NHS demonstrators holding banner NHS in Crisis Demo 3.1.18. Photo: Counterfire

NHS workers have been pressured into accepting a deliberately misleading deal, explains a health worker and union representative 

From 2010 to 2018, NHS workers experienced a 1% pay cap. This was effectively a 14% real terms pay cut, due to the cost of living and inflation rises far outstripping this 1%.

So, when NHS workers were promised a pay rise earlier this year, the news was very much welcomed. Newspaper headlines proclaimed that over the next three years, NHS workers would see their pay rise by between 6.5% and 29%. Many unions (apart from GMB) recommended that their members accept this pay deal.

And this pay deal was a partial victory for the many NHS workers who campaigned and demonstrated for better NHS pay. The deal means: 

  • an extra £4.2 billion in the pay budget, so above the 1% pay cap
  • abolition of pay band one (which was very low pay)
  • fewer years for workers to get to the top of their pay band (in other words, full pay for their job)

NHS workers were told they’d get their pay increase in their July pay (and back pay in their August pay). However, July came and many NHS workers were not happy. They took to social media en masse, expressing how their July pay was much less than they had expected.

As both a Unison representative and an NHS worker, who had voted against the deal, this did not come as a total surprise. I had not seen the pay deal in such glowing terms and felt that it was confusing and divisive.

Many members had found the deal confusing as it was different for those at the top of their pay band than for those in between or at the bottom. I had gone to the Unison National Health Conference, to fringe events, had read the literature, and spoken to others. And yet I still felt that it was a confusing deal.

For the 52% of NHS workers at the top of their pay band, 3 years of the pay deal means a 6.5% pay rise. But as RPI inflation is expected to increase by 9.6% within the next 3 years, this actually means another pay cut.

For those who were not at the top of their pay band, things were more complicated. Workers were directed to an NHS pay calculator to see how much their pay would increase by. However, the pay increases in the calculators included the yearly incremental pay rises that all NHS workers already get (until they reach the top of their pay band). Without including these, the typical pay increase was 1.5% this year.

What had changed (and is good for those not at the top of their pay band) is the length of time it would take to get to the top of the pay band. This would now decrease. So, over the 3 years of the pay deal, workers not at the top of their pay band will progress more quickly through the pay points. This is good for newly qualified staff, who will get top rates of pay more quickly, but not so good for the 52% of long serving NHS staff already at the top of their band, who will not benefit from any of this.

However, there were even downsides for those not at the top of their pay band. Previously, workers got automatic incremental pay rises every year. As part of the pay deal, workers would now only get this if they passed their annual appraisal (which includes meeting often high targets as well as other
criteria). The deal also means that workers on the Band 2 – 3 are receiving a lower rate of pay for unsocial hours work. Moreover, if off ill, workers will no longer get unsocial hours payment at all.

So why were staff so unhappy with their July pay? It seems it was only then that many workers (not at the top of their pay band) realised they would not be getting the big headline-grabbing pay rise from the start of the pay deal (1st April).

What they got was only the typical 1.5% cost of living pay increase, as they would not get their incremental pay rise until their usual incremental pay date. For some this could be as late as next March. This also meant they would not receive a large amount of back pay in their August pay either. 

To add insult to injury, for some this small pay rise has led to increases in tax, national insurance and pension costs, which have cancelled out the pay rise. (There’s a no detriment clause in this pay deal, so workers should be raising this with employers and their union branch.)

Whilst Unison did not make the same mistakes as the RCN and tell NHS workers they’d all get a 3% pay rise this year (regardless of whether they were at the top of their pay band or not), many still feel they did not get the deal they expected.

From my personal perspective as a union member, it seemed Unison only promoted the positives of the deal and ignored the negatives. The deal was confusing and divisive in the way that it wasn’t the same for all and because it conflated the incremental pay rise with an actual pay rise. 

Unison also really pushed for members to accept the deal, rather than clearly giving members all the pros and cons and letting them decide for themselves.

Look at Scotland where they won a non-divisive 9% pay deal for all NHS workers over 3 years.

Unison seems to have gone on the defensive and are not listening to what members are saying. Their response has been to say that they did give members the information (which technically they did, but the information itself was unclear). But with a deal this complex and a union that was so keen for NHS workers to accept, it seems inevitable there’d be a misunderstanding of the deal. Unison seem unable to acknowledge that many members didn’t see the negatives and thought they were getting a different deal to the one that they actually got.

So, if members had really understood the deal, would they have voted to accept it (which over 80% did, with a 30% turnout)? Or have NHS workers become so stressed, worn down and demoralised by years of overwork, increased targets and underpay that they’ll accept a bad deal without a fight.

What’s next is still being discussed in between activists and in union branch offices throughout the country. However, a group of union members have already set up a petition. This calls upon the Secretary of State for Health, Matt Hancock, to issue an apology to those mis-sold the deal and to reopen talks on the pay deal. The petition can be found here.

What’s needed now is for NHS workers, health union members and activists to come together strongly on this issue. We have power in numbers and we need to use this power to demand that talks on NHS pay are reopened and to ensure that we get a deal that is good for all.

Importantly, NHS workers need to be firm and undivided on this issue and fight for the pay deal we deserve.