From the TUC

Our NHS pay system & the principles behind collective bargaining are under attack!

03 Apr 2014, By Guest

Since the Secretary of State for Health announced that NHS workers are to be subject to two more years of pay restraint, with many receiving no cost of living increase at all, apologists for the government have been going to some length to defend the measure.

The government rejected the NHS Pay Review Body’s recommendation for a consolidated 1 per cent pay rise for all staff, instead imposing a non-consolidated 1 per cent only for those at the top of their pay band. Those still working their way up the incremental pay spine will get zero. And then the same again next year.

It has been claimed that NHS staff should just get on with delivering care and stop moaning, to do anything else is labelled as selfish provider interest. NHS workers are cautioned to not even contemplate taking action to defend themselves from what is an outright attack on their pay, terms and conditions.

GMB members who work in a range of occupations in the NHS are asking how it can be justified that the government can blatantly disregard the NHS Pay Review Body’s recommendation when the MP’s own review recommended 11 per cent.

The very notion of ‘fair pay’ is what is at stake here. The current announcement by government on NHS pay will mean:

  • Almost 600,000 workers in the NHS will be denied a below inflation pay award.
  • More than a third of non-medical NHS staff will remain on less than £21,000 and the bottom two pay bands in the NHS below the Living Wage.
  • The average NHS worker will have received a real terms pay cut of around £2000 since the government came to power in 2010.

The government also aims to expand performance related pay (PRP) within the NHS, claiming that the current NHS pay system, despite being tried and tested, is archaic and unable to reward workers for their individual performance, in contrast to what it perceives as good private sector practice.

As with many people who have worked in the private sector, I have some experience of PRP. Pay systems built on time and motion can assess worker performance throughout the production line which can be measured from hour to hour – day to day. But how would PRP be applied within the NHS?

How do you assess individual performances, from the call taker who triaged the call that led to the ambulance worker who arrived at the scene of an incident and through their clinical judgement, skills and experience made decisions that kept the patient alive until they were transferred to the hospital? Or the hospital staff who as a group, collectively administered clinical care, who transferred the patient to the theatre, for example? Or the workers that transferred the patient to the after theatre care team before the porter then transported the patient to a ward and the team on the ward cared for the patient and put a recovery care plan in place so the patient returned home to make a full recovery with the support of community services?

There may be time and motion experts reading this who would rub their hands together thinking of the opportunity to break all of these into individual actions and outcomes, clear in their conviction that there isn’t a job that a person can do that can’t be measured, assessed, evaluated, otherwise quantified and accordingly remunerated.

But back to the patient who is treated in the NHS who then goes on to lead a normal life, or lives that bit longer, or recovers from a life threatening illness. The interventions at a range of stages can’t be individually and scientifically measured and rewarded through a ‘fair pay’ system through time and motion. Surely living longer, a life saved and quality of life can’t be measured by one person’s performance in the NHS that helped towards one patient’s care.

How do you quantify the midwife’s hug for a young mum suffering from post-natal depression, the friendly chats and sympathetic ear, a smile? Or the ambulance worker who calmly speaks and reassures the person trapped in a car in a life and death situation to keep hope.

Incidentally having done piece work, time and motion pits worker against worker and when one person in the production line, through no fault of their own, lets the production line down or the tools don’t work, co-workers come to blame each other rather than the system that created the conditions.

That is why progression, underpinned by knowledge, skills and experience along with professional development that often take years to achieve, means in the NHS you don’t necessarily get paid at the rate for the job from day one. That is why we have incremental progression that allows an NHS worker to arrive at the right rate for their job after acquiring the relevant skills, experience and training.

And, of course, since April last year all progression is dependent on performance appraisal. So, in fact, within the NHS there is already a hybrid performance-related pay system that is transparent and fair and similar to that used by other large complex organisations in the private sector such as HSBC, Fords and E-On. This is the system that the government wants to replace with more complex and arbitrary and, no doubt, costly forms of PRP.

If it wasn’t for union organised workplaces we would have no one striving and campaigning for ‘fair pay’. At a time when hard fought terms and conditions are being attacked, nationally agreed pay systems such as the NHS Agenda for Change (AfC), needs every union organising effort to retain it because a national system is what makes a National Health Service and will keep fair pay in the NHS.

The AfC pay system is not perfect but nevertheless it can be equal, inclusive and flexible. A pay system that doesn’t reward you for time served or units produced but for skills and experience that can be measured through incremental stages. A point that the NHS Pay Review Body understands when it makes a clear distinction between pay progression and cost of living pay rises.

Our NHS pay system is under attack, the principles behind collective bargaining are under attack in the NHS and when government announces this via the media, this has rightly infuriated NHS workers.

The statistics and evidence are well documented as to why Britain needs a pay rise. And there is a very real human cost. While the community nurse or the ambulance worker or the porter continues to worry over how their pay will last from one month to the next, we have a real problem.

The campaign for fair pay in this country isn’t going to be done and dusted in the two weeks of Fair Pay Fortnight. We may be on a collision course with the Government in the NHS but we need a concerted and measured response that substantiates our claim to fair pay on behalf of our members and the public that they serve.

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One Response to Our NHS pay system & the principles behind collective bargaining are under attack!

  1. Ray Stewart
    Apr 3rd 2014, 7:23 pm

    Morale IS at an all time low, on the back of a derisory 1% for some and nothing for others, NHS staff at every level are despondant at this governments treatment of them since 2010.
    Attacks on incremental pay progression, pay protection, parking, and a continuing pay freeze is demoralising situation.
    We need to stand and fight at every level, with local trusts, regionally and nationally. Some staff in Plymouth NHS Trust will pay an EXTRA £260 per year just to park at work!