Christmas Adjournment

Rachael Maskell Excerpts

Tuesday 20th December 2022 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

The nurses are striking, and the people are rising up in support of them. They are striking for the first time in more than 100 years, and it was of course completely avoidable. It could be avoided, if only the Government would negotiate. These professional, loving, caring nurses would prefer to be tending their patients, but instead are taking action because it is unsafe on those wards. If more of them leave, pressure builds, and then even more leave. It is a vicious cycle. They are the canary in the mine, and the Government must heed the warning of these strikes. There are 7.2 million people on waiting lists, sickness levels are rising, and A&E waiting time targets have not been met since April 2021. There are 133,000 vacancies in the NHS, and the staff are burning out.

Poor pay has an impact on retention. Staff cannot afford to work in the NHS, and those who remain are under such pressure that they are walking too. Holding on to staff is an impossible task for employers when those staff are not paid the rate that they should receive. As a recent OECD report pointed out, their rate is one of the lowest in Europe. They are paid for four days but expected to work for five. The real-terms pay cut since 2010 has pushed the profession into poverty—a profession that Labour honoured, and one that Labour paid. Band 5 nurses on pay point 23 have lost 20% of their pay since this Government have been in place, while band 6 nurses on pay point 28 have lost 21% in real terms.

The cost of living, the cost of housing, the cost of travel and the cost of just registering to practice clears out nurses’ monthly wage packets, and it is becoming harder to balance the books. Many are now living on the edge. Some retire early, some just walk, and many are turning to agencies where they are paid more to survive for now, although they will lose their pension and other benefits in years to come. Of course, NHS trusts are being ripped off because they have to pay more to the agencies that profit from this crisis. I searched the agencies, and found that a band 5 nurse earning £27,000 a year in the NHS could be earning £32,000 working for an agency. It is a false economy. Instead of paying nurses, the Health Secretary is paying the profiteers, with £4.5 billion spent on temporary staff over the last five years. To date, my local trust has paid £13.8 million, and it will have paid £20 million by the end of the year, while its underspend on employed nursing staff is £13 million. Do the maths: if you pay the staff more, you do not pay the agencies but you retain your staff.

NHS officials are travelling around the globe to recruit nurses. It costs £11,500 per nurse, and many then struggle to live on the poor wages here in the UK. According to the Royal College of Nursing, the NHS is currently carrying 47,496 registered nurse vacancies. That figure does not take account of the non-funded posts that are needed to address the backlog, increased demand and more acute sickness. Some specialties are really struggling: there has been a 46.9% decline in disability nursing, a 47.8% fall in the number of district nurses, and a 32.9% reduction in number of school nurses. The Nursing and Midwifery Council has also seen more people leave the register. We discussed demand this morning at the Health and Social Care Committee; the demand for paramedics has risen by 16% in just three years, and they too will be on strike tomorrow.

There is a way to stop this scandal, plain and simple: pay our nurses and other NHS staff what they are owed. The Secretary of State last met the unions on 15 November, when he avoided talk about pay. Pat Cullen, who has been an amazing leader of the RCN, spoke to him, but he would not discuss pay. On the “Today” programme yesterday, Christina McAnea, Unison’s general secretary, said that she had had just 15 minutes with the Secretary of State five weeks ago, and, of course, pay was not on the agenda. Instead of grandstanding, touring media studios and hiding behind the pay review body, the Secretary of State should be negotiating. Let us be clear: it is the Secretary of State who appoints the pay review body. He and the Chief Secretary to the Treasury provide the pay envelope, the remit and the parameters of that body, and within that straitjacket the PRB works out the best way of distributing the money that it is given on the basis of evidence taken from a range of stakeholders, including NHS employers, umbrella groups and trade unions. There is no negotiation; pay is then imposed. But the unions rejected this proposal as it was fundamentally flawed and fundamentally too low. When the remit was set, inflation was just 4%, there was no war in Ukraine, and there was no reckless Prime Minister losing £30 billion from the economy. Of course, inflation has risen since then.

Let us face it, the reason that NHS workers’ pay is so low is that 76.7% of the workforce are women. There is an institutional assessment that because women are in caring roles they will not stand up for themselves, but they are and their voices must be valued and heard. The Secretary of State must negotiate now. It is no good his saying that there is no more to pay, because he can always find the money when he needs it. If he values the NHS staff, he needs to pay them and to do it quickly. Tomorrow, as the paramedics walk out, other ballots will be coming in. That is why it is so important that these talks get under way. The Government keep quoting ridiculous sums, but until they talk, they do not know the cost. That is the art of negotiation, which this Government seem to have lost.

Poor staffing is costing lives and chasing our NHS staff out of their jobs. The NHS crisis will not be resolved until the staffing crisis is resolved, and the staffing crisis will not be resolved until the pay crisis is resolved. The Chancellor and the Secretary of State need to stop hiding behind the pay review body, come to the table with a bigger envelope and make nurses and all NHS staff the necessary offer to end this dispute, to value the staff and to start addressing the major challenges across the NHS. If they will not do that, a Labour Government will clearly be needed to sort out the NHS. We have always valued the staff and we will always keep patients safe. I want to thank all NHS staff for their tenacity and care, and I wish them all a happy Christmas, as I do to all in this House.