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Stewart Hosie (in the Chair)
I remind hon. Members that there have been some changes to the normal practice in order to support the new hybrid arrangements. The timings of debates have been amended to allow technical arrangements to be made for the next debate. There will be suspensions between debates. I remind Members participating, physically and virtually, that they must arrive for the start of a debate in Westminster Hall and are expected to remain for the entire debate. I must remind Members participating virtually that they are visible at all times, both to one another and to us in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address. Members attending physically should clean their spaces before using them and before leaving the room. I remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall. Members attending physically who are speaking in the latter stages of the call list should use the seats in the Public Gallery initially and move on to the horseshoe when seats become available there. Members can speak from the horseshoe only where there are microphones. Sadly, because this is a very well subscribed debate, there will be a three-minute time limit for all Back-Bench speakers.
Paula Barker (Liverpool, Wavertree) (Lab)
I beg to move,
That this House has considered NHS pay.
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring this debate. I am pleased to have been allocated such a generous amount of time for the debate. That is entirely justified given the importance of the subject at hand—NHS pay.
I thank all those who have taken the time to sign the following petitions: e-petition 300073, signed by more than 170,000 people and titled “Increase pay for NHS healthcare workers and recognise their work”; e-petition 316307, titled “Award all Nursing Staff in the NHS a pay rise of 10% backdated to 1 April 2020” and signed by more than 140,000 people; and e-petition 560253, which is titled “Recognise all members of NHS nursing profession by giving them a 12.5% pay rise”, has been signed by more than 19,000 people and does not close until 7 June.
Jim Shannon (Strangford) (DUP)
I sought before the debate the hon. Lady’s permission and your permission, Mr Hosie, to intervene. The petitions before us are an indication of the numbers of people across the whole United Kingdom who feel strongly about this issue. The people emailing me are not just NHS workers. They are families; they are people who have been recipients of the goodness of NHS workers. I believe that there is a moral obligation on us—I have said this to Government as well—to deliver a satisfactory pay increase for nurses. We need to give them a rose of appreciation in the springtime, not a dandelion.
Paula Barker
I completely concur with what the hon. Gentleman has said.
The figures that I have given lay bare the strength of feeling that people in our communities have for our incredible NHS staff as a whole. People who know me and have listened to any of my previous contributions on the public sector will know that I like to set the historical context, that context being the last decade and the political decisions taken by the Conservative party in office during that time, especially on matters of public spending and public sector pay—matters that are very close to my heart. During debates such as this, the Government may like to pretend that the pre-pandemic world does not exist. According to them, decisions that they take during the current economic crisis should be taken in the context of spiralling debt and deficits, as well as the looming prospect of inflation. But we have been here before, have we not, especially given that the last economic crisis was not too long ago? The Government are starting to sound like a broken record stuck on repeat, using the same smokescreens that they used in the early part of the last decade, which laid the pretext for an outright assault on public sector pay.
Public sector workers, and not least the brave women and men who staff our national health service, have long memories. What is it that I am referring to that existed at the front and centre of the NHS worker psyche going into this pandemic? It is the fact that nurses’ pay is down £840 in real terms since 2010. Further to that, the likes of the Health Foundation have stated that at the start of the pandemic, NHS wages were £600 lower per employee in real terms than in 2011-12. It is the fact that staff morale is at rock bottom, with many leaving certain NHS professions and the Government failing most spectacularly to fill the gap in staff shortages—nearly 50,000 combined vacancies exist across doctor and nursing professions. It is the fact that workers have had to endure rising demands on their work with less reward.
That is what NHS workers, who make up 4% of our entire labour market staff, have had to suck up since 2010 in order to pay for an economic crisis—a crisis in the casino economy that they had no part in creating. According to research delivered by London Economics for NHS trade unions, pay levels at every single Agenda for Change spine point have lagged behind inflation since 2010-11, resulting in a significant decline in total pay in real terms. Most spine points have exhibited a decline in excess of 10%, and total pay on the Agenda for Change spine point with the highest incidence of staff, at the top of band five, has declined by 15%. That is three times the decline in median earnings experienced by full-time private sector employees across the UK over the same timeframe.
Let all of us here today contextualise the debate by reflecting on the picture faced by our brilliant NHS staff before and going into the pandemic. They have had their pay cut, their spending power slashed, their living standards squeezed, and their morale smashed. That is the so-called old world that the new kids on the block—the Prime Minister and the Chancellor—would rather us all forget, one built by their predecessors. However, no amount of rebranding will disguise the fact that the current Government intend to continue the same legacy of making public sector workers pick up the tab for a crisis they had no part in creating. Indeed, this time it is even worse than that. They are paying for a crisis that they have ensured we have, and will, overcome. Some thanks, I say, and shame on this Government.
In this new decade, the message being received by NHS workers from the Government is this: brace yourself for more of the same. Staff in our NHS have had to endure all of that, and then 12 months ago were asked to once again go above and beyond, to gravely enter the unknown, risking their mental and physical health. They have sacrificed their family and personal lives. Some have paid the ultimate sacrifice of their own lives in the line of service, duty and compassion.
Let us cast our minds back to how terrifying the news headlines, the newspaper stories and social media chatter were when the virus first emerged on these shores. The virus was the absolutely terrifying unknown for all our people, except for our NHS workers who were not afforded the luxury of watching this public health crisis unfold from the sidelines as passive observers; they were the frontline against the great unknown.
To this day, their unrelenting commitment to the public service still moves me, as it should all people here today in Westminster Hall. I am not one to often quote Winston Churchill, or indeed make wartime references, but never was so much owed by so many to so few. If any of this brave few were able to come up for breath for just a moment, maybe because of their shift patterns, and sit in front of a TV screen on a Thursday evening last year, they would have seen many ordinary folk applauding their efforts. They would also have witnessed the galling sight of the occupiers of No.10 and No.11 clapping for the photo op, with little intention of rewarding them for their work, their sacrifice or their trauma.
Appreciation of NHS workers is not about rhetoric, warm words and pats on the head. Let me be absolutely clear. Claps and smiles do not pay the bills. It is about deeds and actions, and when it comes to NHS pay, the only deeds and actions made by the Government have been a fresh round of insulting pay offers, or, in real terms, pay cuts.
The Prime Minister recently told the House of Commons that the Government have delivered a 12.8% increase in the starting salary of nurses. It may well be true to say that some—but not all—nurses have received a pay rise of more than 12% since 2017-18. However, that is in cash terms, not in real terms, and it does not account for the fact that inflation erodes the spending power of workers’ wages over time. It is a flattering figure in other ways: it applies only to one group of nurses rather than reflecting the experiences of all NHS workers in England, and it does not take into account the years of austerity that defined the years prior to 2017-18. The Government cannot spin an assertion that they are awarding pay rises when millions of NHS workers know the exact opposite is true.
All we ever hear from the penny-pinchers that occupy the Government Benches is that we cannot afford this or that—basically, anything of social value or any moral good. The old mantra that public sector equals bad and private sector equals good is making a return. This tired politics draws the economic orthodoxy to the conclusion that suppressing public sector pay is of economic benefit in times of crisis, rather than the opportunity to grow the economy that it represents. It is almost as if a decision has been taken according to the same logic that public wages are a drain on the public purse and therefore a resource to be tapped into in order to control public finances when it suits.
It is sound economics to deliver a just and fair pay rise for NHS staff and a decent pay rise is affordable. Currently, just over 1 million nurses, midwives, allied health professionals and NHS support staff are covered by the Agenda for Change pay framework in England. The same aforementioned research conducted by London Economics concluded that a 10% increase to the NHS England pay bill amounting to £3.4 billion would result in the net expenditure of only £0.66 billion when including factors that are offset against the original figure.
Such offsets include increased tax receipts, because public sector workers pay taxes, and increases in direct, indirect and induced tax receipts, because public sector workers spend money in their local areas that helps to grow local economies and support communities. A pro-public sector agenda is a pro-business agenda. It is a miracle that public and private sector workers exhibit similar economic behaviours—who knew?
There would also be savings in recruitment and retention, because better paid staff are happier staff. There is even an extra £130 million in savings from the lower student debt write-offs for nursing students. This is the sort of sensible, moral and longer-term economic thinking the Government are totally incapable of. Instead, we have crumbs for midwives and support staff; their dignity, livelihoods and take-home pay is unaffordable, according to this Government, but not lucrative, publicly funded contracts for the friends of Tory Ministers to deliver personal protective equipment shortages and botched public health projects to the tune of billions of pounds. Apparently, that sort of spending is every bit affordable: in fact, we are told, it should be celebrated. Not only do we have a Government guilty of cronyism, but of skewed priorities. We see that only too well today when not a single Conservative Member apart from the Minister is here for this debate.
Government policy on the NHS tells us everything that we need to know. Nurses, midwives and support staff are left neglected, their immense contributions disregarded, forgotten by a Government and party intent on reverting to type. There is no policy impact assessment, as the real burden for public sector pay restraint will once again fall on the shoulders of women who make up so much of the public sector, especially our NHS. There is no regional impact assessment on areas more reliant on public sector spending, such as my city of Liverpool—so much for the levelling-up agenda.
To round up, the public overwhelmingly support a pay rise for NHS staff because they, like me, understand and appreciate their service each and every day; in times long before covid, during it and long after. They are out on the frontline, as I speak here today, delivering vaccine shots in the arms of millions of people, as well as catching up on the huge backlog of urgent elective care procedures while the Government parade around this place telling us that the economics will not permit just recognition and reward. If any group of workers in our National Health Service collectively decide that enough is enough and they embark on a course of industrial action, they will have unwavering solidarity. I appeal to the Government to change their course, walk the walk on NHS pay and give the NHS staff the pay rise that they so deeply deserve.
Rachel Hopkins (Luton South) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Hosie. I am very pleased to have secured today’s debate alongside my hon. Friends the Members for Liverpool, Wavertree (Paula Barker) and for Birkenhead (Mick Whitley).
Workers across the public sector have faced unprecedented challenges during the pandemic, and NHS staff have been at the forefront of our response to the coronavirus, spending long hours in suffocating PPE in overwhelming environments. A nurse described to me that it felt like they were part of a horror movie. Frontline NHS staff at Luton and Dunstable hospital have told me that colleagues have broken down on many occasions, and that the past year has had a severe psychological impact on them owing to stress associated with separation from their families, sleep deprivation and heavy workloads. The whole of society is extremely thankful for their work in protecting us, looking after our loved ones and keeping the country going.
The country came together to clap for our carers, but claps do not pay the bills and NHS workers deserve to be rewarded for their dedication. The Government’s recommendation of a 1% increase for NHS staff in England is truly shameful. After a decade of austerity, TUC research shows that if the 1% increase goes through for 2021-22, nurses’ pay will be £2,500 less than in 2010 when adjusted for inflation, with an equivalent fall of £3,330 for paramedics and £850 for porters. Experienced nurses will take home only an extra £3.50 a week. Not only does the 1% pay proposal reflect the Conservative party’s complete undervaluing of NHS staff, but it even breaks their previous measly promise of a 2.1% pay increase set out in the NHS long-term plan.
The British Medical Association, the Royal College of Nursing, the Royal College of Midwives and Unison have all told the Government to reconsider the pay offer. A recent poll from Opinium found that 72% of UK adults believe the Government’s 1% pay proposal is too low.
We have heard already that there is a nursing vacancy crisis that is compromising staff safety. Although the Government state that they are recruiting more nurses, there are still more than 36,000 nursing vacancies, including 3,314 in the eastern region where my constituency is, which has barely changed over the past year. The issue is retention. How do the Government expect to retain experienced nursing staff who have suffered a sustained real-terms pay cut over the past decade? How can the Government expect people to aspire to a future career in the profession when there are reports of nurses having to access support from food banks?
A nurse at Luton and Dunstable hospital told me that they deserve proper recognition of the level of skill and responsibility needed for the roles that they do. They also said that there is no motivation, no incentive, no value or appreciation.
The latest figures from the NHS staff survey show that more than 300,000 staff worked unpaid over the past year. That is 13,000 more staff working overtime than in 2019. The Government might point to the uncertain financial situation and current low inflation for the real-terms pay cut, but that is economically illiterate. If affordability is the Government’s main contention, they should consider the knock-on benefits. The Government hope—
Stewart Hosie (in the Chair)
Order. I am afraid the three minutes are up. You can have half a sentence.
Rachel Hopkins
Apologies. We know the NHS staff will spend pay rises in their local economy, and that will help to rebuild as well.
Sarah Owen (Luton North) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for leading this important debate, and I thank the Members who co-sponsored it. I especially thank my fantastic fellow Luton MP, my hon. Friend the Member for Luton South (Rachel Hopkins). I know that her commitment to the NHS and every healthcare worker in it runs deep. Together we will keep fighting for every healthcare worker in Luton to get the recognition, pay and protections that they deserve. It should run deep for everyone, not just during the pandemic, and it should certainly last longer than the minute that the Prime Minister stands on his steps to clap for the key workers who saved his life and the lives of countless others, and who held the hands of the 126,000 loved ones lost this year.
Among those who lost their lives were healthcare workers, going into battle with covid-19 under-resourced, underfunded and overworked. After the year we have had, I cannot fathom why the Chancellor thought a pay cut was good enough for healthcare workers. It is not good enough. Frankly, it is a disgrace, and I am embarrassed at the excuses that have been given. One Conservative peer even suggested that nurses were lucky to have their jobs, which is an insult. What porters, cleaners, paramedics, nurses, carers, healthcare assistants, operating department practitioners, administration staff, midwives and doctors need and deserve is not Ministers putting their hands together, but Ministers putting their hands in their pockets and their money where their mouth is. Give our healthcare workers a pay rise!
I pay tribute to healthcare workers’ hard work, commitment and sacrifice. It has taken a toll, not only on them, but on their families. A Facebook memory flashed up for me today. It is eight years to the day since my mum, Siew Owen, retired from being a matron. That did not mean she stopped working; she went back to be a staff nurse for the last eight years of her career and only fully retired this year. She worked for a total of 47 years for the NHS after coming from Malaysia when she was just 19. She and thousands of other nurses like her come from all over the world to care for our sick and build our healthcare system. However, if she had come today, under this Government she would have faced a number of unnecessary and unjustifiable barriers, because it is not only pay that is an issue for NHS healthcare workers; there are also hidden costs.
This is the third time in probably as many weeks that I have sat opposite this Minister, and I will ask her again whether she believes that it is right to continue charging healthcare workers who have come here from overseas to use the very system they work in. Is the pause on the immigration health surcharge for NHS workers and care workers temporary, or will it continue post-pandemic? How is it right that a nurse at Luton and Dunstable University Hospital had to borrow money from other nurses to pay the IHS? I have asked the Minister this question before, and I have also put it to the Secretary of State, so I would be grateful if we could get a straight answer today for the healthcare heroes, to whom we owe a great debt. Healthcare workers prioritised our health during the pandemic; it is high time they were prioritised by this Government.
Florence Eshalomi (Vauxhall) (Lab/Co-op) [V]
It is a pleasure to serve under your chairmanship, Mr Hosie. I pay tribute to my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this crucial debate and for her tireless efforts to ensure that our key workers get the fair pay they deserve.
Yesterday, we came together to reflect on the tragic events of the past year. We remembered the family members and friends we lost. We also paid tribute to those who cared for them. My constituency is home to the renowned St Thomas’ Hospital. That is the hospital that saved the life of the Prime Minister and the lives of countless other people during this pandemic. The hospital’s staff are now working hard to deliver the vaccine, while still maintaining the hospital’s regular services to the local community and to people from right across the country. I admit that I have a personal bias for St Thomas’ Hospital, as I received excellent care from the team there throughout my two pregnancies.
This past year has undoubtedly been one of the most difficult years for our NHS workers. They are physically and mentally exhausted. I recently had the pleasure of meeting the staff team at Saint Thomas’ when I was invited to speak at the Unison branch annual general meeting. I am proud to be a Unison member, and I am proud to have such an iconic hospital in my constituency. The staff team—including the dedicated nurses, security team, porters and junior doctors—told me about all the challenges they face while working day and night during this pandemic.
During the lockdown, I participated in the weekly clap for our carers, along with my son and daughter, because I genuinely wanted to show my appreciation. But clapping does not pay the bills. I know that, in some cases, nurses have to rely on food banks as they struggle to make ends meet. Many of my constituents who have been caught up in the cladding scandal are NHS key workers. They have been working long hours and making personal sacrifices to keep us safe, but now they face extortionate costs that they cannot afford.
A 1% pay rise is not a meaningful pay rise; after inflation, it is essentially a pay cut. It sends all the wrong signals to the NHS workers who have kept our country going during this dreadful pandemic. It is an utter betrayal by this Government not to give our NHS workers a bigger pay rise. The Prime Minister spent three nights in intensive care, on a ward for patients who needed specialist attention. He said afterwards:
“I can’t thank them enough. I owe them my life.”
Jenny and Luis stood by the Prime Minister’s bedside, watching him during the night. The NHS protected him. It protected us. Now is the time when we must protect it.
Alex Sobel (Leeds North West) (Lab/Co-op)
It has been a year now since hospital beds started filling up. Since then, there have been more than 126,000 deaths: our mothers, fathers, brothers and sisters, friends, neighbours and colleagues—in the NHS, more colleagues than most. Last night, like many others, I reflected on a heartbreaking year of loss, but while last year was tragic, what happened was not unavoidable. Implementing the first lockdown just one week earlier, as advised, could have halved the early mortality rate. Our hospitals and NHS staff weathered a storm of the Government’s making.
Let us cast our minds back to March 2020. It seems implausible now that the Prime Minister was boasting about shaking hands with every person he met on a visit to a hospital with covid-19 patients. Edwina Currie compared him with Princess Diana. Others were less favourable. It has been revealed by the BBC this week that the Prime Minister said that the best thing would be to ignore the virus and that overreaction would do more harm than good.
The NHS is facing immense challenges, and overcoming them will be fundamental to its survival. There is the pandemic, of course, and the small matter of rolling out the most ambitious vaccination programme in the nation’s history. Not only is our NHS asked to bear the brunt of the pandemic; it is forced to do it with one hand tied behind its back. In February, NHS hospitals, mental health services and community providers were reporting a shortage of nearly 84,000 staff; 38,000 of those vacancies were for nurses—the enduring backbone of our national health service. A decade of underfunding, lack of accessible training and failure to prioritise healthcare workers have hit the NHS hard, but the Minister knows that—it is a situation of Government design.
The NHS is sick. It is underfunded and understaffed. Just as a sick patient is not aided by removing their medicine, the NHS will not be healed by cutting the pay of its workers. The Government’s and their spin doctors’ praise for the NHS has been almost evangelical. We have seen the Prime Minister clapping on our TV screens. We have heard Tory Ministers refer to NHS workers as heroes and angels. We saw the hyperbolic outburst reach fever pitch when the Health Secretary cried on national breakfast television. Most of the NHS workers I know have no desire for constant praise and adoration. They do not want to be called angels. They are skilled professionals who have worked and are working through a deadly pandemic. Most would be happy for their hospitals to be properly funded, for their patients to be given the best chance of survival and, finally, for a pay packet reflecting their workload. To cry hero, and then cut pay, is as manipulative and cruel as it is unsurprising, from a party that has systematically sought to undermine the health service and its workers.
The NHS has done so much more than just jobs during the pandemic. Its staff risked their lives every single day for our most vulnerable. They held the hands of those in the their final moments whose loved ones could not. They have been a bright flame of hope in a year filled with anxiety and fear. NHS workers have given us more than we can ever give back. Their compassion, bravery and will is something we may not ever be able fully to repay. The recognition of their work can be fulfilled by a decent pay rise.
Mick Whitley (Birkenhead) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Liverpool, Wavertree (Paula Barker) and for Luton South (Rachel Hopkins) for their hard work in securing the debate. I draw attention to my entry in the Register of Members’ Financial Interests.
I want to begin by paying tribute to the healthcare heroes who continue to fight on the frontline of the pandemic. In recent weeks I had the great honour of meeting local members of the Royal College of Nursing. Despite the terrible toll that the fight against the disease took on every one of them, their professionalism and commitment to their patients never faltered. While many of us eagerly await a return to normal, they will continue to grapple with the deadly after-effects of covid for years to come, as the NHS struggles to address a backlog of nearly 4 million people.
What has been their reward for their unceasing efforts and tireless self-sacrifice? It is a miserable 1% pay rise that amounts to a real-terms cut and that will barely cover regulators’ registration fees or parking charges. Over the past year, Ministers who have built careers gutting the NHS have spouted warm words for our national health service, and Tory MPs have indulged in shameless photo ops, applauding on their doorsteps, but when the time came to crunch the numbers, they refused utterly to give healthcare workers the pay rise they deserve. They should hang their heads in shame.
At the very moment when the Government should be shoring up the foundations of the NHS, they risk blowing them up entirely by driving thousands of people out of the profession with this insulting real-terms pay cut. Already, too many NHS workers are struggling to make ends meet. Some 39% of nurses have been forced to skip meals to feed their families. Those who make up the bedrock of our health service—the healthcare assistants, cleaners and porters, to name but a few—are some of the most financially precarious workers in the country, all too often surviving on poverty pay and turning to rip-off payday loans just to get by.
Meanwhile, the NHS is facing a staffing crisis that risks seriously jeopardising patient safety. There are already more than 5,000 nursing vacancies in the north-west alone, a figure that is likely to soar in just a few short years, and that is not taking into account the 30% of nurses who will be driven out of the profession by this shameful pay deal.
Our healthcare workers deserve so much better. They know it, the Opposition know it and the British public know it. What we need now is a substantial, well-earned pay rise for health workers that, at long last, recognises all they do for our country and that sets our NHS on a confident footing to face the great challenges of the difficult years ahead.
Barbara Keeley (Worsley and Eccles South) (Lab) [V]
It is a pleasure to speak in this important debate with you in the Chair, Mr Hosie, and I congratulate my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) on securing it.
We are all, rightly, incredibly grateful for the work that NHS staff have done over the last year. They have consistently gone above and beyond to cope with surges of demand in hospitals, to care for people with covid and to support family members who could not visit those patients. Now, the NHS is running the largest vaccination drive we have ever seen. As a reward for this, the Government have proposed a miserly 1% pay rise. With inflation set to rise over the next year, that will mean that NHS staff who have done so much will actually receive a real-terms pay cut. That is shameful and insulting. Ministers should have recommended a real-terms pay rise for NHS staff.
The pay proposal for NHS staff manages to be both wrong and unpopular. More than two thirds of those surveyed, including nearly 60% of Conservative voters, think that a 1% pay rise is less than our NHS staff deserve—but some NHS staff are even more underpaid. Last week, I met healthcare assistants from the north-west to listen to them talk about their roles and their pay. Band 2 healthcare assistants are among the lowest paid NHS staff. In theory, they carry out personal care tasks for patients, such as feeding, bathing and dressing. However, many healthcare assistants are in fact carrying out more wide-ranging and demanding tasks, such as casting broken bones, washing and sealing wounds, and carrying out observations or cannulations—tasks that should be carried out by a band 3 healthcare assistant, who would be paid nearly £2,000 a year more.
In one NHS trust in Greater Manchester, 98% of the healthcare assistants are employed on band 2, compared with a regional average of only 55%. That is straightforwardly keeping costs down by employing staff on one band and asking them to do the work of a higher-paid band. They are being systematically underpaid for the work they do. It is not acceptable. All NHS staff deserve to be fairly paid. When the Minister sums up, can she confirm that Ministers will ensure that all trusts have the funding they need to pay healthcare assistants fairly for the work that they are doing?
Finally, I want to come back to the 1%. For a healthcare assistant I talked to last week, who earns £9.80 an hour, the 1% increase will mean 9p an hour extra. A better pay rise is needed if we want NHS staff to stay in their vital roles in the vaccine roll-out, on covid wards and in handling the big backlog of elective surgery, screening and routine services. A better pay rise is deserved by NHS staff, who went above and beyond in the pandemic, who risked their lives and those of their families, and whom we applauded week in, week out. Clapping does not pay the bills. NHS staff are worth more than the miserly 1% on offer, and the public overwhelmingly agree.
Ms Lyn Brown (West Ham) (Lab) [V]
It is a real pleasure to see you in the Chair, Mr Hosie—and looking so well. I thank my hon. Friends the Members for Liverpool, Wavertree (Paula Barker), for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for securing this debate.
For the last year, as has been said, our NHS staff have been toiling night and day, working bravely and selflessly to protect us from this terrible virus. Even before this pandemic, NHS staff were working an extra 1.1 million hours of unpaid overtime—it is a disgrace. It is those same nurses, doctors, porters, ambulance drivers, paramedics and so many more who have kept our wonderful NHS going. Even when they were on the brink of being overwhelmed by the fifth highest covid death rate in the world, and despite the terrible trauma they have experienced, our doctors and nurses have held people’s hands as they died alone. They have watched the fear and borne the grief of 126,000 people and families, and counting.
Now our NHS staff are on the brink of being overwhelmed too—they are simply exhausted. They have done their jobs bravely night after night, day after day, and they are still doing their jobs, with barely a break, a full year on. My gratitude is beyond words. But we must recognise that NHS staff bear scars from the past year that will last. Almost 60% of nurses experienced a mental health problem during that first wave. In some trusts, the proportion of staff absences relating to mental ill health has doubled.
Our NHS bears the scars too. In January, more than 300,000 people waited more than a year for treatment in hospital, and that figure will have only grown. Our NHS will recover its full health and wellbeing when its staff can recover theirs. That requires action to guarantee decent pay, conditions and, basically, respect. After all our NHS has gone through, if we offer real-terms pay cuts, rather than what our NHS heroes deserve, our gratitude will prove hollow, superficial and meaningless, and it will damage our NHS further. How disgraceful is that? How much more will the health of communities suffer?
The people who have cared for us deserve so much more. This Government must understand the needs of the NHS, deliver for its staff and deliver now.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
In the time-honoured words, it is a pleasure to serve under your chairmanship, Mr Hosie, and to see you in rude good health. To follow that, if I can—almost everything has been said—I heartily congratulate the hon. Member for Liverpool, Wavertree (Paula Barker) for securing this debate.
Let us take this down to brass tacks. First, one of my best friends very, very nearly died of covid, and it was NHS staff who hauled him back from the edge. He is a pal of mine and, in a personal way, I am deeply grateful. All of us will have had similar experiences.
Secondly, it is a sad, true fact that another pandemic will come one day, because that is the nature of human life and the world—these viruses mutate and will come at us again. Therefore, we want to be even better prepared next time, so we have to have our NHS staff at tip-top levels of performance—they have to be absolutely ready. There is no doubt that if people do not get the pay they think they deserve, or the public, in this case, think they deserve, that demoralises NHS staff. When they are demoralised, some people will leave the profession; they will retire early and pack it in, and that is not what we want. As others have said, the general public expect better than 1%. In the Scottish Parliament, Liberal Democrat colleagues will work in a positive way with the Scottish Government to secure a better deal—pay is of course devolved north of the border.
I have one lesson, which relates to when I came to this place nearly four years ago. I said to myself then, “What was austerity all about?” I say that because, now that we have gone into the pandemic, money seems to just appear. So my final point is that the Government can give a better pay rise than 1%—it can be done. Strategically, for the health of the nation, and for the defence of the nation against a killer virus and another pandemic, that should be put in place as soon as possible.
Navendu Mishra (Stockport) (Lab) [V]
It is a pleasure to serve under your chairship, Mr Hosie.
I thank my good friend the hon. Member for Liverpool, Wavertree (Paula Barker) for securing this debate just days after the Government’s shameful decision to give our NHS heroes a paltry 1% pay rise. My hon. Friend has a long track record of championing workers’ rights during her time as a regional convenor for Unison North West, where she fought for better pay and conditions for all public sector workers.
I also pay tribute to Unison North West, which has done so much for tens of thousands of members across our region, many of whom are NHS staff. Its One Team2k campaign has highlighted the need for every worker in the NHS to be given a £2,000 pay rise and to bring the minimum pay to £10.23 per hour, taking the NHS pay float above the real living wage.
It should come as no surprise that during this debate we have heard repeated criticism of the Government’s decision to award NHS staff a 1% pay rise. After the most challenging year for the NHS since its inception, when staff have been stretched to breaking point to keep our country safe and deliver first-class care, despite a chronically underfunded health service, this is no way to reward them.
The Government should hang their heads in shame. To put all of this in context, a 1% pay rise amounts to just £223 million a year, or 2.23% of the £10 billion set aside for new nuclear warheads, and just 0.22% of the £37 billion for the failed Test and Trace programme. If we combine that with the £30 million that the Health Secretary squandered on covid contracts for his former neighbour, we will see that the decision not to give money to those who deserve it most is quite clearly an ideological one.
One of the many lessons the Government should take away from this pandemic is that their death by a thousand cuts approach to the NHS prior to this crisis left it exposed and struggling to cope. We are far from being out of the woods, and now should be the time for not only investing to deal with the current pandemic, but planning for the future. That means retaining existing NHS staff.
Given how they have been treated by this Government, is it any wonder that research by Unison has found that 52% of NHS workers are considering leaving their position within the next year, with one in 10 considering that option very seriously? That is a staggering statistic, and it is not simply because those staff feel overstretched after an incredibly difficult period; it is because 70% feel worse off than a year ago. That is simply unacceptable. They include staff at Stepping Hill Hospital in Stockport and Mr David McAllister, who runs the Unison health branch at the hospital. The Government’s policy right across the public sector should be fair pay for fair work.
It is also unacceptable that staff are being expected to do more for less. There are countless stories of healthcare assistants being employed at band 2 while being trained to do band 3 work. The situation is made even worse by the fact that band 2 staff earn less than £10 an hour, which in many parts of this country, particularly London, is a poverty wage. That is often stretched further still, as almost half of the people served by Unison revealed that they were the main breadwinner in their family. I hope that the Minister will listen and that the shameful 1% figure will be revised.
Charlotte Nichols (Warrington North) (Lab)
May I say what a pleasure it is to serve under your chairmanship, Mr Hosie? I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for raising this important debate.
I am proud to be a member of GMB and Unite, two of the trade unions in the NHS, and have had extensive consultations with constituents in the Royal College of Nursing who are rightly appalled at the 1% offer being floated.
Talk is cheap, but retaining the NHS’s status as the jewel in our national crown is not. Ten years of austerity and real-terms pay cuts for our NHS staff left our NHS on its knees when the pandemic struck. It is a credit to the incredible efforts of our NHS staff, who put their own lives on the line every single day, that we are now at a point where we can talk about what life after covid might look like.
Two nurses in Warrington gave their lives caring for others through this pandemic: Andy Collier, a nurse practitioner at Hollins Park Hospital, and Joselito Habab, a nurse at Warrington Hospital. May their memories forever be a blessing.
Beyond the ultimate sacrifice that they paid, I have spoken to dozens of NHS workers in Warrington about their own sacrifices, including an intensive therapy unit nurse who has been living in a caravan, away from her family home and children. She is terrified about bringing covid home to her family, as she sees the reality of this virus every single day at work. Other NHS workers moved into the Peace Centre to keep their families safe as they cared for the families of others. They are overworked, overwhelmed and yes, underpaid.
NHS staff are among those accessing support from Warrington food bank, and thousands are suffering the mental health effects of their experiences not only in dealing with the pandemic but in trying to make ends meet.
A real-terms NHS pay cut is not only a kick in the teeth for our NHS frontline; it is also economically illiterate. The NHS is the country’s largest employer and putting pay in the pockets of our NHS staff means more money circulating around all of our communities as we recover from this pandemic, as it will be spent in our local shops, local tradespeople, childminders and supporting local economies.
Last year’s claps will not pay this year’s bills, so the Government need to come up with a figure that not only recognises the incredible national contribution that our NHS staff have made during this pandemic, including the thousands of hours of unpaid overtime, but that begins to close the gulf between their pay and inflation over the past 10 years. Anything less is an utter betrayal.
Olivia Blake (Sheffield, Hallam) (Lab) [V]
It is a pleasure to serve under your chairship, Mr Hosie. I congratulate my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) on securing this debate and on standing up for the millions of NHS workers who have put their lives on the line during the covid crisis.
NHS workers need a pay rise not just because they have worked hard for the last year, but because they have had repeated real-terms pay cuts for the past 10 years. The pandemic has shone a light on the fact that for more than a decade, we have failed to value the work done by people in the NHS and care sectors. That has had real consequences.
We have all read the stories about empty Nightingale hospitals. Some of those hospitals were never used because we did not have the workers to staff them. It was a misunderstanding of the long-term crisis in recruitment and retention in the NHS—a crisis with no mystery, as successive pay freezes have had serious consequences on our ability to recruit to the NHS.
For example, pay rates for nurses in the UK are extremely uncompetitive internationally. As a member of the Public Accounts Committee, I have heard evidence that Australian nurses are paid double the amount paid to those in the UK and that those in the US are paid one third more. Experts have even warned of a brain drain abroad. That is disgraceful when the cost of giving our NHS workers a pay rise is so low.
Based on the Treasury’s own figures, London Economics calculated that the net cost of the RCN’s proposal of a 12.5% pay rise is only £0.82 billion. Given that £37 billion has been found to fund Test and Trace for two years, when the annual NHS wage bill has been estimated to be £34 billion, questions should rightly be asked about what can and cannot be afforded.
Instead of investing in staff, the Government’s offer of 1% is only enough to buy NHS workers an extra cup of coffee a week. That is not valuing the work they do, and it does not make up for a decade of pay stagnation. It is no wonder that there are tens of thousands of nursing and other vacancies in the NHS. Instead of investing billions into underwriting profits for private companies, Ministers should be investing in our NHS and the workers who keep it running. The pandemic has shown us what happens when we do not do that.
It is time to end pay stagnation, to back the calls from the RCN, Unison, my own union the GMB and campaigns such as “NHS workers say no to public sector pay inequality”, and to give our NHS workers the pay rise they deserve, which can be achieved with the right goals.
Kate Osborne (Jarrow) (Lab)
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Liverpool, Wavertree (Paula Barker), for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for securing this important debate.
I pay tribute to NHS staff across the Jarrow constituency for all they have done and continue to do in our fight against covid-19. I also pay tribute to all the South Tyneside District Hospital and Queen Elizabeth Hospital workers who have delivered vital care to many of my constituents throughout the pandemic.
NHS staff up and down the country have worked tirelessly in extremely challenging circumstances for the past 12 months, which makes the proposed 1% pay rise completely unacceptable. It is basically a slap in the face for more than a million hard-working NHS staff. I agree with the 14 health unions representing 1.3 million health workers who have called for a significant pay rise for NHS workers. It has been encouraging to see in my inbox messages of overwhelming public support for them. I am sure that colleagues have had the same experience.
As highlighted by my hon. Friend the Member for Sheffield, Hallam (Olivia Blake), a fair and decent pay rise is supported by recent independent analysis by London Economics. It found that the net cost of a pay rise is only around one fifth of the Government’s stated cost once factors such as the additional tax gained and the economic impact of extra consumer spending are taken into account.
There are currently an estimated 100,000 vacancies in the NHS. It is crucial that the NHS can recruit and retain existing staff to assist with the national recovery from the pandemic, because as we recover, the NHS faces new challenges such as the continued delivery of the vaccine roll-out, the potential for further waves of infection, the long-term increased demand on NHS services from long covid, as well as the clearance of the backlog of care that has built up over the last year. I hope the Minister will agree that a significant pay rise for NHS staff would make the NHS a more attractive career option, as well as help to retain those already working within it.
Many of us have applauded NHS staff from our doorsteps for keeping us safe throughout the pandemic. But sadly, clapping on our doorsteps does not put food on the table or pay the bills for those who have suffered 10 years of a real-terms pay cut under Conservative Governments. I hope the Minister will agree that a significant pay rise would finally reflect and respect the value we place in their work. Throughout the pandemic, the Government have wasted billions on failed track and trace and given hundreds of millions to their friends and donors in contracts for faulty PPE. If they can do that, there is no reason why a decent pay rise cannot be funded for people who put their lives on the line every day throughout this pandemic.
Zarah Sultana (Coventry South) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Hosie. I would like to begin by congratulating my hon. Friends the Members for Liverpool, Wavertree (Paula Barker), for Birkenhead (Mick Whitley) and for Luton South (Rachel Hopkins) on securing this debate.
An extra £16 billion for the military, £37 billion for the private Test and Trace system, and billions more in dodgy contracts handed to Tory donors. But for nurses just £3.50 a week. The Prime Minister says it is all we can afford, but the fortunes handed to arms dealers, Serco bosses and the Health and Social Care Secretary’s former neighbour and pub landlord tell us something different. When inflation is factored in, the 1% “pay rise” for NHS workers is really a pay cut—from clapping for carers to cutting their pay. Even for this Government, this is shameful.
While Tory donors have been getting rich off this pandemic, it has been NHS workers getting us through it. On the frontline, nurses, doctors, cleaners, porters and all of our healthcare workers have been truly incredible, battling the virus, working overtime, enduring stress and trauma.
Nearly 1,000 health and social care staff are estimated to have died from the virus, with workers too often not provided with the protective equipment they needed. Nearly half of intensive care staff report symptoms of post-traumatic stress disorder, severe depression or anxiety. All of this comes after a decade of NHS staff being overworked and underpaid, with nursing vacancies in the midlands alone standing at 7,500 and pay down as much as 30% for some staff. Now, according to research, two in three nurses have to work overtime to pay the bills, and reports of nurses forced to rely on food banks are far from uncommon.
Tory Ministers call them heroes. They clapped for them while cameras were watching, but now they think they can get away with a cut in their pay. They pit NHS workers against other workers, saying that if one group has had their pay frozen, it is not fair for another group to have their pay raised. They say that if private sector workers are losing their jobs, others should make sacrifices, too. It is classic divide-and-rule tactics. It is an attempt to turn working people against each other, leaving all of us worse off, while their donors and wealthy mates laugh all the way to the bank.
Here is an alternative plan: instead of spending billions more on new weapons of war or giving more fortunes to private Test and Trace consultants, we could give NHS workers the pay rise they deserve—15% to make up for a decade of lost pay. Instead of letting tax dodging run riot and corporate greed dominate, we could bring in a new windfall tax to make the likes of Amazon pay their fair share and to raise the pay of all our key workers, public and private sector alike. NHS workers are always there for us. Now it is our turn to stand with them.
Taiwo Owatemi (Coventry North West) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this important debate. As a former NHS worker and a current member of the Select Committee on Health and Social Care, it is undeniable that I feel passionately about this issue. I know that my constituents in Coventry North West share my strength of feeling towards this subject, as expressed by the hundreds of emails I have received and the thousands of rainbows still dotted in the windows of homes across Coventry.
The last year as been the toughest year in the NHS’s 72-year history. NHS workers have been pushed to the limit and stretched beyond our wildest imagination. They have worked 1 million hours of unpaid overtime and sacrificed more than should ever have been asked of them. They have done this to keep us, the public, safe. In the last year, at least 230 NHS workers have tragically paid the ultimate sacrifice and lost their lives to covid while serving others. My thoughts are with their families, their communities and the colleagues they have left behind.
After a year of intense sacrifices and unprecedented pressures, it is clear that NHS workers deserve better than the real-terms pay cut proposed. Indeed, our NHS heroes deserve a pay rise. The nation, including members of this Government, clapped on their doorsteps every Thursday to applaud the work of our NHS covid frontline workers. As has been touched on today, however, claps will not pay NHS workers’ rent or bills and cannot be exchanged for weekly food shops.
It must also be emphasised that the ramifications of this pay cut are not just confined to the household finances of our NHS workers. It will exert further pressures on our local high streets at an already precarious time for our local and regional economies. A proper pay rise for the staff of University Hospital Coventry would feed directly into the shops and businesses in my constituency. I have heard at first hand from small business owners that high streets such as Jardine Crescent, Holbrook Lane and Wolseley Avenue would warmly welcome the rise in local spending power to ameliorate the conditions of the last year.
In addition to the impact on our local high streets, I feel compelled to touch on the staff vacancies crisis that our NHS faces. It is alarming but unsurprising that the mental and physical toll of being overworked and underpaid is driving too many NHS workers out of the profession. The extent of this crisis is vast, with an estimated 100,000 staff vacancies, and it is clear that we must act quickly to retain current NHS workers and recruit many more to reduce the significant over-reliance on expensive bank and agency workers. No clearer message can be sent to current and prospective NHS workers about their value than fair remuneration.
Finally, I want to highlight the inequalities that this pay cut will exacerbate. The effect of the pay cut will be heavily skewed against women. Some 76% of workers—nearly 1 million NHS staff—affected by this Government pay cut are women. Surely this is not the message we want to send about the worth that our society places on the work of women. A pay rise will not begin to cover the personal sacrifices made by NHS workers while caring for strangers at a time of need. It is incumbent on the Government to ensure that NHS key workers are paid fairly.
David Linden (Glasgow East) (SNP)
It is always a pleasure to serve under your chairmanship, Mr Hosie. I, too, pay tribute to the hon. Member for Liverpool, Wavertree (Paula Barker), who secured and opened this debate so eloquently.
As we know and has been said before, this week marks the first anniversary of the beginning of lockdown. This anniversary gives us all the chance to reflect on the past year and the tragedy and hardship that we have all experienced. We have had an opportunity to remember all those who have lost their lives due to the virus and to recognise the grief of their families and friends.
This year has thrown up unprecedented challenges to us all, with people across these islands facing financial hardship, mental health struggles and tragic loss. However, it has been the NHS staff who have seen the very worst of the pandemic. I pay tribute to the hard work and sheer dedication of NHS staff across Scotland and, indeed, the rest of the UK who have worked tirelessly during the pandemic. They include the nurses at Glasgow Royal Infirmary, the doctors at the Queen Elizabeth University Hospital, the caterers at the New Victoria Hospital, the auxiliaries at Stobhill Hospital, and the cleaners at Lightburn Hospital. Every single one of them has put in a shift and deserves our thanks and recognition.
I also thank all those working in vaccination centres across Scotland, including the armed forces, who have been utterly invaluable. The vaccination numbers have been truly astonishing, with 2,214,672 first doses administered in Scotland as of yesterday. I particularly want to thank the staff working in the six vaccination centres across Glasgow, including in my own constituency at Easterhouse. After a difficult year, we can see light at the end of this tunnel. It is clear today that we are all thankful for the work of NHS staff during this crisis, but, as many Members have said, warm words alone are not enough.
I have sat here today and listened to Members from different parts of the room—I would not say all parts of the House, given that there is only one Conservative Member here—the Minister—and I remain to be convinced about how much attention she has paid to the debate. All Members have lavished praise on the NHS and its staff. The Prime Minister stood outside 10 Downing Street and clapped for the NHS, but, as has also been said, nurses and doctors cannot be paid in rounds of applause. The NHS has faced a once-in-a-lifetime event. Its staff have risked their lives facing a previously unknown disease and now the UK Government’s proposed financial recognition falls way short of what is acceptable.
We know that this UK Government have been incompetent throughout the pandemic—not delivering on vital PPE, handing out contracts to friends and Tory donors, producing a test-and-trace system that has proven ineffective, locking down too late and endangering too many people’s lives. Now, with the vaccination programme in full swing and the UK Government publishing their road map out of lockdown, it seems that they have all forgotten about the NHS staff who work every day to save lives.
We in the SNP are proud of our record on NHS pay. Staff receive the most favourable pay settlement anywhere in the UK. Moreover, Scottish nurses are the best paid in the UK. To give an example, the salary of a band 5 nurse at the top of their pay scale is currently 3.38% higher than the English equivalent, and social care staff in Scotland are already paid better than those in England and Wales, but we have not stopped there. In Scotland, the SNP Government have delivered a £500 bonus—a thank-you payment—to NHS staff after an unprecedented year treating and responding to covid-19.
The £500 payment is for Scotland’s NHS and social care workers employed during the pandemic. It includes staff who have had to shield or have since retired and includes final-year nursing students who have worked on temporary contracts during the pandemic. The Scottish Government have repeatedly called on the British Government to allow the payment to be exempt from income tax. Sadly, the ability to exempt the bonus in this way is not within the current gift or the current powers of the Scottish Government.
We in the SNP just want a simple payment of £500 to go to all NHS staff in Scotland, to reward them for their unprecedented work during the pandemic. The best and most straightforward way of doing that is by exempting the payments from income tax and national insurance. I again call on the UK Government to step up and ensure that that £500 is exempt from income tax and national insurance. The UK Government have to put their money where their mouth is and truly recognise the sacrifice of our NHS staff, not just with claps, but with cash.
Justin Madders (Ellesmere Port and Neston) (Lab)
It is a pleasure to see you in the Chair, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this important and heavily subscribed debate today. She gave an excellent, impassioned introduction. She summed the issue up very well when she said that NHS staff are being asked to do more for less. That really does sum up the Government’s approach to a lot of things: more for less.
I thank all other hon. Members for their contributions today. There are too many to mention individually, but I will pick out one or two during my speech. I particularly thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring the debate.
Every Member spoke with great passion, sincerity and knowledge about why the Government’s approach to the NHS pay deal is flawed. It is disrespectful and ultimately self-defeating. Members who spoke showed clear support for and appreciation of the NHS workforce. Every single Member had that in common. They also have in common that they are all from Opposition parties. Not one Back-Bench Tory MP has come today to defend their party’s policy—not one. Worse still, not one has come to defend the NHS workforce. That says it all, doesn’t it?
I am sure we all agree, certainly among Opposition Members, that our amazing NHS staff have been the ones who have kept this country going during the pandemic, who have kept us safe and who have looked after our loved ones. They have been on the frontline looking after not just the 450,000-plus people who have been hospitalised with coronavirus, but everyone else who has needed medical attention, while at the same time putting their own lives on the line. Our NHS staff are feeling the strain. Do not forget that we entered the pandemic with a record 100,000 vacancies in the NHS, and with a health workforce smaller than many other countries, meaning that our NHS staff have worked longer and harder than others during the covid crisis.
For many people, the added pressure has had a profound impact on their psychological wellbeing. Almost half of NHS staff in England have reported feeling unwell from work-related stress—the highest rate recorded in the past five years—and NHS staff took 3.5 million sick days off between March and October last year due to mental health issues. The latest figures from the NHS staff survey, published this month, show that 300,000 staff have worked unpaid hours, and that almost 13,000 more staff reported working unpaid overtime compared with 2019, suggesting that over 1 million hours of unpaid overtime have been worked during this pandemic. It is little wonder that NHS staff are exhausted and that they are leaving.
My hon. Friend the Member for Liverpool, Wavertree made a strong case that pay increases can have a positive effect on retention levels, which is something that urgently needs addressing. The Minister will know all about the shocking number of healthcare staff who have left their NHS roles for better pay conditions and work-life balance in recent years, because she has seen the data—it is the Government’s own data that say this. She will be well aware that over the last year, 31,000 nurses and health visitors left the NHS—an increase of 50% since 2010-11.
Justin Madders
I am sorry, but I will not have time to take any interventions.
The Minister will know that since 2010-11, there has been a 181% increase in nurses and health visitors resigning due to their work-life balance, and an 82% increase in the number leaving for health reasons. She will be aware that there has been a 57% increase in resignations since that time because people found a better reward package elsewhere.
Years of pay freezes, record vacancies and relentless pressure have had a devastating effect on our NHS workforce. Not surprisingly, as a last resort, hard-pressed staff are voting with their feet. That should ring alarm bells loud and clear that Ministers are not getting things right, that they need to change course and that they need to start listening to the NHS workforce. It is simply unacceptable that instead of giving our NHS staff the pay rise that they were promised, the Government are recommending that they should receive just 1% this year, an amount that the Government are fully aware is actually a real-terms pay cut. NHS staff are not being properly rewarded, as the Secretary of State said they would be. That is not what is set out in the legislation passed by this House, which the Government voted for in the NHS long-term plan.
As the Minister knows, the plan set out a 2.1% pay increase for all NHS staff. The head of NHS England, Sir Simon Stevens, has confirmed that the NHS did indeed budget for that 2.1% pay rise, so the Government have broken their promise. The Office for Budget Responsibility forecasts that inflation will rise by 1.5% this year, so instead of a pay rise that was budgeted for and indeed voted for, NHS staff will see a real-term pay cut of hundreds of pounds. Experienced nurses will see a paltry £3.50 per week extra in their pay packet, which is just 50p a day. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) told of a healthcare worker who will get 9p an hour extra.
Counting for inflation since the Conservative party took power in 2010, some NHS workers have seen their pay slashed by thousands of pounds a year. The starting salary for nurses, physiotherapists, radiographers and numerous other NHS roles has seen a real-terms pay cut of £841 per year, and average salaries have reduced in real terms by around £2,379. That is not being properly rewarded; it is not being rewarded at all. It is not good enough for those who have performed heroically over the last year to be rewarded in this way. For many, a real-terms pay cut will be the last straw. My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) made the point that we are in an international market for healthcare staff and cannot afford to be complacent in such matters.
It could not be clearer that we need investment in our workforce. Waiting lists have spiralled out of control, and we will need the staff more than ever. The Government urgently need to reconsider their approach; otherwise, the exodus that we are seeing at the moment will become a flood. Hon. Members, the public, UNISON, other unions, the NHS Confederation and other bodies are all urging the Government to reconsider their 1% pay rise proposal, so what is stopping them? It cannot be a lack of money, because, as we have heard, £37 billion can be found for Test and Trace, millions can be spent on unusable PPE, and we have had £2.6 million for the Prime Minister’s new media centre. It is a political choice, and it is a choice that cannot be defended. Indeed, as we see today, it seems that no Conservative Back Benchers want to defend it.
I am sure that the Minister is well aware of the anger the proposals have generated, but let me read out a few quotes from bodies representing the workforce so that she can see the strength of feeling. The British Medical Association said it is a
“total dereliction of the Government’s moral duty”
and a kick in the teeth. The Royal College of Nursing said:
“This is pitiful and bitterly disappointing”
and “dangerously out of touch”. Unison said it is the “worst kind of insult” and “some kind of joke.” The TUC said it is
“a hammer blow to staff morale”
and Unite described it as “unyielding contempt”. So I do not think there is any mistaking how NHS workers feel.
That mood is matched by the public, who overwhelmingly oppose the Government’s position. A poll showed that 83% of the public and 78% of Conservative voters think the Government should increase their pay offer. For a Government who routinely pit people against one another when it comes to pay, that must surely tell them they are on the wrong side of the argument. If it does not, they must surely know they should think again when the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), calls their offer a “miscalculation”. As understatements go, that is right up there. We do not know whether that view is widespread on the Tory Benches, because no Conservative Member is here to tell us what their view is. I am not surprised that the Prime Minister wants to avoid putting the proposals to a vote, because how could any Conservative Member look their constituents who work for the NHS in the eye if they vote for that? I do not know.
It should not have come to this. The Government really need to think again. The whole country is watching and waiting for them to do the right thing. It is not enough to say, “Wait for the pay review body” without giving a guarantee that, should the pay review body recommend a real-terms pay rise, that will be honoured by the Government. If the Minister confirms at least that today, that would be a start.
After the last year, we should not have to fight a battle to ask the Government to consider more than a 1% pay rise. It says everything about how little value those efforts over the last year have been appreciated. Our NHS staff deserve more than that. They deserve an agreed fair and sustainable pay settlement. Ministers should admit their mistakes and undertake to agree a multi-year pay deal with NHS staff. In starting talks, they should take the pay cut off the table and not set a ceiling. Time and again, the Prime Minister said that the NHS would not pay the price for the pandemic. The Chancellor promised that the NHS would get whatever it needed. It is time to put those words into action. It is time to ditch the empty promises and gestures. It is time to do the right thing.
We stayed at home to protect the NHS. We clapped for our carers during the pandemic, and we on the Opposition side meant it. As my hon. Friend the Member for Liverpool, Wavertree said, claps and smiles do not pay the bills. That is why the Opposition will not rest until our brave NHS staff get fair pay and the long-term settlement that they truly and honestly deserve.
The Minister for Care (Helen Whately)
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank the hon. Member for Liverpool, Wavertree (Paula Barker) for securing the debate on this important issue and giving me the opportunity to talk about our NHS staff. I come from a family of doctors and nurses, and before I became an MP I spent years working in hospitals and other NHS organisations, particularly to make the NHS a better place to work, because NHS staff are our health system’s greatest asset. In normal times, they go the extra mile, but in the pandemic they have done so time and again.
I welcome many of the points made by hon. Members this morning. Many have talked about the huge sacrifices that staff have made during the pandemic—not only them, but their families. Some, for instance, moved out of their family home to ensure they did not bring coronavirus home with them.
Colleagues have talked about not only nurses but other members of the healthcare workforce, including healthcare assistants, who are often overlooked in these conversations but are a vital part of our health service.
Some Members have talked about vacancies in the NHS workforce, of which I am well aware, and I will provide some reassurance on that in my remarks. Hon. Members have talked about PPE, but I do not see it as a choice between paying the NHS workforce and providing PPE—we must do both. PPE is not a choice; it is essential to protect those working in the NHS, and to me, it is non-negotiable. The shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), spoke about the need to invest in our workforce. I wholeheartedly agree with that, and the Government are doing so.
As I said, NHS staff are the NHS’s greatest asset. In fact, the NHS is, in essence, its people. The Government are determined to ensure that the NHS can retain and recruit the staff it needs. Over the last few years, the have worked with trade unions to deliver multi-year pay and contract-reform deals for more than a million of our NHS staff. Over the last three years, nurses specifically have seen their starting salaries increase by more than 12%. We have increased the lowest starting salary in the NHS by more than 60%.
We all know that our NHS staff work around the clock to provide care. That is why, on top of the basic salary, NHS staff earn premium rates of pay for working at night and over the weekend, and for agreed overtime. That increases individual pay by around £4,000 on average. On top of that, the NHS reward rightly includes benefits that go beyond the statutory minimum on holidays, sick pay and pensions.
We have also invested in our junior doctors, recognising the huge contribution that they make to the NHS. The deal that we have agreed with the British Medical Association improves junior doctors’ working lives, protecting rest requirements and reducing the number of consecutive shifts worked. By the end of that deal, junior doctor pay scales will have increased by at least 8.2%, and around one in eight junior doctors will receive more as they reach a new higher pay point to reflect their level of responsibility. For our nurses and non-medical staff, this is the final year of the multi-year “Agenda for Change” deal. We have asked the independent pay review bodies to make recommendations on the pay of our NHS staff for 2021-22.
As the Government have set out, the coronavirus pandemic has placed a huge strain on public finances, and the economic outlook remains uncertain. The Government’s written evidence to the independent pay review bodies set out that, in settling the Department of Health and Social Care and NHS budgets, the Government anticipated a headline pay award of 1% for NHS staff. That compares with the pay freeze for the wider public sector and, as we all know, with the context of many people facing unemployment and pay cuts in many parts of our economy.
David Linden
The Minister is setting out the bleak fiscal picture for the Government and the tough financial choices that have to be made. Will she explain, then, why they have seen fit to invest in more nuclear warheads but not in pay for NHS staff?
Helen Whately
The hon. Gentleman will recognise that although the Government have to make some difficult decisions, various things are non-negotiable. One of those things is ensuring that the NHS is there for all our constituents who need it, and another thing is ensuring that we have the defence that we need to protect people from threats from overseas.
Let me return to the matter in hand and set out a bit more about the process that we are going through on NHS pay. As I mentioned, the evidence that we recently submitted to the NHS pay review covered a wide range of data that was relevant to the decisions that that pay review body will make. The pay review bodies themselves are independent advisory bodies made up of industry experts. Their recommendations are based on a comprehensive assessment of evidence from a range of stakeholders, including trade unions. The wide range of factors that they will consider includes the cost of living, recruitment and retention in the NHS, affordability and value for money for the taxpayer, and comparisons with wider public and private sector earnings.
As the pay review bodies are independent, I cannot, and would not wish to, pre-empt their recommendations. We have asked the NHS pay review body, and the review body for doctors and dentists, to report later in the spring, and we will carefully consider their recommendations when we receive them.
Justin Madders
The Minister is setting out the pay review process, but it is also the case that she voted for a 2.1% pay increase only last year. Why has that changed?
Helen Whately
I am very glad that the hon. Gentleman has brought this point up. There have been no changes to the 2.1%. I specifically looked into that, and we are absolutely consistent—the 2.1% in the long-term plan will be invested in the workforce as planned. That 2.1% includes the funding not only for the pay agreements that we will reach through this process, but for existing pay deals and further workforce development, so we will be standing by that 2.1%.
As would be expected, I have had many conversations with NHS staff, from porters to healthcare assistants, nurses, allied healthcare professionals, junior doctors and consultants, both during the pandemic and for many years before. I have asked many times what would help; what do staff most want? Pay is rarely mentioned in those conversations—[Interruption.] The hon. Member for Warrington North (Charlotte Nichols) may laugh, but I am describing the many conversations I have had over many years with NHS staff, including during the pandemic. What is most often mentioned to me is that staff want more colleagues. They want more staff working alongside them so that they can have more time to give patients the care that they want to provide.
Helen Whately
I will make some progress, as time is limited. Staff have told me many times that they want to feel genuinely supported and valued in their work. Someone said that one of the upsides of the pandemic is that when a colleague asks them how they are, they feel that the question is actually a meaningful one at the moment. If they say, “No, I’m not okay”, it has led to a conversation in which they have talked about what would help. I would like to see that continued in easier times.
Staff told me many times that they would like more autonomy in their jobs, and to be able to really make a difference and make improvements in the area they work in. Most recently, staff told me how much they want to be able to take time off, to have some time to spend with their families and time to recover and recuperate from the stresses and strains of the pandemic. I am determined that we shall deliver all those things for our NHS workforce.
Throughout the pandemic, I have worked with NHS England to make sure that all possible support is in place for staff. That includes practical support, like hot food and drinks and the free parking that has been much talked about; and psychological support: mental health support, “wobble rooms”—which I have spoken to staff about and they value them—dedicated support lines and helplines, and access to specialist support through new mental health and wellbeing hubs. As set out in the people plan, we are working with the whole NHS to build a more supportive, compassionate and inclusive culture. A culture in which those who care are cared for in turn.
On the first of the asks that I mentioned, that NHS staff want more colleagues, we are making real progress. In the NHS there are now over 6,500 more doctors, almost 10,600 more nurses and over 18,700 more health support workers compared with a year ago, and we are well on our way to delivering 50,000 more nurses for the NHS by the end of this Parliament.
We estimate that there are 70,000 nurses and midwives in training at the moment, and that includes 29,740 students who began nursing and midwifery courses this academic year. That is an increase of 26% from last year. Forty-eight thousand students have applied to start nursing and midwifery courses later in the year. That is an increase of over a third compared with the number of applicants at the same time last year, so I can assure hon. Members that the supply of people training and coming forward to train to work in the NHS is strong.
Vacancies in the NHS—indeed, there are vacancies, but they are decreasing—have fallen by over 11,000 since last year. There are 2,500 fewer nursing and midwifery vacancies and 1,800 fewer doctor vacancies.
NHS and social care staff do a fantastic job, and they continue to go the extra mile time and again, especially during the pandemic. We must recognise their skill and dedication and make sure the rewards of work in the NHS support the recruitment and retention of the workforce our health service needs. That is why we have the independent pay review bodies. They will properly assess all the evidence, and the Government will consider their recommendations and respond in due course.
Those of us who have spoken today may disagree about many things, but we all care deeply about our NHS and our NHS staff. I thank all the hon. Members who spoke today for showing their support.
Paula Barker
I thank all the hon. Members who spoke today and all the hon. Members who applied to speak but were unable to do so because the debate was over-subscribed. I hope today’s debate will go some way towards demonstrating to our incredible NHS workers that they are valued by some people in this place.
I am astounded that the Minister has come here today to try to defend what is, frankly, indefensible. I extend an invitation to the Minister to meet the NHS staff that I speak to, because they will tell her that what they need and want is a pay rise.
I am horrified to hear that some things are non-negotiable, yet NHS staff do not seem to fall into that category. I assure every worker who has held the hand of someone in their last moments, who has comforted family members who were unable to be with their loved ones at the end or who is currently vaccinating people to ensure that the spread of this virus comes to an end, that I, and my colleagues on the Opposition Benches, will continue to fight for the pay rise they deserve, and the dignity that they should be afforded, because that is what we believe is non-negotiable.
The Minister’s Government has the power to do the right thing. They do not have to wait for the pay review body to tell them what the majority of people in this country already know. If there are billions of pounds for Serco’s failed Test and Trace and for failed PPE contracts, there is money to reward those who have personally given so much during the pandemic. Our NHS staff must be awarded a decent pay rise because nothing less will do.
Question put and agreed to.
Resolved,
That this House has considered NHS pay.