29 JUN 2017

Public Sector Pay and the NHS

Public sector pay increases, including for NHS staff, have been capped at 1% since 2013–14 and for two years prior to that subject to a pay freeze affecting the majority. NHS employees' pay fell by 10 per cent in real terms between 2009/10 and 2014/15 and continues to fall.

It is time in my view for pay restraint to be loosened but that cannot be done without a clear plan for how it will be funded.

In 2015–16, the Department of Health spent £48.7 billion on NHS provider staffing costs. The IFS estimates that each 1% increase in staff pay would add approximately £0.5 billion to the pay bill, just for the NHS. This means either additional funding for the service or painful reductions in other areas of the NHS or DH budget.

I agree with the pay review body that there are also costs in ignoring the need to increase pay. As the gap between NHS pay and jobs outside the public sector widens, this is hitting the recruitment and retention of key staff, especially when there is fierce international competition for skilled healthcare professionals. The fall in real incomes is also affecting morale, especially where staff are having to work under greater pressure to compensate for unfilled posts. Vacancies and staff shortages can also affect patient safety as well as lead to higher agency costs. Pay restraint is becoming a false economy.

For all these reasons I believe it is time for a rethink but it will require a clear plan from the Treasury as to how it will be paid for. Ending the pay cap won't happen through a simple amendment to the Queen's speech.

It is essential for all Political Parties to face up to the scale of the funding challenge across the NHS and social care and to work together to find a way forward. The reality is that the wider challenge in funding these vital services, in the face of an extraordinary increase in demand and costs, will be there for which ever Party is in Government after the next election. It is in everyone's interests for MPs to work constructively together across Party lines in the national interest. We have a responsibility to level with the public and with each other because the reality is that we are all going to have to pay more to put the NHS, social care and our other valued public services on a sustainable long term footing.

Much of the ground work has already been carried out and we should look again at the full range of proposals from the Barker Commission and the House of Lords inquiry into the sustainable long term funding of the NHS and social care.

24 comments

I admired your stance on public sector pay in parliament yesterday, you told us how the folks we regard as heroes could take no more. Then you voted against them. I require my MP to be driven by conscience, not by a desperate need to cling to power.
- Christopher Mockridge

Brexit u-turner mid campaign. Now this slap in the face. Find a way to fund it? It took your leader five minutes to find a billion to prop your party up. Sickening. I don't believe you understand the anger at this vote; this cheering that went on. It's a game once you get into the Common, where you can forget about the salt of the earth. Like that policeman that died right there at the mother of parliaments - laid down his life for a hardened political class.
- Rosalind Salter

In my 62 years I have never been so disgusted with a party as I currently am with the current Conservative party. To see the cheering following yesterday's vote denying essential public sector workers a raise after 7 years of falling wages sickened me. Your sheer hypocrisy, claiming on your blog and twitter feed to support a loosening of the pay cap whilst voting for the opposite shows that you have no morals or integrity and are clearly in politics for the benefit of your party, not for the good of the British people. Utterly shameful.
- Ian Scott

So, why not grow a backbone and vote with the opposition last night? Austerity is a political choice, not an economic necessity. And your leader proved it by finding £1.5 billion down the back of the sofa for her bigoted DUP friends in 5 minutes. Nurses having to use food banks, policeman & fireman driven to suicide because of the pressure cuts have put them under. You and your party should be ashamed. I really don't know how any Tory MP sleeps at night. At last, the country is awakening to Tory fraud. The quicker there is another GE, the better.
- Mark Jones

You write all that and then troop through the lobies opposing any increase.It is this sort of behaviour that gets politicians a bad name.This is why Jeremy Corbyn is different.During the last Labour government,if there was a policy he disagreed with he voted against it.I hope you were not one of the hooligans who cheered when the amendment was defeated.If the amendment had been passed It would have forced the treasury to look at ways of finding the money.I am 86 and owe my life to doctors and nurses in the NHS and it's time they were adequately rewarded.The firefighters and police who risked their own lives in recent events are praised by Mrs May,but are still seeing their wages fall behind and yet a billion pounds is found to keep your party in power by bribing a party that were hardly going to oppose the government.It stinks.
- Alan Bailey

Blah blah blah. "It is in everyone's interests for MPs to work constructively together across Party lines in the national interest." You had your chance yesterday.
- Figrat

I can only agree with other posters above. Funding public serve is is a choice. Finding the money reflects choices made elsewhere. Austerity has been, and continues to be, a brake on the growth of the economy, never mind the suffering it continues to cause. Choosing to spend a billion on shoring up the outcome of a pitifully poor performance around the general election (which cost another, what, £130 million of taxpayers' money and was entirely unnecessary?) is also a choice, isn't it. The public do not want this. Our elected representatives are presumably there to serve the wishes and needs of the public, for the good of our society. We are being very very badly let down, and this public hand-wringing while continuing to support these poor decisions is hypocritical in the extreme. Cross the floor, Sarah. Please.
- Veronica Conboy

Could you please explain to us WHY you voted to keep the cap Sara? Speaking in favour of lifting the freeze and then voting to keep it is pure hypocrisy! Especially since MP's have been given a pay increase and they are public sector workers, and they are also able to claim extortionate expenses. Its a slap in the face! I work in the NHS as a Emergency ambulance crew, many of my colleagues in London and the country don't want to be hailed as hero's, we just want a right to earn a decent wage.
- Noelle

The Barker Report is wide ranging but has a very important conclusion: "With a view to raising additional revenue, we recommend a comprehensive review of wealth taxation". If you also agree with this maybe it is time to cross the house or at least vote in line with your beliefs.
- Ken Pickering

Agree with all the other comments on here, SHAME ON YOU ALL!! Unbelievable scenes yesterday, cheering the decision! I had to explain to my 6 year old why all the people of TV were so happy ! Disgraceful behaviour!! VOTE for what you believe in and stop being a May Puppet. Oh and reply to your constituents and enjoy your pay rise!
- Jack

I wish I could say I was shocked by the two faced, cowardly and selfish approach shown by yourself and other members of your party. There is no point in anyone saying shame on you, for you all lack integrity and any moral standing. Of all the people to cower to, a leader who is scared, has sold members of her own party, who saved her skin,down the river and won't stop short of buying her way out with public money. You are a representative of the people yet all you do is take for yourselves, you are pathetic and immoral, all of you. Sadly you all think this is acceptable.
- Dave Hennig

As a new constituent I was at least reassured by your public pronouncements and apparently principled response to the Leave campaign's complex relationship with the truth. However I can only agree with the other posters here: You have really let yourself, and us the people you represent, down.
- Nick Quine

Many of us in the Southwest had high hopes following your election that at last there was a person who came from and really understood the health service, its needs, pressures, and the welfare of its staff and patients. So very disappointed that after all the rhetoric, in which you appeared to understand the impact that the pay freeze has had on morale aand recruitment, and therefore patient safety, that you voted against the words you had spoken. Thank goodness most of us in the NHS are advocates for our patients and not afraid to speak out, and refuse to simply toe the line if we feel something is wrong. Let's now look forward to spending even more money on agency and locum staff, and see services wither, such as dermatology at Taunton which another Conservative lady wrongly stated that she had saved.....
- Teresa

You are a disgusting person, a disgrace to your profession and your country.
- Birte Evenden

I have always been a fan of your political stances as you always seem To represent fairness and stand up for the principles You hold dear., however I was very disappointed to see you vote against the pay rise for Nhs staff despite your entry, statements and blogs to the contrary. This would seem hypocritical and you certainly have lost a lot of this integrity in my opinion with this vote. It is also maddening when politicians have a 10%pay increase that you can credibly take this stance.
- Ed Schwallins

I think your blog and the work you do is excellent. Unfortunately, your excellent work in the commons health committee failed to hold the sec of state for health to account for misleading the house regarding "increased spending"; by changing indexing, adding a year to the period and including monies already promised. As you point out retention is disasterous, and for nursing means 1 in 5 posts vacant, and applications to nursing dropped significantly since the bursary was removed. This means more "bank/locum" work with increased costs. The SOS for health plans to privatise the body which has saved money in providing locum/bank staff. Really? When you state "an amendment in the queens speech isn't the way to address this" you are being politic. The DUP deal cost £1.5 billion. That was also being politic. Honesty is required. The govt states the NHS is "safe in our hands". It is not. We need 8% of GDP (or more) to fund the NHS. The suggested cuts have been criticised by practically every body that has commented that it is not possible. The govt should be honest that the plan is for privatisation of the NHS. Why aren't you? It's called being politic; you know anyone stating this would not get into power. So you made a choice to be politic. That's your choice. But please accept that's what it is. The cheer when the ammendmemt failed was an insult to all of us working in the emergency services (including you of course as a Doctor), and was disgusting.. I was in Washington DC last week and saw live at Capital Hill the speeches made to fight against the repeal of Obama Care which would mean 22 million people not having access to health care in the U.S. if repealed. This govt seems to be demonstrating privatisation through stealth, as per the motion passed at the BMA ARM. I ask you to consider your role in that, as I have really admired you taking SOS to task; however it seems misleading the house is just accepted these days...
- Dr Peter Taysum MBBS MPhil MSc MA (home)

I always thought you were one of the good Tory MPs. I feel sickened to see that you voted for keeping the pay cap in Parliament. You are a wicked person.
- Dimer Caprol

And despite Labour having a clear unambiguous plan on how to fund the long over due pay rises you flatly refuse to accept it as it doesnt fit in with your ideology. Meanwhile you continue supporting a failing system that has seen unfettered growth for one part of society whilst at the same time sending public servants along to food banks, leaving in huge numbers and retiring as early as they possibly can to escape the unfair pressures that your 'Austerity ' plans have created. Even Marie Antoinette offered cake. All the Tories do is offer platitudes. Ive yet to see one cooked and served up on a plate that will fill the belly of anyone. Your blog on the public sector pay cap is apropos of nothing. Nothing by way of a solution offered except bread tomorrow, if you live that long. As usual in all areas where money has to be spent its 'Lets set up a review panel and procrastinate a little longer' But it just aint good enough, Sarah . And deep down you know it. Trouble is you are stuck in the middle of this Tory quagmire and dont really know how to extricate yourself without losing a lot of your friends and being rescued by getting to the Socialist side of the mire, where I think your heart as a doctor would love to take you. The Tory patient is terminally ill no chopping off of the parts of the poor to use as transplants can save it as the one ingredient medicine cannot provide is spirit and its long gone from the tory body.
- steve howard

It seems to me, you took the Hypoctritic oath. Shame on you.
- Derek Robinson

you, your party..sicken me..You are lacking in everything that I regard as decent.Ashamed that my beautiful home Town ever considered you as someone that could represent them.
- Virginia Keyes

There is no excuse for Theresa May and your so-called government to find a huge sum of money when it suits them to prop up an unworkable majority by stitching up a deal with a bunch of ulta-right thugs. We all know it. You know it. Droning on about how to help the NHS is a little thin in the circumstance - especially as everybody knows that the Tories want to privatise it bit by bit. Your party is morally bereft, ethically corrupt and has sacrificed what little respect it might have expected.
- Sam Richards

Well said all of the above. Take heed Dr Wollaston. Your constituents are watching & they are not happy.
- Jane Begley

Absolutely disgusting behaviour in the commons the other day. You had your chance Sarah but you blew it. You just join a long list of MP's we can't trust.
- Alex Clough

Where is the fair society Theresa May promised before the election ? 1. BBC presenters vastly overpaid (at license payer expense and we have no option but to pay it) whilst public sector workers get a pay freeze. 2. Even public sector workers are much better off than those who are unable to work and only get Employment Support Allowance which is less than £6,000/PA and has also been frozen since 2104 ? Theses people need help more and long term poor health can happen to anyone. There is a lot that could be done to help theses people such as unfreezing the benefit, bringing in a council tax exemption and more.
- Stuart

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