Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more


'We firmly believe regional pay would destabilise the entire NHS'


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.


Readers' comments (20)

  • I would be quite happy to go over to regional pay - when the politicians do the same. Medical and dental staff will not be included - this is discrimination, plain and simple. I would urge everyone to contact their MP. Equality? You must be joking!

    Unsuitable or offensive? Report this comment

  • Has Ms Farmer seen the difference in the cost of living between the North and the South? At the moment, staff in the North are being paid a lot more in relative terms than those in the South. Is that not inherently unfair?

    Unsuitable or offensive? Report this comment

  • I agree that the current proposal is an effort to cut wages and I think it should be opposed on that basis.

    However, in the longer run I think regional pay is a much fairer way to go. Nurses in, for example, the North East are not currently getting equal pay with nurses in Bristol. They receive the same wage but the buying power of the wage is much higher in one area than another.

    It is always important to remember that the pay you recive is equal to the buying power of the wage you are given. The money itself is just paper.

    Unsuitable or offensive? Report this comment

  • John Spashett,Mickey Rich, my daughter is finishing her degree in Middlesbrough next month,thankfully not in nursing. We occasionally visit her and when we do we buy her food. We may possibly be shopping in the wrong places but the price of food in her local Sainsbury's doesn't seem any cheaper than our local one in Lincoln. Petrol is a penny or so more expensive a litre up there and electricity and gas appears to cost her the same as us. The only thing that is cheaper than down South is housing. People choose to work down South in the knowledge that it's going to be expensive.It's the reason why I don't work there.Finally it will be interesting to note, if, when this exercise is finished, as it surely will be, will they then bring in regionalised pay for the Police,Fire and Army or God forbid M.P's?

    Unsuitable or offensive? Report this comment

  • Anonymous | 24-Apr-2012 6:20 pm

    I agree, regional pay should be across the board for every single job/profession that exists, if they do bring it in for nurses....and they will, because they do as they like with us and we quietly accept everything that is thrown at us.

    Interesting point that petrol is more expensive up North....

    We should look more closely at many of the government proposals and their hidden agendas of divide and rule, we seem to be falling for it

    Unsuitable or offensive? Report this comment

  • totally against the whole idea, along with London councils moving tenants out because housing benefit doesn't cover their rent, paying us lower wages up North, shipping our water down South-sounds like the plan is to create an England toally split on wealth/poverty.
    And if this goes ahead I think the government should be obliged to put itself and all its departments in the cheaper North to save taxpayers' money, after all in this electronic age there is no need for government to be based in an overpriced, overwaged capital city-Some chance of that happening.

    Unsuitable or offensive? Report this comment

  • It's time our weak and compliant unions and governing body stopped bowing down to the edicts of the Government and self-serving NHS managers who want to bankroll the country on the back of hard-working nurses.
    I don't know many colleagues who don't already work pool shifts to supplement their pay. Driving down pay will result in a huge recruitment and retention crisis in already struggling areas, leading to spiralling inequality of care. This will knock back the nursing profession and nursing care by decades.

    Unsuitable or offensive? Report this comment

  • In reply to the anonymous comment mentioning Middlesbrough.

    Although I work in the South I'm actually from Middlesbrough (and i'd love to go back to the north east). I agree that things like food are the same price but as you say, housing is cheaper. Indeed housing is massively cheaper and I think that would probably have to be the basis for regional pay.

    For the cost of my London flat I could rent two houses in Doggie (or one nice one on the Linthorpe road).

    Surely it can't be equal for a nurse on the south to have to live in much worse conditions than one in the north whilst doing the same job.

    As before, I don't believe the current reforms are being done for the right reasons nd so oppose then but I do think this needs to be looked at in the future.

    Unsuitable or offensive? Report this comment

  • Florence

    No other profession would allow this to happen. We have to be proactive and oppose this. As mentioned in an earlier comment, MP'S wouldn't stand for it. As Nurses we can be our own worst enemy at times.We have the ability to oppose this through the voices of our unions and as individual Nurses we have to start valuing ourselves more as the professionals that we are.

    Unsuitable or offensive? Report this comment

  • Splitting us already, eh. John Spashett, you do get extra pay for working in London, don't you? Every nurse in Middlesborough ( or anywhere outside of London) has a mortgage on a lovely big house with a 3 car garage and 200ft long gardens that can be paid off in 5 years as the cost of housing is soooo low and our wages are soooo high?
    If conditions in London are really that bad (it's grim down south tha knows)perhaps you should move back North and get some mushy peas in you, the Southerners have obviously turned you a bit Bertie!

    Unsuitable or offensive? Report this comment

Show 1020results per page

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.