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Josie Irwin: 'Unjust comparisons with the private sector sap nurses’ morale'


Constant critical comment from politicians and media commentators chips away at nurses’ confidence and optimism about their roles, says Josie Irwin

Preliminary findings from this year’s Royal College of Nursing employment survey show that 93% of nursing staff in the NHS usually work in excess of their contracted hours and, for half of these people, these extra hours are unpaid. For 20%, this means working extra hours on every shift. Of the respondents, 83% reported their individual workload had increased over the last 12 months, and 61% were too busy to provide the level of care they would like to offer.

These findings reinforce the conclusions of the RCN 2012 survey Beyond Breaking Point? This looked at members’ health, wellbeing and stress, and revealed a nursing workforce struggling with increased workloads and work pace, while feeling unsupported and detached from changes being implemented in the workplace. Respondents reported working long hours, unrealistic time pressures and unachievable deadlines.

“While pay has never been the primary consideration for nurses, once they start to feel that pay is unfair, morale is strongly affected”

Poor working environments, where morale is low, damage the ability of nursing staff to provide safe and compassionate care. At the end of June, the chancellor George Osborne announced further pay restraint for public sector staff, including NHS pay being held at 1% in 2015-16. This follows a 1% pay rise for this and next year, and a pay freeze in the period 2011-2013.

He also set out reforms to automatic progression, telling MPs: “Progression pay can, at best, be described as antiquated; at worst, it’s deeply unfair to other parts of the public sector who don’t get it, and to the private sector who have to pay for it.”

While he went on to make it clear that his targets for removing automatic increments are civil servants, teachers, prison officers and the police, his inference that public sector staff more broadly receive increments for “time served” and do not earn them is contributing to nurses feeling unvalued and demotivated. While pay has never been the primary consideration for nurses, once they start to feel that pay is unfair, morale is strongly affected.

Nursing staff are anxious about pay - both now and for the future. There continues to be noise in the NHS human resources community about further reductions in pay, terms and conditions. And the Foundation Trust Network has said the changes implemented from April 2013 to link pay progression with performance do not go far enough.

Inaccurate and unfair comparisons with the private sector and constant inferences that NHS staff are not performing sap morale; this may already be impacting on recruitment and retention. This year, we have seen a rise in NHS trusts recruiting abroad - particularly from Spain and Portugal - increases in spending on agency nursing staff and evidence of difficulty filling shifts in specialties such as critical care.

Of course, other factors are influencing the nursing labour market - the supply of new registered nurses has been affected by cuts to training places and demand has risen because the recession has taken a toll on health. However, constant critical comment from leading politicians and media commentators is bound to chip away at nurses’ confidence and optimism about their roles.

It would be unrealistic to hope for a change of heart from the chancellor on the continuation of the 1% cap on public sector pay, but he should stop his unfair comparisons with the private sector and inferences that public sector staff, including hard-working nurses, do not earn their pay. This unfair comparison only serves to impact negatively on morale and motivation.

Josie Irwin is head of employment relations at the Royal College of Nursing


Readers' comments (11)

  • Comparison with NHS and private sector nurses & their duties is completely inaccurate and unfair. The Private sector can 'cherry pick' their patients who are for the most part well and fulfill the pre set criteria for admission, also applied for those who take a bed in a private facility paid for by the NHS to avoid breaches of target, under 'choose and book'. The NHS has to take all comers, no matter what,and deal with it.
    However I can speak from experience that private sector nurses are every bit as abused as their NHS counterparts. They are bombarded with the added burden of being reminded how much they contribute to cost efficiencies when the daily charge sheet is filled, and how to demonstrate to patients that paid for care is better than that of the NHS. Staff - patient ratio is always at full stretch as it is in the NHS and managers often question if patients really need that much care & nurse attention after their surgery! And in some emergency cases, its the nearest general hospital that takes the ill patients from the private sector.

    In short, nurses are still taking the flack for the failings of others, adding low pay or draconian terms and conditions just fans the flames of resentment. Those in the private sector deal with the same kind of rubbish we do in the NHS.

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  • Private Sector Nursing Homes pay scales and enhancements are no where near as good as NHS.
    Our conditions, staffing, and managerial support also deeply lacking.
    I think this article doesn't clarify which sector is the comparison.
    Banking maybe?

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  • What pay progression? a 1% cap will hurt more at the lower end of any pay scale, which also tends to be those involved directly with patients most of the time. Another stick to beat compassion out of staff.
    Wonder why there's so much recruitment abroad? Could it be rising costs of educational + training, reducing student numbers, reduction of local recruitment + retention, down banding / grading of posts?
    It's sad to see reliance of bank staffing, who work so many extra hours, and not paid double rate or more - the provisions of overtime are overlooked. So staff switch over to doing agency work, which pays a bit more (loss of certain benefits have to be factored, such as sickness + pension provisions).
    The future might realise a treasury raid on the NHS pensions coffers, people deciding to opt out, and some people when retiring may take their pension slice out of the country to sunnier + better cost of living countries. Shelf stacking, check-out work looking more attractive + offers an environment of customer service with a bit less stress on staff health + well-being ;)

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  • I interpret 'private sector' as not just healthcare but all other businesses.

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  • RCN....bleat bleat bleat. So Josie Irwin, what are you going to do about it? Rally your membership and take on the government? No probably not, eh?

    I know. Why don't you have another conference and wheel out blubbering delegate after blubbering delegate to tearfully wringe their hands and tell the world what poor little picked upon folk we nurses are? Or we could hand over the platform to a gut wrenching, sickly sweet poem? That's what the RCN normally do isn't it? How's that working out for you and your patients?

    Here's an idea. Tell this government that enough is enough, draw up a list of demands and RECOMMEND industrial action to your membership to achieve these demands. Grow a spine!!!

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  • As someone who worked in the private sector for all of my working life, until I was bullied into stress and depression, the pressures in the private sector are no easier withstand than in any other sector. I am now embarking on a nursing degree. My eyes are open. I know what the pay and conditions are like. As a medical rep, I worked with nurses and doctors for years. Nearly thirty years. And you know what? I will be fine. And I will be fine because my focus will be on patients and being useful, instead of working for a small group of investors who care not a jot about anything or anyone, except themselves and their bank balances.

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  • I agree with David Baird, I too was bullied out of my job in the private sector, The staffing levels were appalling, and the management team were nurses who had not worked in a clinical environment for years, and hadnt got a clue how nursing has evolved over the years i became so de-skilled in their employ that i had to get back to the nhs to save my sanity and career. It may look like the private sector is easier, but you dont get the level of pay and unsociable hrs increments you get in the nhs, and that includes working christmas day!

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  • Anonymous | 23-Aug-2013 6:01 pm

    "...but you dont get the level of pay and unsociable hrs increments you get in the nhs, and that includes working christmas day!"

    In the interests of balance, I have to point out that for the majority of my three decades in nursing, those in the private sector were paid far more than their colleagues in the NHS. Indeed, one of the primary reasons for the NHS staff pension was that they had to do something to counter the longstanding, consistent, low pay of NHS staff and provide some kind of incentive to remain within the NHS. Staff wages and conditions have only caught up with the private sector in recent years and almost immediately, guess what has happened? Yep. They froze pay for years, went after the NHS pensions, are now going after the increments and have successfully blamed NHS workers (and other public sector workers) for sucking the resources out of the country's pockets. The bankers, meanwhile, carry on as before.

    The bottom line is that ALL nurses regardless of which sector they work in, should expect fair remuneration and decent conditions for their high skilled expertise , the demands of their daily work and their lifelong learning. There should be no either/or here. We all deserve decent conditions and we should all be working together to achieve them. That's where the trouble starts though, isn't it?

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  • tinkerbell

    Anonymous | 25-Aug-2013 11:16 am
    I agree with you, in fact I totally agree with you:) all for one and one for all but the divide and conquer strategy has worked well down through the centuries and still appears to be going strong. Let the peasants turn against each other and fight it out amongst themselves, saves them the trouble.

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  • I worked in a private hospital in south Kensington. The conditions of work were no better than the NHS. The difference for me was I had a great boss. That's what made the place bearable. I gave exactly the same level care to private patients as NHS patients. In fact I worked with doctors who came straight from their usual place of work, NHS, to their private clients. I don't believe patients got better treatment either, just the same as usual. The thing that people liked was the waiter service, they could have wine with their meals. Nothing else was any better.

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