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Sara Gorton: Why a pat on the back is simply not good enough for NHS staff

Praise for NHS staff is all very well, but it means nothing if it is not matched with extra cash in the Budget and a clear signal that better pay is on the way, says Unison head of health Sara Gorton

Praise for NHS staff is all very well, but it means nothing if it is not matched with extra cash in the Budget and a clear signal that better pay is on the way, says Unison head of health Sara Gorton

A pat on the back is a lovely gesture. It confers solidarity, communicates a job well done, and signals acknowledgement and thanks. But gestures only have currency when they are genuine.

If the government continues its wholesome praise of healthcare staff and their efforts while failing to deliver tangible signs of appreciation, it will damage itself – potentially irreparably – with the NHS, its staff and those who use it.

Pay is the main way the government helps the NHS keep and motivate its workforce. There are other issues where government intervention would be helpful, such as bursaries and the right for European Union healthcare staff to stay in the UK, and there are other important ingredients in this recipe, such as workload, culture and job insecurity. But pay is an important totem.

Turning the tide

It is the key means through which the government communicates to NHS employees the ‘value’ placed on their work. We know staff feel ‘unvalued’. Last year our survey showed that the NHS was in choppy waters, with over half of health employees thinking of leaving.

Since then concerns have risen, along with the number of staff leaving professional registers, with worries about workforce stability flooding in from provider organisations, think tanks and system leaders. That there is a problem is not in dispute, and although sorting out pay may not calm the waters completely, it is universally acknowledged as a means of turning the tide.

The let-up after getting through what was presented as the short, sharp shock of austerity never happened. Staff in the public sector in general, and in the health service in particular, have seen their pay fall behind costs for six years in a row. Staff right up to band three – that’s more than 80,000 employees – now earn less than the real living wage.

More of the same

That’s 80,000 people who could easily decide that a job in one of the thousands of living wage employers offers more dignity than working for their local hospital or health centre. Cutting pay has been the biggest single contribution to NHS ‘efficiency savings’. The thanks for this? More of the same.

Despite recent promises from health secretary Jeremy Hunt that the pay cap has ‘gone’, not one health worker has seen an increase in their pay. Instead, ‘productivity’ deals are suggested. Staff can have more money, but only – the implication seems to be – if they are able to deliver on ever more ambitious targets.

Paying staff properly is popular with the public, who understandably want to see investment in the local services they rely on. A report from the Institute for Public Policy Research indicates that a pay rise at or above the cost of living could deliver significant economic benefits to the UK. It would add to tax receipts and pass on better spending power to a large number of people working in the NHS and living in communities across the UK.

Treating staff fairly

Yet the economic argument is a side effect that is probably of more interest to the Treasury than the public, who just want to see NHS staff treated fairly and services run efficiently.

Frustrated by the lack of any information about the coming pay round, Unison and the 13 other NHS unions launched a pay claim in September. That same month, more than 80% of the public polled supported an NHS pay rise that would exceed the cost of living.

NHS staff know the work they do is important. They appreciate the pats on the back they get from managers, colleagues, patients and yes, from politicians too. Yet if the fine words from ministers are not matched with extra cash in the autumn Budget when it is presented to parliament on 22 November, and a clear signal that better pay is on the way, the government may find itself given the kind of gesture that hits it right in the ballot box.


Sara Gorton

About the author

Sara Gorton is Unison head of health

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