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NHS pay: More health unions join backlash against 1% pay rise

Medical staff attend the clap for carers at the Southend University Hospital on May 28, 2020

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The government is coming under further pressure to reconsider its planned 1% pay rise for NHS workers in England, with more unions joining the backlash.

The British Medical Association and other unions said their staff “have literally kept the country alive for the past year”.

In an open letter to the chancellor they called for a “fair pay deal”.

Health Secretary Matt Hancock earlier defended the pay increase, saying it was “what we think is affordable”.

News of the pay deal emerged earlier this week, when the Department of Health and Social Care officially recommended the 1% pay rise to the independent panel that advises the government on NHS salaries.

The panel is due to make its own pay recommendations in early May, when ministers will make their final decision.

But healthcare staff reacted with anger at the plan. The Royal College of Nursing called the rise “pitiful” and started preparing for strike action, saying that its members should get 12.5% instead.

And Unite – the third largest union in the NHS – said it was considering a strike ballot.

Now more unions have joined their calls. The BMA, the Royal College of Midwives, the Royal College of Nursing and Unison have written a joint letter to Chancellor Rishi Sunak to express their “dismay”.

“The proposal of a 1% pay offer, not announced from the despatch box but smuggled out quietly in the days afterwards, fails the test of both honesty and fails to provide staff who have been on the very frontline of the pandemic the fair pay deal they need,” the letter said.

“Our members are the doctors, nurses, midwives, porters, healthcare assistants and more, already exhausted and distressed, who are also expected to go on caring for the millions of patients on waiting lists, coping with a huge backlog of treatment as well as caring for those with Covid-19.”

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What do NHS workers in England earn?

  • The lowest minimum full-time salary – for newly-employed drivers, housekeeping assistants, nursery assistants and domestic support workers – is £18,005 per year
  • The starting salary for most newly-qualified nurses is £24,907
  • Staff in “high-cost areas”, such as London, get extra payments

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Meanwhile, NHS Providers – which represents hospitals and other NHS trusts in England – said the government had previously set out funding for a five-year period that assumed a 2.1% pay rise in 2021/22.

Saffron Cordery, the organisation’s deputy chief executive, told BBC Radio 4’s Today programme: “Given where the NHS is at, given what frontline staff have been through, it seems absolutely wrong to take from their pockets right now the pay rise that was due to them.”

Although these assumptions were published in 2019, before the pandemic, NHS Providers said the last year has “strengthened the case for a larger pay rise for NHS staff”.

Nurse Susan Graham from Kent told the BBC the proposal was a “disgrace” after NHS staff had worked “crazy hours” during the Covid crisis.

Nurse John Anderson, from East Sussex, said he had taken colleagues to intensive care after they caught coronavirus and the pay offer was a “kick in the teeth” for them and their families.

“It feels like the government are happy to have us risk our lives – or even die in this pandemic – but not pay us properly for our jobs,” he said.


But the Department of Health maintains that while it set out a legal commitment for funding the NHS, the assumption of a 2.1% pay rise was not enshrined in law, and the financial pressures from the pandemic could not have been foreseen.

The government has repeatedly insisted that a 1% increase is all it can afford at a time when public finances are already stretched.

Speaking at Friday’s Downing Street briefing, Mr Hancock said the pay award reflected the “difficult financial circumstances the country is in”.

“We’ve proposed what we think is affordable to make sure in the NHS people do get a pay rise,” he said.

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The pay award would cover nearly all hospital staff, but not GPs and dentists.

In addition, some staff whose pay band is being changed will get more than a 1% increase as a result of a previously agreed three-year pay deal.

The government said newly-qualified nurses got a 12% pay rise over the course of that three-year agreement, adding that 1% was a “real-terms increase” as the latest official inflation figure was 0.9%.

But Unite’s national officer for health said it would turn into a “pay cut in real terms” if inflation rises over this year.

The boss of the Royal College of Nursing, Dame Donna Kinnair, also said the rise showed ministers were “dangerously out of touch with nursing staff, NHS workers and the public”.

The NHS already faced a “massive deficit” of nurses with 40,000 vacancies before the pandemic and the pay decision risked making them feel as if they were not valued at a critical time, said Jane Ball, professor of nursing workforce policy at Southampton University.

Tory MP Dan Poulter, a former health minister who continues to work as a doctor in mental health, said past experience of keeping down NHS wages had proved it was “quite counter-productive economically”, pushing agency staff costs from 1.5bn to almost £5bn.

“When you squeeze permanent wages, you begin to erode morale and you push people to work as agency staff and you end up paying much more,” he told the BBC.

Meanwhile, Labour has said NHS “heroes” deserve more money and the proposed increase is “nothing short of an insult”.

Alex Norris, Labour’s shadow health minister, said he would have recommended a real-terms increase for NHS staff, but said the exact figure should be set by the independent pay review body.

He said the public had been out on their doorsteps clapping for the work of NHS staff during the pandemic, and the government should not be “clapping for them one day and cutting their pay the next”.

The NHS in Scotland, Wales and Northern Ireland is run by the devolved administrations.

The Scottish government has announced that 2021-22 pay negotiations will be delayed until the summer because of the disruption caused by Covid. Staff have been given an “interim” pay rise of 1%, which will form part of the new settlement.

NHS workers in Northern Ireland were promised a one-off £500 “special recognition” payment in January, following a similar announcement in Scotland.

The Welsh government has said it will not set a “ceiling” of 1% on NHS pay rises for 2021-22.

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