MPs have unanimously passed a motion in favour of a fair pay rise for NHS staff, though the government has stopped short of announcing a formal end to the pay cap.
In a debate in the House of Commons today, MPs approved a Labour motion calling for a pay rise for nurses and others health service staff.
“We need extra investment now to give staff the fair pay they deserve”
Although it does not bind the government to any policy changes, it has almost certainly increased the pressure on ministers to drop the 1% pay rise cap over the the coming months.
The motion was passed unopposed, without a vote, with the government choosing to abstain in what opposition MPs described as a government move to avoid an embarrassing outright defeat.
During the debate – for the first time since the general election – government allies the Democratic Unionist Party made it clear they would support the motion, making a defeat highly likely for the Conservatives if they had taken it to a vote.
Labour health spokesman Jonathan Ashworth, who put forward the motion, said it was “extremely rare” for the government not to vote against an opposition motion. “The only explanation is it avoided a vote, because it knew it would lose it,” he said.
Nursing union leaders and others are now calling for official confirmation that the 1% cap on NHS pay rises is at an end.
“Valuing staff also means looking at non-pay issues as well”
Public sector pay was frozen for two years in 2010, except for those earning less than £21,000 a year, and since 2013, rises have been capped at 1% – well below the rate of inflation.
Previously, chief secretary to the treasury Elizabeth Truss had announced on Tuesday that ministers would have “flexibility” when it came to setting pay above the current 1% cap.
It came as the government said police officers would get a 1% rise plus a 1% bonus, with prison officers getting a 1.7% rise – but both expected to be funded from existing budgets.
The news about prison officers and the police had resulted in an element of confusion, with some media reports suggesting that only those two professions were getting a pay rise, while others said it marked the start of the dismantling of the cap across the whole public sector.
At the outset of today’s debate, Mr Ashworth said any lifting of the cap “must apply to the whole public sector” and Labour would not accept a “divide and rule approach”, which involved “playing one set of public sector workers off against another”.
“It truly is awful. We’re so under-staffed it is unbelievable”
When it came to the health service, he claimed the pay cap was at the heart of a “recruitment and retention crisis”, with nurses turning to food banks, pawning their possessions and facing eviction as the result of ongoing salary restraint.
“Not only is it unfair on hard-working staff who are struggling to make ends meet, it is unfair on patients who suffer the direct consequences of under-staffed, over-stretched services,” he said.
However, he stressed that cash-strapped hospital trusts should not be forced to foot the bill for long-awaited pay rises and moves to increase pay must come alongside extra central funding.
“Over-crowded, over-stretched hospital trusts cannot be expected to absorb pay rising from existing budgets. We need extra investment now to give staff the fair pay they deserve,” he told MPs.
During the debate, health secretary Jeremy Hunt sought to defend the ongoing pay cap, describing it as necessary to get the economy back on track. But he accepted it was currently “very tough on the frontline”.
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“The progress that we have made in the NHS in improving outcomes for patients, despite the huge pressure on the frontline, is possible because of the brilliant staff we have in the NHS,” he said.
“And I want to recognise that pay restraint has been extremely challenging and that is why yesterday the chief secretary to treasury did announce a new policy which does allow departments flexibility, where there are recruitment and retention issues and where productivity savings can be found.”
He said the government intended to stick to its commitment to listen to the views of the independent pay review bodies that make recommendations on public sector remuneration levels before making any decisions on pay.
Mr Hunt agreed that the NHS needed more nurses, but stressed the need to look beyond pay when it came to addressing staffing shortages and other issues.
“I would say to this house that valuing staff also means looking at non-pay issues as well. It means making sure that we are training enough staff, so that when hospitals have the budgets to employ staff there are the actual staff there for them to employ,” he said.
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“It means looking at flexible working, where frankly the NHS can do a lot better,” said the health secretary.
Additional measures included return to practice schemes and increasing new support roles, such as nursing associates, and other new routes into the profession like nursing apprenticeships, he said.
He also faced questions from MPs on the decision to scrap bursaries for nursing students, but was adamant the policy would open up training to more people – despite early evidence there has been a drop in numbers embarking on courses.
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“There has been a dip in the number of people taking up nurse training places this year, as there was when the higher education reforms were introduced in 2012,” said Mr Hunt.
“But that recovered soon after and now we see in other parts of higher education record numbers of students from poorer backgrounds going to university – but we will look at and continue to look at that situation very carefully,” he said.
The debate heard from several MPs who had experience of working in the NHS and had seen the pressures it faced first-hand.
Lincoln Labour MP and nurse Karen Lee, who still does monthly bank shifts, said the NHS “really is in crisis”.
“It truly is awful. We’re so under-staffed it is unbelievable,” she said. “The last time I did a shift I looked after 10 patients.”
Former nurse Maria Caulfield – Conservative MP for Lewes – said she was on the lowest band 5 wage when she did shifts, despite 20 years as a specialist cancer care nurse.
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“I worked during the period of 2010 to 2015, when the pay freeze and then the pay cap was introduced, so I know exactly how difficult it is to manage on a nurse’s wage and not see an increase,” she said.
“With inflation close to 3% now, that is getting increasingly difficult and seven years is enough for anyone to have live with a pay cap or pay freeze,” said Ms Caulfield.
She also hit out at Agenda for Change pay bandings and its system of incremental pay rises for nurses, which she claimed was “used to pay nurses as little as possible”.
While she maintained she fully supported the Royal College of Nursing’s Scrap the Cap campaign, she said the government simply did not have the money to give everyone a pay rise.
“If we focus that pay rise on bands 1 to 7 and help those in high cost areas get a high cost living area allowance, we can make a difference,” she added.
Dr Philippa Whitford, surgeon and Scottish National Party MP for Central Ayrshire, said in her experience staffing levels were generally the number one priority for nursing colleagues, but added that nurses in England had been hit by a “double whammy” of pay restraint and job cuts.
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“Until recently, what I would have heard from nursing colleagues wasn’t actually money, but was staffing – people being on shifts feeling thinly spread, unable to care, anxious about the danger to their patients. I would say that is number one,” she said.
“What has happened in England is that people have had a double whammy,” she said. “They had the pay freeze and the pay cap and yet they have still had redundancies.
“And from what we read through the STPs [Sustainability and Transformation Partnership plans] there could be a lot more to come and that is just plain wrong,” she added.
Dr Sarah Wollaston, chair of the health select committee and Tory MP for Totnes, said she supported the lifting of the cap but also added that it was important to look at wider issues beyond pay.
She announced that her committee would be looking at pay, among a wide range of other issues in a new review of the nursing workforce.
“If we just look at this as an issue of pay, we will be missing something here,” she said, highlighting that pay restraint was estimated to account for up to £3.5bn of the savings the NHS was being asked to deliver by 2019-20.
She said: “In other words, if that goes, what is going to fill the gap? We do have to be very careful that within that we don’t see a loss of services and a loss of workforce, because it is actually workforce pressures that contribute to nursing staff leaving more than any other issue.”
Liberal Democrat health spokesman Norman Lamb, who served as a minister in the coalition government, described the passing of the motion as a “wake-up call”.
“The pay cap is hitting morale and recruitment across the health service,” he said. “We simply cannot sustain the NHS with year after year of cuts to the pay of dedicated staff, who are working flat out to keep services running.
“We already have a catastrophic shortage of nurses and other staff in the health service,” he said. “This recruitment crisis will only get worse unless the government gives NHS and social care staff the pay rise they deserve.”
The Royal College of Nursing welcomed the outcome of the debate, but said it was disappointed that the pay rise cap was still in place at present.
“The government saw the strength of opposition and backed away to avoid defeat,” said RCN chief executive and general secretary Janet Davies.
“Despite this, the pay cap sadly remains in place tonight,” she said. “The government failed to take the opportunity to scrap it explicitly.”
Ms Davies said the college would keep on fighting until there was a clear policy that the cap would be lifted. It has held what it called a “summer of protests” under its Scrap the Cap slogan, which culminated in a rally in Westminster last week.
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“Ministers must listen to tens of thousands of nurses who are campaigning on this and put in writing that the cap no longer applies to NHS staff,” she said. “Nursing staff will continue fighting until there is evidence that next year’s pay body can recommend more than a 1% rise.
“Ministers are continuing to hold pay down, leaving professionals over £3,000 a year worse off. It drives nursing staff out of the NHS and patients pay the price,” she warned.
Earlier in the day, Unison general secretary Dave Prentis said DUP support for the motion was “more evidence” that the Conservatives had lost the argument on public sector pay.
“It’s now time for the prime minister and the chancellor to deliver those proper pay rises, and not drag this out a day longer,” he said.
On Tuesday, the government announced that chancellor Philip Hammond would give his autumn budget speech on 22 November.