As Small as a Nat’s Cough

When I opened my wage slip, after the much talked about and hyped NHS pay rise, I couldn’t see any increase. My pay had barely risen by a few pounds. I was not the only person to experience this, it wasn’t a payroll error, the vast majority of NHS staff were shocked by how little they received in their pay rise. Some people got as little as a 35p pay rise (1).

In June we (nurses) voted to accept a pay deal that we were told would give us a 3% pay rise (2), so why did we get such a small one, certainly not 3%?

Back in April I blogged about the pay deal (3), while it was still being offered to us, and I found it wanting. I actually found it a poor deal that took away far more than it gave (And to answer the question at the end of blog, in the end I didn’t vote for the deal because researching it showed me how bad it was), and that was when we were being told we would be getting a 3% basic pay rise. The reality turns out we only received a 1.5% pay rise in July (4), but how did this happen?

The advice the RCN issued to their members, they said nurses would receive a 3% basic pay rise for 2018-2019 (5). This briefing was were I took my information from, like many others did, but this information wasn’t correct. The actual deal stated that by the end of the next financial year (March 2019) all NHS staff will have received a 3% overall increase to their pay (6). This pay deal saw a restructuring of our Agenda for Change pay points, the yearly pay increases staff receive under the Agenda for Change deal (5), for most nurses their pay points will be cut from six to three, meaning people will reach the top pay for their pay bands quicker and then will only receive the yearly, negotiated pay deal (3). Most nurses will therefore be re-banded this year and will see their pay increase, but only when they reach their Incremental Date, the date they joined or re-joined the NHS. For most nurses their Incremental Date was not in July, mine wasn’t, and for many nurses they will not see a year’s worth of their new pay point when we hit April 2019. The government’s deal was that we would get a 1.5% basic pay rise this year and then our re-banding would see our pay increase by an average 1.5% and so by April 2019 our overall pay would have increased by 3% or so. This deal never contained the offer of a 3% basic pay rise (6). NHS Employers made this clear in a statement dated July this year (6). So why didn’t the RCN tell us this was the deal on the table when we voted on it?

In July, RCN general secretary Janet Davies wrote a letter to all RCN members (7), in it she said: “In good faith, we told all members they would receive a 3% uplift [??] this summer. I now find this is not the case for everyone. I can assure you I am demanding answers for you.” (7) The wording here is important. She wrote “a 3% uplift”, she didn’t say pay rise. Why didn’t she say “pay rise”? Did she already know that we wouldn’t be getting a 3% basic pay rise?

The RCN issued guidance to their reps (8), which was leaked in July, which stated: “The initial increase for most other staff will typically be 1.5% until they reach their normal incremental pay date.” (8) Clearly the RCN knew the vast majority won’t be receiving a 3% pay rise this July, and clearly the RCN was expecting large numbers of very unhappy members. This guidance document is very much a damage limiting exercise, fortunately it didn’t work.

NHS Employers statement contradicted Janet Davies’s letter (6). They issued a statement that stated: “The letter states that the RCN has in error told members in one of its documents that they would all receive “a 3 per cent uplift this summer.

“The framework agreement, which is the document agreed by the NHS Staff Council that the RCN consulted its members on, does not make this claim.” (6) So, according to NHS Employers, the RCN knew that we wouldn’t be getting a 3% rise well before July, so Janet Davis shock and anger are at best misplaced, and at worst dishonest.

But all this still doesn’t explain why the RCN signed up to such a poor pay deal.

The RCN commissioned the Electoral Reform Services (ERS) (9) to conduct an independent review of how the RCN handled this. This was commissioned by the RCN as they were facing an Extraordinary General Meeting (EGM) were there was a call for a no confidence vote in the whole RCN leadership and calling for the RCN council to step down (10). I wonder how much they hoped this report would be another damage limitation exercise. If they did it failed.

The ERS published an interim report in early September (9), the full report is to come out later this autumn.

The ERS interim report (9) found that the RCN lacked communications leadership, and failed to successfully communicate the Government’s offer to its membership. This is shocking. An organisation the size of the RCN (It has 435,000 members (11)) should have a well-oiled communications machine. It represents nurses, midwives and healthcare assistants, it needs to be able to communicate complicated information to its members quickly and clearly, and yet it wasn’t able to communicate to its members that this pay offer contained a 1.5% pay rise and restructuring of our Agenda for Change pay points which would give most members an average rise in overall pay, by March 2019, of 3%? Why was that so difficult?

But this wasn’t the only finding from this ERS report. They also found a lack of scrutiny of the offered deal by the RCN leadership. On the 2rd March Josie Irwin, the RCN’s lead negotiator with the Government, tried to go through the offer, line by line, with the RCN’s executive team, but there hadn’t been enough time allocated to that meeting for her to do so (9). This I find shocking, the RCN’s executive team didn’t have the intelligence to allocation the time needed to do this. They were in negotiations with the Government for the first decent pay rise NHS nurses would see in eight years, and they could not or would not be bothered to make it a top priority, with the time it needed. It was certainly a top priority to the vast majority of RCN members.

At that meeting RCN Wales director Tina Donnelly wanted to scrutinise elements of the offer but was stopped by then General Sectary Janet Davies, saying the deal was only for England and Tina Donnelly’s input was “not required” (9). It seems that Janet Davies actually stopped scrutiny of the offer, which again calls into question the letter she sent out to RCN members, and what she said in it.

The worst thing to come out of this report was a briefing from RCN lead negotiator Josie Irwin to the chair of council on 21 February, which stated: “If the unions (this means Unison and/or RCN for all practical purposes as the two biggest trade unions) are not able to go out to members with a positive recommendation to members the Treasury will… consider it too risky to proceed and the framework will be off the table.” (9)

This is just breath-taking in its spinelessness. The RCN were giving in to Government demands that they accept the deal now or they would remove it altogether. The RCN gave into the Government’s threats and bullying, and they didn’t even tell their members about the Government’s actions.

Of course the Government wanted the unions to quickly and quietly accept this deal, without any public embarrassments coming from the unions. The junior doctors’ one day strikes in 2016, over another deeply unfair pay deal, were toxic for the Government, and left they marred under negative headlines and public support for the doctors. The Government certainly didn’t want any more industrial action from the rest of the NHS. And the RCN played right into their hands and gave the Government all the good headlines they wanted, all the positive press over a 3% pay rise for nurses. And even more cynically, the Government gave us our smaller-than-a-nat’s-cough pay rise in July, when Parliament was off on its summer holiday. So Theresa May didn’t have to answer an awkward questions, in the House of Commons, about robbing nurses of any sort of a decent pay rise. Nice (!!).

Heads have rolled at RCN, over this appallingly poor behaviour, and rightly so. Janet Davies, RCN’s General Secretary, resigned in August (12). Did she jump or was she pushed? I am not sure but her behaviour was deeply unprofessional. Following a vote of no confidence in them, at the EGM on 28^th September (13), and the RCN Council have all resigned (14). I would say the Council did the “decent thing” but it took an EGM to force them to do so, and before it they produced an email, to be distributed to RCN members, claiming, “This is a potentially dangerous time for the college with [a] small group of members putting at risk what has always been a proudly non-party political organisation, acting on behalf of and representing members whatever their opinions or background.” (15) This is a breath-taking claim, when the RCN gave in to Government pressure to accept a pay deal, which they hadn’t fully scrutinised, which has actually left nurses worse off.

What about Josie Irwin, the RCN lead negotiator, who negotiated us into this mess? According to the RCN website and her twitter feed, she is still in post.

What next for the RCN? Nominations for the RCN council elections has opened (16), so we need people willing to stand. But we need new and dynamic people, not the same old people who are standing as a nice career move or people who have been hanging around the RCN for years and want the status quo to continue. We need new blood to shake up the RCN. We need an RCN that will actually fight for its members.

What I am hoping for is that RCN will take on the Government over this deeply unfair pay deal. There is already a campaign to Ditch the Deal (17) and I would really hope that the RCN will join it. I want the RCN to put pressure on the government to rip up this deal and start again. Nursing, in the UK, is in crisis, last year 33,000 nurses left the NHS (18), and there are over 35,000 empty nursing posts in the NHS, which is a little over 10% of all nursing posts (19). One of the reasons nurses are leaving the NHS the poor pay, a report to the Commons Health Select Committee found (20). The RCN should have been using this as a negotiating point, that the government needs to do a lot more to reverse the lose of nurses or else patient care will suffer, and patients denied care because there are no enough nurses to provide it makes for very poor headlines, and this government does not like bad headlines. Last week, the Salaries Review Body recommended that senior judges in England and Wales should receive a 32% pay rise (21), and one of the reasons for this huge rise is the poor recruitment to senior judge posts. How will 1.5% pay rise encourage people to stay in nursing, let alone recruit new people into the profession?

What I am I going to do? There have already been calls for us to strike over this, over the sheer contempt the Government has shown us (22). At he moment I am not sure. So firstly I am going to email my MP and call on her to support us (there’s a copy of the email below, feel free to copy and use it to email your MP), and then I am going to email my RCN rep, and the new council members and the new General Secretary, demanding that they Ditch the Deal and get us a decent pay rise. We all need to keep the heat on the RCN and on our MPs, they both rely on our support and we should make them work for it.

Theresa May, in her speech to the Tory party conference, claimed the end of austerity is in sight (23). This is not true for any of us in the NHS, and it’s her government keeping us in austerity.

Drew Payne

P.S. Find you MP’s name and contact details here

My Email

Dear _____

I am an NHS nurse and one of your constituents.

I am very concerned that again nurses have received a pay rise that sees us worse off in real terms.

This year classroom teachers received a 3% pay rise, the armed forces received a 2% pay rise (plus a one-off 0.9% payment), prison workers are receiving a 2% (plus a one-off payment of 0.75%) and junior doctors received a 2% pay rise.

Back in March we, nurses, were told we would be receiving a 3% pay rise but the reality was very different. In July we only received a 1.5% pay rise and a restructuring of Agenda for Change yearly pay increments, these were reduced from six to three, for most nurses, leaving most of us worse off in the long run.

Nursing is in crisis, last year 33,000 nurses left the NHS, and there are over 35,000 empty nursing posts in the NHS, which is a little over 10% of all nursing posts. One of the reasons nurses are leaving the NHS is over the poor pay.

We were sold this pay deal on false claims that we’d see a 3% pay rise, when the reality was much less. This less than inflation rise will see more nurses leaving the NHS, and we are the backbone of healthcare, without us so much patient would be impossible to deliver. 10% of nursing posts being unfilled is only increasing the workload of the other nurses in the NHS, and this pay deal will not encourage nurses to stay. If more nurses leave at the rate we have seen over the last five patient care will be irreparably damaged.

I am emailing you to ask for your help in supporting us nurses. Will you write to the Minister of Health, Matt Hancock, and ask him to relook at this pay deal that leaves most nurses worse off in real terms, and does nothing to encourage nurses to stay working in the NHS, were we are needed.

Yours,

(My name)

(My address)

[Always include your address when emailing/writing to your MP, to prove are a constituent]

Public sector pay rise details (24)

The 1% Problem

In one speech in Parliament, Jeremy Hunt scrapped the hated 1% cap on NHS staff’s pay rises (1), the cap that saw staff’s pay cut in reality. With one speech the seven year old pay cap was gone.

As nurses, this is what we wanted to happen, this is what we have campaigned for (2), we have even threaten industrial action for it (3), but this really a victory?

When Hunt was questioned by MPs, he wouldn’t say what pay rise NHS staff could expect, he wouldn’t say if he’d got the Treasury to fund a pay rise, but he did say that any pay rise would be linked to “productivity” (4).

Only a few months ago, Chancellor Philip Hammond was reported as saying, at a cabinet meeting, that public sector staff are overpaid, being paid 10% above their private sector equivalents (5). Now this is not true and is a distortion of the facts (6), which is unsettling enough for our Chancellor of the Exchequer to do, but it does show Philip Hammond’s attitude towards NHS staff’s pay. In his last budget he provided no increase to NHS funding (7).

A decent pay rise for nurses is urgently needed, and not just as a selfish pat on the back. The NHS is haemorrhaging nurses. There are 40,000 full-time equivalent empty nursing posts in the NHS, 1 in 9 of all nursing posts (8), Janet Davies (General Secretary of the Royal College of Nursing) directly linked these empty posts to low pay and high workloads forcing nurses to leave the NHS (9). Since the pay cap was started in 2010, nurses’ pay has fallen in real times by 14% (10), which equates to nurses being at least £3,000 worse off each year (11). Fourteen unions, including the RCN and Union, have called for NHS staff to receive a 3.9% pay rise (12), which only seems fair to me.

In his announcement, Hunt did talk about any pay rise being linked to “productivity”(4), which is unbelievably arrogant. The NHS would be in a far worse state if it wasn’t for the dedication for its staff. This year we’ve seen NHS staff, and especially nurses, going above and beyond their roles when faced with the aftermath of terrorist attacks and disasters; the Finsbury Park mosque attack (13), the Grenfell Tower fire (14), the Manchester Arena bombing (15), Royal Stoke University Hospital fire (16), and the Westminster Bridge and London Bridge attacks (17). But it isn’t just the nurses responding to national disasters, like so many other NHS staff, its the extra work that nurses provide on a day-to-day basis that is holding the NHS together. This isn’t just my opinion, Sir Robert Francis QC, the chair of the investigation into the Mid Staffordshire NHS Trust scandal, earlier this year said the NHS was only being held together by the “superhuman effects” of its staff (18).

But I think Hunt’s reference to “productivity” is something different. During his speech to the Conservative Party Conference, Hunt announced that he wants to pilot an app whereby staff can be called in to fill shifts at a short notice (19). Sound familiar? He wants to introduce an Uber like app were staff will only work when they are needed or staff will be called in to work on their days off. Is this how we want to work and is this safe for patients? I wouldn’t want to be looked after by a nurse dragged into work on their day off. But I fear accepting this app maybe a condition of receiving a pay rise next year.

There is also the question, who will fund any pay rise we’re offered next year. Neither Hunt or Philip Hammond have announced any extra funding for the NHS, and Hammond’s attitude shows he’s unlikely to do so (5). NHS Trusts cannot afford to fund any pay rise. Simon Stevens, the chief executive of NHS England, told the Commons cross-party health select committee, after Hunt announced he’d scrapped the cap, that the Government will need to increase the NHS’s funding to met any pay rise because Trusts’ funding is far too stressed to do so (20). I suspect that we will get a pay rise and then Hunt will announce that we will only receive it if there are substantial cuts to fund it. This is an approach he’s used before.

At the beginning of the year, during a speech, Hunt said he wanted to increase staff’s pay but he “couldn’t” because that would take money away from recruiting more doctors and nurses (21). In 2014 Hunt vetoed a 1% pay rise for nurses, saying that to fund it would mean losing 15,000 nurses from the NHS (22). This was an out-and-out lie. After industrial attack, Hunt backed down and we were awarded a mere 1% rise (23), and strangely enough no nurses were sacked to fund it.

(The Government found £1.5 billion to fund their deal with the DUP, to secure the DUP’s support in parliament (24). A 1% pay rise for all NHS staff would cost £500 million (25). Therefore the £1.5 billion found very quickly to fund the DUP would fund a 3% pay rise for all NHS staff. Says a lot about this Government’s priorities)

I fear that Jeremy Hunt’s announcement that the cap has been scrapped is nothing more than spin. The Government needed some good news and so Hunt’s announcement, without any funding or guarantees behind it. I fear that the wage cap has only been replaced by spin, emotional blackmail and demands for us to work even more unrealistically harder. With Hunt still in charge, I’d be very surprised to get a pay rise next year above 1%, and certainly not one without a lot of strings attached.

Drew Payne

Jeremy Hunt: The Man Who Doesn’t Understand Nursing?

“If I put money into pay, it would be hard to increase doctor and nursing numbers.” Jeremy Hunt (1).

At a conference for senior nurses, last month, Jeremy Hunt made the above statement. He said he “dearly” wants to increase nurses’ pay but he just can’t, resources are too tight. He was basically saying that we, nurses, have a choice, a decent pay rise or more nurses working on the wards, he can’t do both. This is emotional blackmail at its worst. He should be ashamed of himself for trying to guilt people into accepting his own harmful policy, and for lying.

He is lying because it is his decision what pay rise nurses receive, he is the Sectary of State for Health. I, as a Community Nurse, have NO SAY over my pay rise. Nobody came to me and said, “You can have a pay rise equal to inflation but the five empty poles in your team will go unfilled.” I was never given that chose, even when Hunt is trying to use emotional blackmail to imply it is the only choice. Even for him it is not the only choice.

NHS resources have been cut to the quick. Since 2010 NHS funding has only increased by 0.9% a year (2), well below inflation and obscenely below the increased demand on the NHS. But Hunt is the Sectary of State for Health and could be making special petitions to the Treasury for more funding, he could be lobbying the Chancellor for a realist increase in the NHS budget, Hunt is a member of the Cabinet (3). But instead he does nothing, and when faced with angry nurses looking at another real term cut in pay, says his hands are “tied”.

Hunt says he “dearly” wants to give nurses a decent pay rise, but his previous actions show the opposite. In 2014 he vetoed a 1% pay raise for nurses (4). At the time he claimed that the NHS couldn’t afford this measly pay rise, and that it would lead to the loss of 15,000 nursing posts to pay for it (5). Hunt’s argument sounds all too familiar. Yet after industrial action, Hunt did a climb down and we got that 1% rise (6). Strangely enough, the NHS didn’t sack 15,000 nurses to be able to afford it.

But why does nurses’ pay matter? Because of the high number of nurses leaving the NHS. Last year there were 23,443 empty nursing posts in the NHS, 9% of the nursing workforce (7). Last year 5% of nurses did not renew their Nursing and Midwifery Council (NMC) membership (8). All Registered Nurses have to be registered with the NMC to work as a Registered Nurse, if you do not renew your membership you no longer can work as a nurse, or you no longer want to work as a nurse. There also has been a 92% fall in EU nurses coming to work here since the Brexit Referendum (9).

With such large numbers of empty nursing posts Hunt should be doing everything he can to fill them, nurses are the glue of healthcare because without us the vast majority of patients would not receive the treatment they need. Yet Hunt seems to be doing everything to increase those empty nursing posts. Nurses’ pay has fallen in real terms by 14% since 2010 (10), while MPs’ pay has increased by 14% since 2010 (11).  This has seen a 50% increase in nurses applying for hardship grants since 2010 (12), grants to help nurses pay household bills and mortgages and for travel to work, the essential things of life. Last year alone £250,000 was paid out in hardship grants (13).

The NHS is haemorrhaging experienced and well trained nurses. At the same senior nurse conference Hunt spoke about this, but his answer left me dismayed. “We need to think about new ways into nursing,” Hunt said (1). Instead of looking at keeping nurses in nursing, his attitude seems to be “Just find me some new ones to replace them.” Why isn’t he valuing the experienced nurses he has? A newly qualified nurse couldn’t simply replace me, with the best will in the world they would not be able to do all the clinical work I can. They would need the years of training and experience that I have been fortunate to accrue. The NHS needs nurses like me, especially as we face increasing demand from increasing unwell patients. Hunt needs to ensure the NHS keeps its experienced and well trained nurses, so why isn’t he doing this?

Retention of staff is about pay and conditions, is about keeping staff working for your organisation. How does cutting staff’s pay in real terms by 14% (10) while their workload increases year on year encourage people to stay in their jobs? How can Hunt think this is a rational way to run an organisation like the NHS? He cannot reply on the false idea that nurses are “dedicated” and therefore will work for low pay. Nurses need to pay the bills as well, and are leaving the NHS in droves to find better paid work. What will Jeremy Hunt do when there aren’t enough experienced nurses left to safely deliver patient care? How is this man still Sectary of State for Health?

Someone has published on Amazon the book Everything I Know About Nursing by Jeremy Hunt (14). It consists of 100 blank pages and nothing else, and it sums up so much of what I feel about Hunt. At the coming election I can but hope that Hunt will lose his seat and the NHS will be finally free from him. Unfortunately Theresa May would probably appoint someone just as awful and arrogant as Hunt to replace him, the NHS is such a low priority to her.

Drew Payne