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Tough road lies ahead on nurse pay

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Battle lines have been drawn for next year’s pay review. Richard Staines looks at who wants what and why

The main healthcare unions, employers and government have now submitted their written evidence to the independent pay review body for the 2008–2009 financial year.

The government’s decision to stage last year’s pay award in England led to threats of industrial action from healthcare unions, which only fizzled out with the angry realisation that ministers would budge little further than offering an extra £38 towards NMC fees.

Unfortunately, the evidence submitted this time round points to more strife over the coming months. Like last year, the UK health departments have already indicated they intend to peg public sector pay at 2%, in a bid to hold back inflation and protect the economy. NHS Employers has also put forward the same figure.

Meanwhile unions are calling for a pay rise ‘substantially’ above inflation, as measured by the retail price index (RPI) – currently running at 4.2%.

Evidence from Unison and the RCN, submitted to the review body earlier this month, sets out in detail the financial realities facing many nurses in the NHS (NT News, 13 November, p4).

Housing, fuel and transport costs have soared over the past year, meaning the 1.9% staged pay rise awarded to nurses in England, and even the full 2.5% given to nurses in Northern Ireland, Scotland and Wales, has amounted in effect to a pay cut.

The fact the NHS also finished the year with a surplus of nearly £1bn has led unions to claim an above-inflation pay rise would be easily affordable.

Mike Jackson, Unison senior national officer for health, said: ‘In the last pay round, there was reduction in the value of [nurses’] pay. What the PRB must recognise is that staff pay must not go down for a second year.

‘The NHS is back in surplus to the tune of £940m in the last year and can well afford a fair pay award for our members.’

But worryingly for nurses, the evidence submitted this year by health departments is almost identical to what it produced last year, suggesting there will be no loosening of the public purse.

Barrie Brown, head of nursing at Unite/CPHVA, predicted that the government would attempt staging for a second year.

‘We will wait and see whether we are going to see a repeat of government interference in the recommendation next year. There is every chance that it will happen again,’ he said.

Government evidence again called for the PRB to take into account the incremental salary increases that nurses and NHS staff would receive as they progressed along Agenda for Change pay bands.

‘They have again referred to incremental progression, when last year the body rejected that they should take this into account,’ Mr Brown said. ‘It makes you wonder whether they have bothered to read the review body’s report.’

Government evidence has also claimed the end of the health service’s recruitment crisis as further justification for a 2% rise. Low vacancy rates of 0.5% in March this year – a fall of nearly 3% since March 2001 – pointed to an NHS with enough nursing staff, according to its evidence. It also denied that vacancy rates had reduced because of recruitment freezes.

But Josie Irwin, RCN head of employment relations, said: ‘Our evidence states that many trusts simply are not recording vacancies because of the financial cutbacks last year. We would expect vacancy rates to be reduced in acute settings as the focus shifts to primary care.’

She accused the government of turning a blind eye to the problems facing the NHS. ‘Our own research shows that there are huge problems with respect and feeling valued,’ she said. ‘Our research shows that if these issues are present, then pay becomes more important.’ (NT News, 30 October, p2).

The RCN has warned that unless nurses are paid properly, the government’s drive to improve standards in the NHS will be affected.

‘Our staff-side evidence shows that productivity improvements, and better care and better value, are affected by the pay award because of the impact it has on morale and motivation,’ Ms Irwin said. ‘These issues are not mutually exclusive.’

Once again, NHS staff look set to come into conflict with their paymasters, with both
sides putting forward very different expectations. Last time, nurses bit the bullet and accepted a less than perfect settlement. A repeat would not be popular outside Whitehall.

‘What we are saying is that morale has never been lower and a lot of that is down to pay,’ Ms Irwin said.

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