To ask Her Majesty’s Government, further to the assumption set out in the NHS Long Term Plan Implementation Framework, published in June 2019, of a 2.1 per cent pay rise for National Health Service staff in the 2021/22 financial year, what plans they have to review their submission to the NHS Pay Review Body.
My Lords, our written evidence to the independent pay review body set out what is affordable. We have increased the size of the NHS workforce over the last decade and have committed a record-setting additional £33.9 billion by 2024-5 for the NHS to meet the rising demand for services. With strides being made in recruitment and retention, an enormous effort is under way to make the NHS a more inclusive and enjoyable place to work, with excellent well-being support for all staff.
My Lords, the Government say that they cannot afford to give nurses a decent pay rise, yet they have managed to squander billions of pounds on management consultants, fly-by-night companies and friends of Ministers. The long-term plan built in a 2.1% pay rise for NHS staff next year; it was factored into the funding settlement and enshrined in legislation. It is one thing for the PM to be filmed applauding his appreciation for NHS staff, but no amount of clapping will help pay for rising living costs. Does the Minister agree that the Government should reverse this evidence and give staff in the NHS the increase they deserve?
My Lords, I start by saying how much nursing staff and all healthcare staff are appreciated, not only by the Government but by the entire public. Of course we stand by that appreciation, and there is no way that the Government have anything less than the most enormous amount of appreciation for all those who have committed so much during Covid. On test and trace, I remind the noble Lord that that is an essential service which delivers value for money and, of course, pay increases are recurring and last for a long time. However, the evidence to the pay review body is clear: affordability is a key challenge for the whole country and we wait for the pay body to review that evidence.
My Lords, last year, at the height of the first lockdown, we on these Benches argued that all NHS and social care staff should receive a one-off payment from the Government as thanks from a grateful nation for their tireless dedication and sacrifice. Not only have they not received this but the Government are now reneging on this year’s pay rise as set out in the NHS 10-year plan. What on earth do the Government plan to do to retain and recruit staff after letting them down so badly?
My Lords, I am not sure that retention is necessarily the challenge that the noble Baroness suggests. There has in fact been a 26% increase in acceptances to nursing and midwifery courses when compared to last year, and 1,290 more applications were made in 2020 compared to 2019. The truth is that nursing is a challenging job but one that many people want to take up. There is a long queue of people who want these positions because they are rewarding in many different ways. We appreciate the contribution made by nurses and the whole healthcare sector, but there is no disguising the fact that these are attractive jobs, which many people wish to take up.
Does the Minister accept that it was not a 2.1% increase but a 2.1% addition to the bill, which included a number of emoluments that are added each year? It was not 2.1% for everybody; it was a whole package. The Government need to get their case across a bit better, particularly with what the Minister just said about recruitment. I suggest that the Government pay attention to getting their case across. As the Minister said, nursing, with its lifetime pension, is a very attractive proposition at the moment.
My Lords, the percentages are unbelievably complicated. It is difficult to stand by one single number to represent pay that goes to hundreds of thousands of different nurses under different circumstances. However, I agree completely with my noble friend. What is at stake here is not just one pay rise in one year but the entire package of circumstances in which nurses do their job. We are determined to ensure that that workplace package is as good as it can possibly be. We acknowledge that there are cultural challenges of working in the NHS, which we are fighting hard to improve. We recognise that training opportunities for nurses should be better and we are working hard to improve those. We recognise that nurses have little capacity for holidays, which is why we are recruiting a very large number of new nurses. It is the entire package that we are focused on, which is why we have put forward the affordability argument as we have.
My Lords, Ministers have time and again stated that supporting our nurses is a top priority but, as unions have pointed out, an offer that amounts to £3.50 per week looks more like a kick in the teeth than a top priority. I am sure there is one thing we can all agree on: nurses and other healthcare professionals have had to work in some of the most difficult, demanding and dangerous circumstances, and they have done so with astonishing care, compassion and commitment. The Government have got this badly wrong, and I urge them to reconsider their meagre, miserly, measly 1%.
My Lords, I reject the rhetoric of the noble Lord. We absolutely do support nurses, which is why we are focused on recruitment, training, culture and opportunities. It is not right to think that one pay rise represents the entire and sum contribution to the welfare of nurses. That is the response we get from nurses themselves, what the public understand, and what the Government’s guidelines are about.
My Lords, could you imagine any employer, other than those of the sweatshops of the Far East, seeing their workers perform heroics to save the business and, in the process, the lives of millions of their clients, only to be rewarded by having their wages actually cut? Does the Minister agree with the Health Minister Nadine Dorries, who expressed surprise at the generosity of the Government’s offer, or with the view that a good employer would first offer a substantial bonus to its staff before taking time to negotiate a fair and sensible pay award? If we can pay a bonus to local publicans for sourcing easily obtainable files, surely a bonus to those who have saved our lives should be a no-brainer for this Government.
My Lords, I agree with the noble Lord on the point about heroics—we appreciate those—but I do not agree that this represents a pay cut. On the broad thrust of the noble Lord’s point, I gently remind him that millions of people are out of work off the back of this pandemic. Lots of people have had an extremely tough time and face a period of unemployment. Nurses are well paid for the job, which is a secure job, and they have other benefits. There are many people in this country who look upon professional jobs in the NHS with some envy; we should not forget that some public sector jobs are, in fact, extremely well-paid.
The Lord Bishop of Worcester
My Lords, I appreciate the immense, unprecedented and unforeseen pressure that the Government are under as they struggle with the devastating effects of the pandemic on public finances. At the same time, as has been noted, we all want to recognise the huge debt of gratitude that we owe to nurses and other health workers. Recognising that would best be done by a pay increase. We are told that a 1% increase is all that can be afforded. Can the Minister comment on whether he thinks tackling the estimated £2 billion lost annually through inefficiencies related to unnecessary A&E attendance and GP consultations might give more wriggle room?
My Lords, I completely endorse the right reverend Prelate’s point about the heroics of—and the debt that we owe—nurses, but I just cannot agree with him that the best way of recognising the contribution of nurses is to give them a pay increase. That simply is not my experience of workplace engagement. Yes, pay rises are important and a recognition of work done, but there are other, much more important reasons why people work. They work for the status of that role, for the opportunities that it gives them in their life, for the security that it gives them and for the collaboration of working with fellow members of staff. There is a whole package of reasons why people do the work that they do. We live in extremely economically challenging times. It is right that the advice given to the pay review body looks at the entire package, not just at the pay increase.
The Minister is quite right: it is not just about the 1% rise. A newly qualified nurse will earn £21,000 in 12 months; that is their starting salary. The consultants building the track and trace system, at £7,000 an hour, earn more than that amount in under four hours. Perhaps that will help the Minister understand why so many people are outraged at the proposed 1% so-called pay rise. Will he explain to the House what values and priorities he holds that lead him to believe that the Government’s decision is an acceptable one?
My Lords, the noble Baroness makes some vivid comparisons on completely incomparable pay differentials. The values that we have are absolutely aligned with public service values. We are determined to create a workplace that is just, fair and equitable. We are committed to giving people a fair reward for the work that they do and to giving people decent job prospects within that role. Those are the values that people go to work for and are motivated by. We need to put together a package that works across the piece and is not narrowly focused on one particular material point, such as pay. I stand by what I said previously: the package of measures that was put in our evidence to the pay review body sees all those values in the round.