NHS pay review body: why nurses need to see an improvement on 1% pay proposal

Final pay announcement must improve on ‘insulting’ 1% pay proposal

Now the NHS Pay Review Body report is in, the ball is firmly in the government’s court

Picture: Alamy

The dark clouds often seen at the start of a Scottish summer seem to be mirroring the sense of foreboding felt by many as we await the government’s response to the NHS Pay Review Body (RB) report.

As an experienced registered nurse and trade unionist, the irony of this pay review is not lost on me.

Where is the real recognition of the ‘heroes’ of the pandemic?

The nurses who were lauded as heroes of the pandemic response and who have been working under immense pressure are the same professionals who were told in March this year that their value equated to a proposed 1% pay increase.

The RCN is continuing to campaign for a restorative pay award; our members have said that a 12.5% increase would be more fitting. This would enable us not just to recruit but also to retain staff, ensuring we have safe staffing levels that allow for the provision of high-quality, person-centred care.

In all my years of working at the RCN, I have never witnessed such a bleak mood among our members. Colleagues who I have worked with for many years and would have described as moderate in their views are now talking about the need for confrontation, dispute and action.

‘We have seen enough to understand that ultimately pay is a political decision – but ministers still have time to show that they have listened’

Prime minister Boris Johnson, chancellor Rishi Sunak and newly appointed health and social care secretary Sajid Javid are no doubt working behind closed doors to hatch a plan for NHS pay this summer.

For months, the government trotted out the standard rhetoric that it was awaiting the independent RB report, which is now in government hands.

Nurses have seen enough to understand that ultimately pay is a political decision – but ministers still have time to show that they have listened. Nursing staff have articulated eloquently and powerfully the need for a salary that attracts people to the profession and also retains the skills and expertise of experienced professionals.

Industrial action is the ‘strongest but final card’

This discussion about what to do next can be polarising for many and, as with all that we do at the RCN, decisions sit with members.

The purpose of industrial action can often be misconstrued. When an employer refuses to negotiate and closes all discussions, members of a trade union may decide to take action to ‘force’ the employer back to the negotiating table.

The RCN itself does not strike – it is the individual members that take action, not the union. It is the members who hold the power. The RCN has a key role in negotiating and organising members, but the arguments gain weight when the members are visibly driving them.

‘Nurses have had the toughest year imaginable and digging even deeper to campaign on pay will not be easy. Indeed, our governments may be banking on that’

Industrial action does not happen overnight and is always a last resort. It is a worker’s strongest but final card to play – after every other option has been exhausted.

Nurses have had the toughest year imaginable and digging even deeper to campaign on pay will not be easy. Indeed, our governments may be banking on that.

What happens when our members reject a government pay offer

When I became chair of the RCN’s trade union committee, I committed to consulting with members on the pay deals that affect them – as such, I will be asking members for their views on whatever the government announces.

This approach was taken recently in Scotland, where members made it clear that they rejected the 4% pay offer put to them. The RCN lodged a letter of dispute with the Scottish government and NHS Scotland, which sets out the opposition to the offer, opening a way for the issues to be addressed and the dispute closed.

If the dispute is not resolved, an indicative ballot could take place – perhaps asking whether, in principle, members would take any form of industrial action, such as only working contracted hours, ensuring that breaks are taken and only carrying out nursing duties, or even – as a last resort – full strike action.

RCN will listen to members if the government fails to

It should be noted that this process is governed by the Trade Union Act and set within a framework of complex legal tests. We are obliged to look at all alternatives to resolve a dispute, including arbitration and conciliation services, before any industrial action is taken.

At every step of this long journey, governments have the ability to engage with us to resolve the dispute. RCN negotiators and representatives will make clear what you expect – and, of course, governments always have the power to put an end to the situation.

The same member-led approach taken in Scotland will be used in the other three UK nations when the government announces its decision on the pay award.

Whatever the decisions made, there must be no cost to the integrity of our profession. Patients always remain at the heart of what we do and their safety is what drives the determination to achieve real change. The RCN would therefore ensure that special arrangements enable life-preserving services to continue on any proposed days of industrial action.

Prepared to respond if members decide to take action

This is a weighty subject. It is particularly technical and there is a complex legal warren to negotiate. The decision whether or not to take industrial action is fraught with personal, professional and ethical concerns.

But the RCN has the expertise to coordinate action and, if members have the determination to stand up for the profession and their patients, and if our governments fail to listen, I fear that it’s where we could end up.

Graham Revie is chair of the RCN trade union committee