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Can nurses expect a new deal on pay?

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Unions have submitted their evidence to the NHS Pay Review Body calling for a recommendation that the government reopens the talks on pay. Helen Mooney analyses the facts and figures

Evidence submitted to the NHS Pay Review Body last week made the case for an improved pay rise for nurses and other non-medical NHS staff (NT News, 28 October, p2).

As the economic downturn continues and the UK slips into a recession, unions have claimed nurses are facing tough times ahead and the original pay deal agreed earlier this year is no longer reflective of the cost of living.

The current 7.99% three-year pay deal equates to a 2.75% pay rise for nurses in the year 2008–2009. Awards for the next two years agreed between the government and the unions mean an extra 2.4% in 2009–2010 and 2.25% the following year.

However, a ‘reopener clause’, which was written in to the agreement, means that the Pay Review Body can be called on to make recommendations to the government, should the economy deteriorate – which it now has.

The system effectively means that nurses’ pay decisions are in the hands of the independent Pay Review Body – and ultimately the government, which can decide in favour of or against a Pay Review Body recommendation.

The documents that were produced by the unions as evidence for the Pay Review Body make for depressing reading.

They warn that staff across the NHS are now facing severe hardship and for nursing a recruitment and retention crisis is predicted.

Graduate intake is down – at the end of July 2007 there were 3.7% fewer students attending undergraduate nursing courses than the year before.

In addition, more than 25% of students are dropping out of their courses and those who are already working in the profession are leaving before retirement age.

The evidence also shows that record numbers of NHS staff are now accessing help on managing severe debt and house repossessions. Many are also being forced to take second jobs and to work overtime because of the impact of inflation and the rising costs of fuel, food and childcare.

Karen Jennings, staff side chairperson and Unison’s head of health, said: ‘Hard-working staff across the NHS accepted a three-year pay deal six months ago believing the government and economic predictions that inflation had peaked and would start to fall.

‘This clearly hasn’t happened. No one then could have predicted the worldwide credit crunch or that inflation would
hit a 16-year high,’ she added.

She warned that the government had to make sure that working within the NHS was an attractive career option and to do so it would need to ‘pay workers decently’.

‘The reopener clause was intended to be a safety net for NHS staff. They need that safety net now,’ she said.

The RCN has urged the government to take action in the face of recruitment and retention warnings.

Chief executive and general secretary Peter Carter said: ‘NHS staff put their faith in the government when they accepted their pay deal – now it’s time for the government to honour the day-in day-out commitment of NHS staff by agreeing to reopen talks to secure a fairer pay deal across the health service.’

Heads of midwifery across the UK last week warned of a service ‘buckling under the pressures of rising birthrates, inadequate funding and a lack of staff’.

The findings of a survey conducted by the RCM of all heads of midwifery across the UK reveal that as many as 75% consider they do not have enough staff to cope with the current workload, yet despite this one-third have been asked to cut their budgets and reduce expenditure.

The survey also shows a significant drop in midwives’ morale with one-quarter of heads of midwifery saying their staff are unhappy.

As a consequence recruitment and retention has been hit with over one-third of survey respondents saying it has become a problem – compared with only 13% last year.

Jon Skewes, director of employment relations and development at the RCM, called on the government to make
sure that more midwives joined the profession and that those who are already in employment are retained.

‘This will not happen without fair reward. Midwives are facing a double whammy of static resources at work and salaries not keeping pace with inflation so they are increasingly hard-pressed in terms of household bills,’ he said.

‘Better resourced and fairly paid midwives translate directly into better care for women,’ he added.

Meanwhile, the union Unite has gone a step further.

It is the only union not to have accepted the original three-year pay deal, which it described as ‘derisory’ and last week it balloted its members on industrial action.

David Fleming, Unite’s national officer for health, said: ‘I appreciate that we are living through very difficult economic times but that is no excuse for dedicated and hard-working NHS staff to be penalised by derisory pay awards as a result’.

In its submission of evidence to the Pay Review Body, Unite criticised the government for its ‘lack of economic rationale’ in the current pay agreement.

‘The economic crisis and recession should not be seen as a reason to decrease investment in the NHS and avoid tackling the problems in staffing levels,’ it said.

‘Previous low levels of pay for NHS staff and a lack of investment led to a decay in the service,’ it added.

But despite the compelling evidence, there are doubts that the government will commit itself to improving pay for nurses during these testing economic times.

The two-stage reopener clause means that the unions have first to convince the Pay Review Body and then the Pay Review Body has to convince the government – that NHS staff should receive more pay.

The government’s decision last year to stage the pay deal for nurses in England and threats earlier this year of another staged pay deal if unions rejected the multi-year package on offer, show the government is willing to ignore pressure from staff and the review body.

Key staff side recommendation

'In view of the significant and material changes in recruitment and retention and wider economic and labour market conditions, staff side organisations seek a review of the pay uplifts for 2009 and 2010. Staff side seeks revised awards for 2009 and 2010 significantly above inflation levels, that restore income lost from 1 April 2008 as a consequence of the steep rise in inflation and that recognise that the high inflation level has had greater impact on low paid staff.'

Some say that the Pay Review Body simply will not have sufficient influence to bring about change.

Mike Travis, RCN steward at Alder Hey Children’s NHS Foundation Trust in Liverpool, said: ‘I have complete confidence in the staff side evidence, which has been built up over time but it depends how the Pay Review Body will react when it is put under political pressure.’

But Ms Jennings was more positive about the possible outcome. ‘I would be very shocked if the government did not listen to any recommendation the Pay Review Body may make to reopen talks,’ she said.

NHS trusts, represented by NHS Employers, have already vowed to fight any attempt to increase pay to staff in the health service.

The Department of Health has also produced its own evidence to the Pay Review Body, which was submitted at the time of
writing and is likely to make similar arguments.

Gill Bellord, director of pay, pensions and employment relations at NHS Employers, said: ‘Employers have told us that they support the three-year pay deal for Agenda for Change staff and do not think there is sufficient evidence to justify a review of the provisions agreed with unions’.

If a Pay Review Body recommendation is put forward and the government reopens talks, discussions will begin in the new year.

Any extra pay increase that is agreed on top of the existing one would come in to force in the financial year beginning
April 2009.

To read more about Pay 2008 click here.

What the evidence shows

  • Staff are experiencing severe hardship as a result of rising inflation. One union found that three-quarters of members needed to work overtime to meet living expenses and one-fifth could not afford to heat and maintain their homes.

  • More than 200,000 nurses are aged over 50 and due to retire within the next decade.

  • Recruitment continues to be low in the NHS and for the first time in two years there has been an increased reliance on bank and agency workers.

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