Tuesday 26 January 2016

An Honest Day's Pay for an Honest Day's Work?

Not many people come into nursing for the pay but we do need to survive and our pay is the reward
for our dedication and professional development. At least I still hope that it is, but the evidence is rapidity evaporating.

The government has just announced that they want nurses' pay rises to be frozen at 1% until 2020, another four years of below inflation pay rises. They also want to abolish the yearly increments that nurses receive under Agenda for Change (AfC), first introduced in 2004. These yearly increments were designed to encourage professional development, as an incentive for nurses to develop within their role, to improve their clinical skills and therefore their patient care skills.

Yet again this government is attacking nurses through our pay. This plan will mean that nurses facing 10 years of frozen pay or just 1% pay rises (Many nurses didn't even get the 1% pay rise because if you got an AfC increment last year then you didn't get the 1% rise). Nurses got a 2.25% rise in 2010 and since then it has been frozen pay or a 1% rise (though not for all).

But this is nothing new, since 2004 nurses pay has fallen in real terms. In 2004 the starting salary for a Band 5 Nurse (The grade most Staff Nurses are employed on and the starting grade for qualified nurses) was £18,698 (1). Using an inflation calculator, if that salary had increased in line with inflation it would now be £26,364 (2), but it isn't. Today that Band 5 Staff Nurse starting salary is £21,692 (1), £4,672 less than the inflation corrected salary. In the last eleven years, nurses' salary has fallen in real terms by 21.5%. MPs received an 11% pay rise last year to bring their salary in line with other professionals; I do not hear George Osborm or Jeremy Hunt calling for a 21.5% pay increase for nurses to restore the pay we have lost in real terms.

Osborn and Hunt are calling for the opposite. They are saying that any higher pay rise then 1% is unaffordable. Previously there has been a lot of talk about removing unsocial hours payments to nurses too. Many people may say it is all just Government spin, but there is some truth in their claim, a very, very uncomfortable truth. Britain spends almost the least on health out of the original 15 EU countries (3), we are 13th out of the 15 countries (4), well behind countries like Germany and France.

In 2000 we spent 6.3% of GDP on health compared to 8.5% of GDP by the other EU countries. Tony Blair committed us to increasing this amount until we were equal with the other EU countries. We managed this in 2009, under Gordon Brown, when our spending had increased to 8.8% of GDP. Since then, under George Osborn's policies, the spending gap has again increased, as we fell behind the other EU countries. We currently spend 7.3 of GDP on health (compared to 10.1% in the other EU countries) and it is set to fall to 6.6% of GDP (4). Under this Government (During both terms in office) we have seen a real cut in health funding that is starving the NHS or resources – and the Conservatives promised to “ring fence” spending on “frontline care” back in 2010, they must have a definition of “frontline care” that I have never heard of.

Osborn did find an extra £3.8 billion for the NHS in his autumn statement (5), but almost of all of this (If not the total £3.8 billion) looks as if it will be swallowed up the debts already run up by NHS trusts in the first half of this financial year by the cuts to their funding (6). The Government currently has Lord Carter heading up review to find £5 billion of cut from NHS funding (7). That will certainly crawl back the amount that Osborn found for the NHS last autumn.

But how will capping nurses' pay (Cutting it in real terms) affect the NHS? 92% of the 225 acute hospital trusts in England do not have enough nurses to meet the safe staffing levels on their wards (8). Over 9 out of 10 hospitals are short staffed, they don't have enough nurses to fill all their roles. Well staffed hospitals save people’s lives (9). A study published in the British Journal of Anaesthesia found that the third of hospitals with the lowest number of nurses per patient had death rates 7% higher than the third with the most number. The Department of Health has said that staffing levels are a priority (10) yet how is cutting nurses' pay in real terms and stopping our yearly increments dealing with this shortage?

Nurses are leaving the NHS because of the low pay and the heavy, tiring workload. They are joining Nursing Agencies were their pay is higher and they can pick when they work, or else they are leaving nursing altogether for jobs that pay more. These are experienced and skilled nurses leaving the NHS and as they leave so their skills and experience are also lost. This Government seems to be doing nothing to change situation and everything they can to increase it. Are they blind?

I was a Staff Nurse before Agenda for Change (AfC) came in and I remember how hard it was with pay. Each year our pay rise was set by the Government, if we got a pay rise at all, and they were always below inflation. One year (Under John Mayor's Government) I received a 1% pay rise that was phased in over three separate increases. My pay by 0.3% each time, I didn't notice the increase it was so small. The only way to get any decent pay rise was to go after a promotion, either be promoted to the next grade on the Unit were you worked (not always possible) or else look for a new job elsewhere. The turnover of Staff Nurses on wards was terrible, it made professional development and building up staff teams very difficulty.

Janet Davies, Chief Executive and General Secretary of the Royal College of Nurses (RCN) said it best: "We have to keep the nurses we've already got...They're leaving because they're overtired - it's a bit of a vicious circle... Nurses haven’t had a significant pay rise for a long, long time, they are struggling to make ends meet. It is about time we valued our nurses." (11)

The backbone of the NHS and its biggest resource is its staff, we are the people that keep the NHS running and provide its high quality of care, so why is this Government attacking us? Cutting staff's pay in real terms is a direct attack on us. Nurses have always been a soft target for politicians because of our deep reluctance to strike and this Government is exploiting it. This is an issue we need to strike over and make sure the public know why we are doing it. Even a simple one day strike by staff not providing emergency care will deeply embarrass this Government. The very limited one day nurses’
strike back in 2014 did this.

Whether you are a nurse or not, if you were ill in hospital would you be happy to be cared for by a tired and under paid nurse? No? Then why are we tolerating another attack on nurses by this Government?

Drew Payne

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