The NHS strikes could continue for many months amid anger over UK government plans to raise staff pay by just 2% next year, which health unions have condemned as more “misery of wage cut in real terms.
Ministers have called on the NHS wage review body to cap the wage increase for frontline health workers to 2% in 2023-24 to help the government achieve its ambition of curbing runaway inflation.
But the attempt of the secretary of health, Steve Barclay, limiting the annual wage increase to such a low level could lead to the NHS facing prolonged industrial action, warn the heads of the health services. 2% is barely a third of the Office for Budget Responsibility (OBR) estimate that inflation as measured by the CPI index will average 5.5% during 2023-24.
The 2% plan comes against a backdrop of widespread strike action across the NHS in protest of the government’s decision to give most staff a £1,400 raise, or around 4%, for 2022-23. In England, ambulance staff will withdraw again on January 11 and 23, while nurses will refuse to work on January 18 and 19, disrupting a wide range of services, including planned surgeries and outpatient appointments.
On November 16, Barclay wrote to the NHS payment review body, which tells ministers what size enhancement staff, in addition to doctors and dentists, they should receive, giving them their mandate for the 2023-24 deal. While it did not specify the 2% figure, the NHS Confederation hospitals body, the Health Foundation think tank and several health unions say the fact that England’s NHS budget for 2023- 24 has already been established means that’s the amount Barclay wants to see awarded, with a 1% contingency potentially making it a 3% raise. Either sum is likely to cause further unrest among NHS staff.
Pat Cullen, Secretary General of the Royal College of Nursing (RCN), said: “Our dispute is over the NHS pay award for 2022-23, and we are deciding how to participate in the 2023-24 award discussions. Ministers must resolve our dispute with them over this year’s award before moving on to next year.”
But in a direct response to the debated 2% increase, he added: “Inflicting a decade of misery of real-term pay cuts on nursing should be more than enough without considering going down that path again next year.”
Matthew Taylor, chief executive of the NHS Confederation, urged Barclay not to try to impose such a small below-inflation increase for the second year running.
“The unions are calling for a pay increase for NHS staff that is above current levels of inflation, which at 2% to 3% would not be met. If the government wants to avoid the prospect of prolonged industrial action this year, it must be prepared to negotiate on wages and both parties must be willing to compromise,” Taylor said.
Anita Charlesworth, director of research at the Health Foundation, said: “The NHS budget for next year was set by the government on the basis that health service staff would receive a 2% increase in the next round of pay. This would be less than half the inflation forecast and below the [OBR’s] official forecast for earnings growth across the economy, which is 3.5%.”
A 2% allotment would risk exacerbating the NHS’s deepening staffing crisis, it added. “The result would be that NHS workers would face a further cut in real income. At a time of rising vacancies, it would mean NHS wages would lag further behind other sectors, with risks to recruitment and retention.”
In his letter to Philippa Hird, chairwoman of the NHS pay review body, Barclay reminded her that “the NHS budget has already been set up to 2024 or 2025.”
He said: “Wage allocations must strike a careful balance: recognizing the vital importance of public sector workers while providing value for the taxpayer, considering private sector wage levels, not further increasing the country’s debt, and being careful not to drive prices even higher in the future.”
And in advice backing the likely 2% offer, the health secretary added: “In the current economic context, it is particularly important that you also take the government’s inflation target into account when making recommendations.”
NHS England cannot easily raise 2%. It is under pressure to use its budget to cope with the heavy backlog of 7.2 million people waiting for hospital care and the intense strain the entire service is under. That, coupled with the fact that “NHS spending is projected to rise to a record low next year”, means it has “little or no scope to fund additional wage costs”. [beyond the 2%]with the government holding a potential contingency for a further 1% increase,” Charlesworth said.
A GMB union official said: “The Department [of Health and Social Care] He has already sent his mandate to the salary review body for next year and budgeted for a 2.1% salary increase. This is about a third of the inflation forecast in 2023. The fundamental problem in the dispute is that the NHS wage agreements have consistently been too low.
However, Rishi Sunak and Jeremy Hunt, the chancellor, have ruled out raising this year’s £1,400 offer because they want to show restraint on public sector wages to help the Conservatives regain a reputation for economic competition.
Hunt has ruled out a one-time bonus pay for nurses to try to end the government’s increasingly bitter standoff with the RCN, even though such a move is popular with voters.
The Department of Health and Social Care said it had not yet decided what pay increase for NHS staff for 2023-24 it could afford. “NHS staff are greatly valued and appreciated by the government and we have committed to giving NHS workers a pay increase, asking independent wage review bodies for recommendations on staff pay in scope,” a spokesperson for the NHS said. DHSC.
“This follows the acceptance of last year’s recommendations in full, in which the lowest earners in the NHS received a 9.3% pay increase.
“We will carefully consider reports from independent wage review bodies when we receive them. The government has not yet established the position on affordability for 2023/24.”