While justifying the government’s refusal to negotiate with NHS unions over pay, the health secretary, Steve Barclay, has ducked and dived to such an extent that it is little wonder there is “no trust left”, as Christina McAnea, the Unison leader, put it on Monday. Ahead of an unprecedented week of strike action involving both nurses and ambulance workers, Mr Barclay and the government continue to hide behind the fiction that the recommendation of the independent NHS pay review body – which suggested a pay increase of around 4% for nurses – must be the last word on the matter. “Ultimately, independent bodies are there for a reason,” suggested the health secretary last week. “To take the politics out of this kind of stuff.”
As Mr Barclay will know, this is disingenuous nonsense. “Politics” – specifically the politics of austerity – led the current chancellor, Jeremy Hunt, to reject a pay rise recommendation from the review body in 2014 as “unaffordable”. Between 2010 and 2017, nurses’ average earnings fell by 1.2% a year in real terms. This was not down to supposedly apolitical deliberations by the review board; it was a result of a seven-year, government-imposed public sector pay freeze.
Last November, a formal remit letter from the then health secretary, Sajid Javid, warned the review body that this year the need for fair pay should be balanced against the need to protect funding for frontline services. This contentious political framing was disputed by the unions, which reasonably argued that frontline services could not be safeguarded amid a recruitment and retention crisis that was partly down to poor pay.
Since then, soaring inflation has transformed the context of the resulting 4% pay award. But the government claims (on the basis of next to no evidence) that revising public sector pay upwards could contribute to a wage-price inflationary spiral. It is therefore attempting to impose a huge financial hit on NHS employees, after a decade in which their average earnings have fallen by 5%. This too is a political judgment and trade-off, and one that exposes the extent to which this government’s priorities are out of kilter with those in the country. Weekend polls suggested that support for nurses is growing, with close to two-thirds of the population now backing the industrial action.
With regard to public sector pay, the government has chosen to pursue what is, in effect, an aggressive and unpopular incomes policy. But it lacks the courage to be upfront about it. In the rail dispute, just as with the NHS strikes, ministers have sought to dodge direct accountability for the ongoing disruption. Negotiations with the RMT are nominally the responsibility of the Rail Delivery Group, which represents the train operating companies. Behind the scenes, however, ministers have limited the train companies’ room for manoeuvre and compromise, while guaranteeing their profits in the face of strike action and waging a propaganda war in the press.
This sly outsourcing strategy has dismally failed. However much Mr Barclay might seek to obfuscate matters in relation to the NHS, the government is a principal protagonist in a crisis with potentially lethal consequences. The majority of the public are well aware of this and will draw their own conclusions if the strikes continue in the new year. Mr Barclay urgently needs to put the politics back into NHS pay discussions, sit down with the unions, and negotiate.