'The NHS Pay Review Body benefits nurses'
Constrained in recent years by the governments insistence on a 1% pay cap, the review body is often criticised for being toothless. In fact, nurses would be much worse off without it, argues the RCNs lead pay negotiator Josie Irwin
Since it was established in 1983, an independent review body has been making recommendations to the government on how much the UKs nursing staff should be paid.
The original review body, covering the pay of nurses, midwives and health visitors, was set up following years of boom and bust pay cycles, with low awards periodically followed by special reviews four in the 1960s alone. These briefly improved nurses salaries only for them to drop again, with subsequent below-inflation increases.
Traditional negotiating machinery was unable to...
Constrained in recent years by the government’s insistence on a 1% pay cap, the review body is often criticised for being ‘toothless’. In fact, nurses would be much worse off without it, argues the RCN’s lead pay negotiator Josie Irwin
Since it was established in 1983, an independent review body has been making recommendations to the government on how much the UK’s nursing staff should be paid.
The original review body, covering the pay of nurses, midwives and health visitors, was set up following years of ‘boom and bust’ pay cycles, with low awards periodically followed by special reviews – four in the 1960s alone. These briefly improved nurses’ salaries only for them to drop again, with subsequent below-inflation increases.
‘Traditional negotiating machinery was unable to generate fair pay for NHS staff,’ says RCN head of employment relations Josie Irwin. ‘By its nature, the model of negotiating was about conflict rather than arbitration, resulting in industrial disharmony.
‘The review body came after the 1970s when there had been huge instability across a range of public sector groups of staff. It was seen as a stabilising influence and it has been ever since.’
In its first report in 1984, the review body stressed that it would be keeping pay under review ‘continuously from year to year’. In practice, this meant it could take into account job content and organisation, pay developments elsewhere and changing economic circumstances. To that end, the NHS Pay Review Body continues to assess evidence submitted by unions, including the RCN and Unison, the government, representatives of NHS employers and others, before making its recommendations in a detailed annual report.
‘I’ve no doubt that it adds value just by introducing that process of independent arbitration and evaluation to the world of pay for NHS staff,’ says Ms Irwin. ‘It’s much better than relying on negotiating because the government is always going to have the upper hand – they have the power in the relationship. And if you look back at its history, you can see how nursing staff have largely benefited, in terms of where pay is pitched compared to inflation. In general, they have been served well by the pay review body, better than if there had been a more traditional negotiating structure.’
During its first 4 years, the review body recommended pay increases ranging from 8-11%.
In 1988, the introduction of clinical grading heralded a major structural shake-up in nurses’ pay. It meant that many nurses received substantial pay awards, although initially around one third were dissatisfied with the outcome. The review body was involved in ‘pricing’ the structure, but was critical of some of the management involvement in the initial grading process.
Throughout the 1990s, the review body continued to make annual recommendations, with governments accepting them, although sometimes they would be phased or delayed.
In 2004, Agenda for Change, the current grading and pay system for all NHS staff, came into being. The pay award was agreed with NHS Employers, rather than the review body, as part of the package.
The process returned to normal for the 2006-07 pay round, although by this time the review body’s remit had grown to include most NHS staff. In England, a staged award followed, with 6 months between the first payment of 1.5% and a further 1%, reducing the value of the review body’s recommendation from 2.5 to 1.9%. After that, a 3-year pay deal that ran until 2010 was agreed, followed by 1% rises or a pay freeze.
When the review body was established, the then-government said it was committed to implementing its recommendations, unless there were ‘clear and compelling’ reasons to act otherwise. In 2014 the government rejected the recommended 1% increase, the first time it had done so. The government insisted that only some staff should receive an increase, as those getting incremental pay rises for experience or length of service were already getting a pay boost.
‘Some might say the review body has been toothless over the last few years because of public sector pay policy and the 1% cap,’ says Ms Irwin. ‘But I would argue that even during this period of pay restraint, its independent reports have been important, helping to head off some government ‘reforms’ that could have been dangerous. The power of these reports to influence is of real benefit.’
The review body challenged the need for local pay bargaining in 2012 and expressed the opinion that the Agenda for Change terms and conditions were not a barrier to the government’s proposals for 7-day care. Ms Irwin believes that, without this influence, it could have been the beginning of the end for unsocial hours payments.
While the government’s staging or ignoring of recommendations is undoubtedly problematic, it doesn’t diminish the review body’s overall value, argues Ms Irwin. ‘It has endured since 1983,’ she says. ‘Even when there has been a contentious decision, or its recommendations have been rejected, we’ve always been able to go back the next year and have another bash.’
Its UK-wide remit is also vital. ‘We’re living in an age of increasing fragmentation,’ says Ms Irwin. ‘But the review body is able to make comments and recommendations that apply across all four countries, taking into consideration differences in economic and workforce situations, supply and demand and so on. As a trade union representing members across the whole of the UK, that’s significant for us.’
Does the review body have a future? ‘I think it’s important that there is and continues to be a review body,’ says Ms Irwin. ‘We would miss it profoundly. Even if the government doesn’t take any account of their recommendations, we always have a campaigning device to be able to say: “The review body recommended this – and the government ignored it”.’
Nursing pay: the highs and lows
1984-87: Review body recommendations ranged from 8 –11% in increases, with some paid in full, while others were staged or delayed for a few months.
1988: An average of 15% in rises, following the introduction of clinical grading. But there were also thousands of appeals. More than 30,000 were outstanding in 1992, with some taking a decade or more to resolve.
1995-96: The review body recommended mixed national and local pay awards, prompting a vigorous RCN campaign.
1997: A return to a wholly national increase of 3.3%.
1999: Starting salaries were increased by 12%, with an overall award of 4.7%.
2004-05: The introduction of Agenda for Change, with 3.25% extra agreed by NHS Employers.
2006-07: A total of 2.5% awarded, but staged in England.
2007-08: An increase of 2.75% and the beginning of a 3-year pay deal.
2011: The first year of the pay freeze, which ran for 2 years. Those paid less than £21,000 annually received an extra minimum of £250.
2013-14: A total of 1%, following the imposition of the government’s cap.
2014-15: The government rejected the review body’s recommendation of 1% extra on all pay points. Instead it awarded 1% non-consolidated pay to those on the top point of their scale or who met their employer’s criteria. Scotland paid 1% on all points, with local agreements in Wales and Northern Ireland.
2015-16: A 1% increase for some, following a pay dispute and industrial action by several unions.
Lynne Pearce is a freelance health writer
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