Jonathan Ashworth
Main Page: Jonathan Ashworth (Labour (Co-op) - Leicester South)Department Debates - View all Jonathan Ashworth's debates with the Department of Health and Social Care
(6 years, 11 months ago)
Commons ChamberI beg to move,
That this House notes that in 2017-18 NHS pay rises have been capped at one per cent and that this represents another below-inflation pay settlement; further notes that applications for nursing degrees have fallen 23 per cent this year; notes that the number of nurses and midwives joining the Nursing and Midwifery Council register has been in decline since March 2016 and that in 2016-17 45 per cent more UK registrants left the register than joined it; and calls on the Government to end the public sector pay cap in the NHS and give NHS workers a fair pay rise.
This is the first Opposition Supply day for six months, and it is my pleasure to bring a motion to the House on lifting the public sector pay cap. In the past 24 hours, the Government have been briefing that the pay cap has ended. The Chief Secretary to the Treasury has said that Ministers now have “flexibility” when setting pay above 1%. If—and it is a big “if”—that flexibility means lifting the cap for the whole public sector and giving public sector workers a fair pay rise above inflation, which stood at 2.9% yesterday, that will be a victory for the Labour party, for the Leader of the Opposition, for the Royal Colleges, for the trade union movement, for the MPs of all parties who signed the early-day motion and, above all, for the millions of public sector workers who have campaigned for fair pay. That flexibility that the Chief Secretary to the Treasury has talked about must mean giving NHS staff fair pay as well.
What a climbdown this represents for the Prime Minister! The House will recall that, in the general election campaign, she showed the deftness of touch that has come to characterise her dismal, beleaguered premiership by dismissing the heartfelt concerns of a nurse, saying that there was no “magic money tree”. It is funny that the money was there when the Conservatives needed the votes, though.
May I tell my hon. Friend about Neil Thompson, a district nurse from Eastwood in my constituency? He has told me:
“I didn’t expect, after 40 years in the NHS, to be as poor now as when I first started out.”
How can that be just?
My hon. Friend is right to raise that point. It is not just, which is why the Labour party has consistently campaigned to get rid of the cap. The Conservatives have voted against getting rid of it when we have brought motions on this issue to the House.
Given that the Government are now briefing that the cap is being abandoned, I trust that they will accept the motion in the name of the Leader of Opposition and myself and not divide the House later today. If they are indeed abandoning the cap, let us put them on notice that it must apply to the whole public sector, including the 55% of workers not covered by pay review bodies. We also put them on warning that we will not accept a divide-and-rule approach that plays one set of public workers off against another. Nor will we let Ministers get away with presenting below-inflation pay offers as amounting to a fair pay rise when that is still, in effect, a pay cut.
My hon. Friend is making an excellent beginning to his speech. What is his view of the impact of this crucial question on recruitment and retention in our hospital trusts?
My hon. Friend is right to raise that point. I shall go on to explain that the pay cap is at the heart of the recruitment and retention crisis that is now facing the national health service.
Does my hon. Friend share the shock of GPs and NHS staff when they learned that, while frontline staff were limited to a 1% pay rise, the governing body of the Liverpool clinical commissioning group gave themselves rises of between 15% and 81%? None of the regulators noticed this, including NHS England and NHS Improvement, and it all took place under the nose of the Government. This shows that there is one rule for the bosses and another for the workers.
My hon. Friend is absolutely right. She has been determined in her pursuit of this issue and I know that that will continue.
I will make a little progress now, if I may. I promise I will take more interventions later.
I say directly to the Chief Secretary to the Treasury, who will be responding to the debate later, that if Ministers are given flexibility to set pay rates, and if the pay cap has indeed been abandoned, she also needs to grant the NHS the funding that it needs. The NHS is underfunded and it is going through the biggest financial squeeze in its history. On the published figures, head-for-head NHS spending will fall in the next year. Hospitals are in deficit, waiting lists are at 4 million, the A&E target is never met and the 18-week target has been abandoned. Hospital bosses are warning that there will not be enough beds this winter. Last winter, hospitals were overcrowded, ambulances were backed up and social care was at a tipping point. Some even characterised it as a humanitarian crisis. It is not good enough for the Chief Secretary to the Treasury just to grant “flexibility” and expect hospitals to fund a staff pay increase from existing budgets.
If the hon. Gentleman does not get the increases he would like, will he support co-ordinated illegal action?
The Labour party supports people taking legal industrial action, and if the hon. Lady supports public sector workers, she should be joining us in the Division Lobby later.
Does the hon. Gentleman agree that the pay restraint over the past few years has been uncomfortable but necessary, in order to bring Government spending—[Interruption.]
None of us would want anyone to be paid any less, but it has been difficult but necessary, in order to control the overspending by Government and put right the financial mess that the country was left in after the last time the hon. Gentleman’s party was in government.
I agreed with the hon. Lady’s comments at the time of the debate on the Gracious Speech, when she said:
“I’m of the view we need to look at public sector pay in the light of increasing inflation.”
If those were her comments then, she should be joining us in the Division Lobby this afternoon.
I will let the hon. Member for Wells (James Heappey) in because he has been very persistent, but first let me make some progress.
It is not good enough for the Chief Secretary to grant the Secretary of State flexibility and not grant him the funding that the NHS needs. Overcrowded, overstretched hospital trusts cannot be expected to absorb pay rises from existing budgets. We need extra investment now to give the staff the fair pay they deserve.
Let me make a little bit of progress, and then I will give way.
Over the past seven years, a public sector worker on the median public sector wage has seen the value of their wage drop by £3,875. That is more than the cost of feeding the average family for a year. Given what we know about inflation, on the figures published yesterday and on the Treasury’s own inflation forecast, if this cap was to remain in place until the end of the Parliament, a public sector worker on the median wage since 2016 will have seen their pay drop by at least another £2,200.
The Chief Secretary says it is not true. These amounts are based on her own Treasury figures.
The shadow Minister has been very generous in giving way. May I be helpful and invite him perhaps to revise his earlier statement that the pay rise should be universal across the public sector? Surely that would advantage those in more senior, management positions, who would disproportionately benefit from such a pay rise, and perhaps actually the Government’s position of offering Ministers flexibility to increase pay where there is a clear need is a much better proposal than the universal pay rise that would only benefit fat cat managers.
There we have it—the Conservative party playing one part of the public sector off against the other. We believe the whole of the public sector deserves a pay rise.
In my constituency, NHS staff are having to rely on food banks in order to be able to eat. A constituent, an ambulance technician who transports critically ill children across the country, told me that she does not have nearly enough money to live on. Does my hon. Friend agree that this is a disgrace?
It is a shocking disgrace, which is why the Labour party has consistently campaigned to get rid of the pay cap; it is why, in our manifesto, which we took to the British people a few months ago, we said we would get rid of the pay cap, and why it is absolutely disgraceful that Conservative Members stood on a manifesto to keep the pay cap.
Mandy McKeown’s son Liam died seven times. He survived, thanks to the dedicated work of neonatal intensive care nurses. Tracey, who came to Parliament last week, spoke of having suffered a 14% cut in pay, two-thirds of her fellow nurses taking second jobs and a haemorrhage of nurses from the profession that they love. Does my hon. Friend agree that it is utterly shameful to treat those to whom we owe the difference between the life and death of sick babies in this way?
My hon. Friend has spoken incredibly powerfully about that case and he is quite right to say it is shameful.
The hon. Lady has often spoken out on this matter, so I feel I should take her intervention, but then I will make progress, if the House will indulge me.
It is generous of the hon. Gentleman to give way. As he says, I support the lifting of the pay cap and I am pleased that the Government are moving on this. My concern about supporting this motion is that Labour do not seem to have learned the lessons from crashing the economy in the first place. Could he outline what level of pay rise the Labour party is proposing for public sector workers—1.5%, 2% or 3%—and how it will be paid for? That is crucial to influencing the voting intentions of Members like me.
I have a huge amount of respect for the hon. Lady; we have had conversations outside the rough and tumble of this Chamber, and I know she takes these matters extremely seriously. I would ever so gently say to her that she has been telling newspapers that she supports getting rid of the cap; she has been hosting nurses in Parliament, saying that she would get rid of the cap; well, this evening she has an opportunity to take a stance, ignore the Tory Whips and vote for getting rid of the cap.
In this debate, we must be honest with the British public about how we are going pay for the lifting of the pay cap. If Labour wants to lift the pay cap, can the hon. Gentleman explain how the Labour party will pay for it? Will it be through increased taxation or more public borrowing, or will Labour shift spending priorities? We need to know the detail in order to be able to support this policy.
I hope the hon. Lady made those points at the rally last week, when she was talking to nurses. But I would say to her that the Government have found an extra £1 billion or so for Northern Ireland. We do not begrudge Northern Ireland that, but the Government have found more money for Northern Ireland. Also, the Government are giving away billions and billions in corporation tax cuts. They have given away £1 billion in inheritance tax cuts. Government is indeed about making choices. We would make a different set of choices, but if the hon. Lady is genuine, as I believe she is, and sincere, as I believe she is, in wanting to get rid of this cap, she needs to send a message to the Chancellor, not the Tory Whips, and vote for our motion.
I thank the hon. Gentleman for giving way on this very important issue, and I must say that I and my colleagues are minded to support the motion that he has put before the House. But it would be appropriate if true sincerity was shown by all Members of this House—if they stopped attacking the Government for giving Northern Ireland that £1 billion, so that we can alleviate the costs that would allow us to make that pay gap narrow.
I did say I did not begrudge Northern Ireland the money; I was just making the point that the Government have found the money, when they keep telling us that there is no money for anything else. But we are grateful that the Democratic Unionist party has signed the early-day motion in the name of my hon. Friend the Member for St Helens North (Conor McGinn), and we are aware that the DUP has said consistently that it supports getting rid of the pay cap for public sector workers. We would be very happy for the party to join us in the Division Lobby this evening.
I am really pleased to hear what the hon. Member for North Antrim (Ian Paisley) has said today, but I want to put it on the record that DUP Members did have an earlier opportunity to support the removal of the pay cap but actually voted against that—all 10 of them—in the debate on the Queen’s Speech. An amendment was tabled by the colleagues of the hon. Member for Leicester South (Jonathan Ashworth), and the DUP voted it down, but we always welcome repentance.
I am grateful to the hon. Lady and I am grateful that she also signed the early-day motion. This issue may be debated further as hon. Members make their speeches today.
As we know, according to the Office for National Statistics, many public sector workers regularly work an average of 7.8 hours’ unpaid overtime a week, worth £11 billion to the economy. With the pay cap, the Government have effectively been asking them to do more and more on less and less. That is unfair.
I will make progress, if I may.
MPs on both sides of the House have spoken out against this pay cap. We would hope that they will join us in the Division Lobby, including the hon. Member for North Antrim (Ian Paisley). I pay tribute to my hon. Friend the Member for St Helens North for tabling early-day motion 132, which calls for an end to the NHS pay cap, and which we have picked up and adopted as our motion today.
I know there are many who have sympathy for getting rid of the pay cap. The reason that many in the House have sympathy for getting rid of the pay cap is that in all our constituencies we have met nurses, very directly at our advice surgeries, or indeed in lobbies at Parliament, who have told us that the cap has meant they have seen a 40% real-terms drop in their earnings since 2011.
I want to make progress; but I will try to let in as many hon. Members as possible.
We have all read reports of nurses on their way home from a shift stopping off at food banks. The Royal College of Nursing tells us that two-thirds of its members are forced to undertake bank and agency work to help make ends meet. Is that not an example of how self-defeating the pay cap is, because it is driving an agency bill of £3.7 billion in the NHS?
We have all read surveys showing that more and more NHS staff are turning to payday loan companies and pawning their possessions, and we will have heard from the RCN lobby recently of the huge hardship that our nurses are facing. Many nurses have been in touch with us.
Let me give the House the story of Rebecca, who got in touch with my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams). Her story brings into sharp focus the impact of the pay cap, particularly when it is combined with the severe social security cuts that the Government are pushing through. Rebecca is a single parent. She was originally on working tax credit, but she was transferred to universal credit last year, with her payments falling as a result. As a consequence of that reduction and of the ongoing cap on her wages, which have lost their value, she has accrued rent arrears of over £800. Her landlord has now issued her with an eviction notice. There we have it: nurses are turning to food banks, pawning their possessions, and even being issued with eviction notices. Is that not shameful in 21st-century Britain? What a depressing human consequence of Tory economics.
I am a nurse and I believe in fairness. This is not just about paying nurses properly; it is about the porters, the housekeepers, the cooks, the cleaners and the admin staff, because they all do a good job. This is about not just healthcare workers but the whole public sector, because if the Government can find £1 billion for the DUP, they can pay the public sector properly.
What a pleasure it is to see a Labour MP in Lincoln, Mr Speaker. My hon. Friend is a former nurse—
She is still a nurse—I do beg her pardon—and she makes her case powerfully.
I will give way to the hon. Member for Croydon South (Chris Philp) because he has been so persistent, but I will then try to get on with my speech.
It is kind of the shadow Minister to give way. Of course our hearts go out to the people in the stories he is relaying to the House, but we need to consider the whole picture. In its March report, the NHS Pay Review Body said:
“We do not see significant short-term nationwide recruitment and retention issues that are linked to pay.”
The pay review body itself says that pay is not causing retention issues, so should the House not take account of that?
Perhaps we really should, but I think the hon. Gentleman, who is an enthusiastic supporter of his Front-Bench team, is quoting selectively from the report, which I will move on to in a few moments.
Today’s motion is not just about doing what is right for NHS staff; it is about doing what is right for patients, too. I remind the House that we are significantly short of GPs and that we are short of 3,500 midwives. According to the Royal College of Nursing, we are also short of 40,000 nurses, with one in 10 nursing posts remaining vacant. Nearly 40% of the full-time vacancies advertised on NHS Jobs earlier this year were in nursing, and the Opposition know that Brexit is having an impact through nurses leaving the UK. The Nursing and Midwifery Council shows an increase in the numbers of nurses and midwives leaving its register. The average midwife has seen the value of their pay drop by over £6,000 since 2010, and we are significantly short of numbers, with 80% of midwives intending to leave the profession in the next two years as a result of the pay cap.
May I make a little progress?
The hon. Member for Croydon South said that pay does not affect retention and recruitment, but the Opposition say that the pay cap is at the heart of the retention and recruitment crisis. Earlier this year, NHS Providers, which represents hospital trusts, warned that low pay is causing staff to leave the NHS to stack shelves in supermarkets. Chris Hopson said:
“Years of pay restraint and stressful working conditions are taking their toll. Pay is becoming uncompetitive. Significant numbers of trusts say lower paid staff are leaving to stack shelves in supermarkets rather than carry on working in the NHS.”
Does the hon. Gentleman appreciate that anybody listening to his speech would take away from it a story of gloom and doom about our NHS? While there are difficulties and challenges, every day millions of people overwhelmingly enjoy one of the finest health services anywhere in the world, and I and many others are sick and tired of Labour talking it down.
The right hon. Lady says that we are talking the NHS down. We are not talking it down; this Tory Government are running it down. She seemed concerned about public sector pay in the NHS a few months ago when she tweeted:
“The important retention & recruitment of public sector workers is about working conditions (esp in NHS) as well as pay”.
If she stands by that tweet, she should join us in the Lobby this evening.
I thank my hon. Friend for giving way, but I thank him even more for coming to Eastham in my constituency, where our precious walk-in centre is closing owing to staff shortages at our A&E, which is in crisis. The Tories says that we are talking down the NHS and lowering morale, but does he agree that it is not words that matter but action, and that is why we need action on pay?
My hon. Friend is right. A popular, successful walk-in centre in her constituency has had to close to shift the staff to fill vacancies at the local A&E at Arrowe Park hospital, because the pay cap and other Government decisions have led to a staffing crisis in the wider NHS.
I did promise my hon. Friend that I would give way, but I will take no more interventions afterwards.
Has my hon. Friend noticed that the Government do not necessarily have to abide by the pay reviews? In other words, they could give an increase that goes further than what the pay review body recommends. The Tories are wrecking the national health service. They should put their money where their mouth is. If they really appreciate NHS and its staff, they should vote with us tonight.
My hon. Friend is absolutely right. The Tories have been running the NHS for seven years now. It is going through the biggest financial squeeze in its history and we have some of the worst waiting times on record.
The hon. Member for Croydon South should note that the NHS Pay Review Body’s March report said that
“public sector pay policy is coming under stress. There are significant supply shortages in a number of staff groups and geographical areas. There are widespread concerns about recruitment, retention and motivation that are shared by employers and staff side alike.”
Again, NHS Providers said that
“seven years of NHS pay restraint is now preventing them from recruiting and retaining the staff they need to provide safe, high-quality patient care. The NHS can’t carry on failing to reflect the contribution of our staff through fair and competitive pay for five more years.”
We agree. Addressing NHS pay and lifting the pay cap are crucial to addressing the retention and recruitment crisis now facing the NHS.
I have given way to the hon. Lady once and I have been generous, so I hope she will forgive me if I do not give way again.
We have heard several examples of what vacancies in the NHS mean for services. We have heard about the walk-in centre in Wirral, but Macmillan Cancer Support warned last week that bigger workloads and vacancies in key roles are creating “unrelenting pressure” on the cancer care workforce and that some cancer patients are attending A&E because they cannot get help elsewhere. I have mentioned midwifery, and this summer we revealed that almost half of maternity units closed their doors to patients at some point in 2016, with understaffing often used as the justification. Earlier this year, I revealed FOI requests that showed a rising number of cancelled children’s operations, with 38% of trusts citing workforce shortages as the reason for those cancelled operations. Visit any hospital and doctors will talk about rota gaps, and the latest NHS staff survey reveals that 47% of staff view current staffing levels as insufficient to allow them to do their job properly.
Not only is the pay cap unfair on hard-working staff who are struggling to make ends meet, but it is unfair on patients, who suffer the direct consequences of under-staffed, overstretched services. We look forward to the Health Secretary telling us how he will use his newfound flexibility. We look forward to his telling us what remit he will set for the NHS Pay Review Body in the coming days. He has had all summer to think through his response to these demands. I know that he got into a big argument with Professor Stephen Hawking, but we will leave that there. The Health Secretary sets the remit—he tells the pay review body what it is able to provide—so we look to him to tell us what he is going to ask it to provide. We want him to tell us today when he will publish the remit letter.
I have been very generous to Government Members, and the hon. Lady has already had a chance.
The pay cap must be scrapped, and it must be done by giving the NHS extra investment. The self-defeating nature of this policy means that we are already spending £3 billion on agency workers, and the Government have found billions for corporation tax and inheritance tax giveaways, so this new flexibility must mean more investment. We will not tolerate hospital bosses being forced to cut services to find these funds.
I have been very generous, and I want to wrap up because a huge number of Members want to speak in the debate.
As the Government are briefing that the pay cap has gone, we expect the Health Secretary or, if he cannot do it, the Chief Secretary to the Treasury to tell us what extra investment will be made available to the national health service in the coming year to get rid of this pay cap. If they are not prepared to put the extra investment in the health service to get rid of this pay cap, we can quite rightly conclude that the consequence will be further cuts to services at the frontline.
I have been extremely generous, and I will now wrap up.
If the Government are genuine and sincere about getting rid of the pay cap, I see no reason why they should seek to divide the House today. If they do seek to divide the House, I say directly to all those Conservative MPs who went to the Royal College of Nursing rally last week, to all those Conservative MPs who have tweeted that they support getting rid of the pay cap, but just not on this occasion, and to all those Conservative MPs who have responded to constituents by telling them that they have their sympathy and that they want to get rid of the pay cap: this is not a time to sit on your hands. I know Conservative MPs will be reconciling the pressures of wanting to be loyal to the Treasury Bench and to their Whip, but 1 million NHS staff, nurses and their constituents are looking to this House to show some leadership and take a stand by giving our NHS staff the fair pay they deserve.
I commend our motion to the House.
We have had an important debate, in which it is fair to say that both sides of the House have recognised the importance and hard work of workers across the NHS. I saw this hard work in action on the Becket ward of Worthing Hospital a few weeks ago, where deputy sister, Sue Grace, and her team were in an improvement huddle, where every day they look at how they can make life better for their patients. That goes on right across our NHS. Because of the hard work of NHS workers across the country, there have been 1 million more operations and cancer clear-up rates have improved.
The Health Secretary recognised in his opening comments that there are challenges to address. We need to ensure that we retain those hard-working staff, that we can recruit the next generation into the service and, as my hon. Friend the Member for Totnes (Dr Wollaston) pointed out, that we are able to recruit people in specialisms. We need to look at making jobs more flexible so that people have a good work-life balance and we need to look at banding, as my hon. Friend the Member for Lewes (Maria Caulfield) pointed out. That is why the Government announced yesterday that we are moving from a blanket approach of having a 1% public sector pay cap to greater flexibility in each workforce across the public sector.
Just to be clear—because there seems to be some confusion on the part of Opposition Members—the prison officers and police settlements were for 2017-18. Our new policy is for 2018-19. There is already a clear process in place for that. The Health Secretary will submit evidence to the independent pay review body. It will look at issues such as recruitment, retention and affordability, and will then come back with a recommendation. That is the way we should do it; we should look at the evidence. Rather than shouting out numbers in the debate, we need to look at the circumstances. We need to ensure that pay is fair for people in the NHS, but that it is also fair for the taxpayers who fund those services.
OECD figures show that we spend 9.8% of our GDP on health and social care. That is above the European Union average of 8.6%. We are able to do that because we have run a strong economy. Today we announced record levels of employment. We have not heard any concrete proposals from Labour Members this afternoon. We have just heard reckless pledges that they will spend more money without looking at how they are spending it. As my hon. Friends the Members for South West Bedfordshire (Andrew Selous) and for Copeland (Trudy Harrison) pointed out, the Conservatives do not just spend more money. We actually make sure that the money goes to the frontline, that it helps and empowers people there to do their jobs, and that it makes those jobs more fulfilling.
It is not just about spending more money; it is also about the way we spend it. If we followed the Labour party’s advice, we would end up crashing our economy in exactly the same way the Greeks did with their economy. What was the result of that? They ended up cutting health service spending by 36%.
We have recognised that there are challenges in the national health service and in other parts of our public sector, and this policy applies right across the public sector. We have reflected on that situation, and we have moved to a more flexible policy that looks at issues of recruitment and retention.
However, it is important, as my hon. Friend the Member for Walsall North (Eddie Hughes) pointed out in an excellent speech, that we also look at fairness for the people who pay for our public services. It is only by having a strong economy and by being disciplined in our approach to debt that we can get the great public services that we all want.
Question put and agreed to.
Resolved,
That this House notes that in 2017-18 NHS pay rises have been capped at one per cent and that this represents another below-inflation pay settlement; further notes that applications for nursing degrees have fallen 23 per cent this year; notes that the number of nurses and midwives joining the Nursing and Midwifery Council register has been in decline since March 2016 and that in 2016-17 45 per cent more UK registrants left the register than joined it; and calls on the Government to end the public sector pay cap in the NHS and give NHS workers a fair pay rise.
On a point of order, Mr Deputy Speaker. Is it not now clear that the House has been unanimous in saying that we should end the pay cap in the NHS and give health workers a fair pay rise? Is it not also clear that the reason the Government did not divide on this motion is that they knew they would lose?
The point of order is well made. It is not for me to judge, but I am sure many people will make a judgment, whatever side of the House they may be on.