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