Monday:
Today the NHS has suffered the indignity of a strike by thousands of nurses and midwives protesting that their pay has been frozen for years and all they are asking for is the 1% that was recommended by the independent review body and that the Government has reneged upon.
Except that’s not really true, is it.
The Government offered 1% to everyone who wasn’t already getting an automatic pay rise.
So if you’ve not had a rise in four years, it’s not the Government blocking the 1% on offer; it’s those people who want 5% rather than “just” 4%.
Nursing is a tough job. And a necessary one. Especially as we’re all getting older and more reliant than ever on the Health Service. And this year, we’ve been personally especially grateful to some good nurses, I can tell you. So who wouldn’t want to reward them well?
But it begins to look like their representation is, well, misrepresenting them.
Quite rightly, our nurses have the sympathy and support of the public, but they risk losing that if the public – many of whom have genuinely seen 0% increases, that’s a real terms (i.e. after inflation) decrease – discover that the NHS Unions insist on using such mendacious tactics as claiming that nurses have not had a pay rise when in fact nurses’ pay comes with a built-in increase every year.
More than a million NHS staff – except for doctors, dentists and some senior managers who are on a different scheme – are paid according to a system called Agenda for Change (you can tell it came in under Tony Blair, can’t you).
Under this arrangement, you are assigned to a “Band” based on your job and seniority level: nurses and midwives, for example, start from Band 5; sisters and senior radiographers are in Band 6; and so on. You then have “points” on the payscale and in the normal course of things you would expect to go up one point each year.
Here, from the Royal College of Nursing, are the current (agreed in 2013) pay bands.
So for a nurse in Band 5, you begin at point 16, which is a salary of £21,388 on the 2013 agreed rates.
Then in your second year you advance to point 17, and receive a salary of £22,016, an automatic increase of 2.9%.
In your third year this goes up to point 18 for £22,903, a 4.0% increase and so on up to your seventh year when you reach top of your Band. In fact it’s 4% increase all the way up to the top of the scale for Band 5 when a nurse can earn £27,901.
Similarly for Bands 6 and 7, the salary increase between different points varies from point to point but on average is 3.5% per year, to a top salary of £40,558.
(Bands 1-4, incidentally, who are assistants, secretaries and porters earning between £14,094 and £22,016, have average rises of 2.5%.)
The review body’s proposals, then, were to increase all of these pay points by 1%.
So the effect for a nurse going into their second year would be an increase from £21,388 (on the 2013 rates) to £22,436 (on the new 2014 rates) which is a pay rise of 4.0%. And pay increases of 5% for nurses in their second through seventh years.
The people who wouldn’t be getting an automatic pay rise are the people at the tops of the scales… to whom the Government is offering the 1% that they say they are striking for.
(So actually, the people affected by this are new NHS staff, coming in at the old starting rate rather than the new proposed one.)
There are 380,000 nurses in the NHS in the UK, earning at least £21,388 each or a total wage bill somewhere north of eight billion quid. That 1% increase will cost the NHS, will cost you because you pay for the NHS, at least eighty million pounds.
Or, in the emotive terms that people like to pitch this debate, 4000 nurses.
Not that nurses are paid brilliantly, but the £28,180 on offer (after 1% increase) to an ordinary ward nurse at the top of the Band 5 pay scale is above the median average national wage, and quite a lot more than quite a lot of people get, particularly people on sickness benefits who get hardest hit by NHS strike action, or people on minimum wage or zero hours contracts who lose money when they have to refuse work in order to turn up on time for their NHS appointments, and only get told when they get there that they’ll have to miss more work without compensation because their appointment’s been cancelled through NHS strike action.
Everyone is fed up with austerity. Everyone is tired of tightening belts. And it’s true that to get through the worst of the recession that they inherited, the Coalition did freeze all those pay rates that were over £21,000. The rates were kept the same for the first three years: 2010/11, 2011/12 and 2012/13.
Although rates were increased for those lower paid NHS workers, on Bands 1 to 4, but not the nurses who were already better off than that. And, of course, you would still get an increase by progressing up the rates each year.
But, something I’ve just noticed from the RCN website: all pay rates were increased by 1% for last year (2012/13).
So that “not had a pay rise in four years” just cannot be true.
A nurse starting in 2010 on £21,176 would expect to be earning £24,799 in 2014, an increase of 17% or an average increase of 4% a year. Better than inflation in every year except 2010 when Alistair Darling’s devaluation and George Osborne’s VAT rise both hit.
In real terms, then, nurses are barely any better off. But try telling that to people who really haven’t had a pay rise in four years.
It’s said that the NHS is what the British have instead of religion these days. It’s an article of faith that we must preserve it, as much as it’s a standard mantra that the NHS is in crisis. Labour in particular have made a fetish of “their” NHS – “don’t let the Tories ruin it”, they cry when all other rational reasons to vote Labour fail them; any attempt to empower local people to vary provision to suit their needs is greeted with cries of “post code lottery” and results in power being snatched back to the Secretary of State; at the last gasp, any reform at all is answered with the desperate war cry of “privatisation”.
But locked-in inflation-busting salary increases are another reason, along with Labour’s privatization through the PFI door, why the “best health service in the world” is going to go bust in spite of having ring-fenced, real terms cash increases no matter what the damage that does to other spending commitments.
The NHS has been made a sacred cow by at least five major Parties (and UKIP) including, sadly, my own. And as with most cows, the debate seems to come with a quantity of bull.
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