release this report to undermine the negotiations and speed up the privatisation schedule. All this report does is agree with the South West Trust Mafia in their efforts to get their nurses to work longer for substantially less. Yet again the Unions saying plenty, doing nothing...I don't even know why they bother. Frankly, I would rather my local Plumber in my corner than any of the Unions...at least he may do something!.
    A local pay agreement will not "encourage higher-quality care, and reduce the expenses arising from medical error." because all the Trusts in this country will use it as an excuse to force nurses to sign contracts at significantly lower wages (combined with the removal of all benefits and probably all shift enhancements) in a "sign-or-leave" tactic which will reduce staffing numbers further leading to lower-quality care and higher medical error expenses. This Think-Tank clearly hasn't been thinking otherwise they would have factored in Trusts' over-riding drive to reduce costs as much as possible, regardless of the impact it has on patient care and safety.

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