NHS pay cuts proposed

[Emoo]

NHS Employers are proposing to freeze incremental pay progression for all staff groups, see here, and are in negotiation with the unions, see here and here. In return NHS staff would get "a commitment to provide a guarantee of 'no compulsory redundancies' for as many staff as possible".

This is in fact a pay CUT, with the burden preferentially falling upon those lowest on their salary scales. This would include nurses, doctors, allied health professionals, pretty much everyone working in the NHS. The only people unaffected are those already sitting comfortably on the top of their salary scales.

This comes on top of the 2-year cost-of-living freeze already imposed, representing a 3.3% per annum cut in real terms (using most recent inflation estimate).

Details of the proposal are not readily available, and the information below is based on an interpretation of the sketchy information provided.

For those of you who don't know how NHS pay works, here's an example. A newly qualified nurse gets £21,176. Over 8 years, their salary would gradually step up in annual increments to £27,534, reflecting their increased experience in the role. They would then remain on this salary unless they took on a different role with significant additional responsibilities. The recent proposals would mean that the nurse would earn £21,176 for an additional 2 years, and be 2 points behind on the payscale thereafter.

For a typical nurse, this would mean a cut of ~4% (compared to expected pay) in the first year, then ~7% thereafter until they reached the top of their scale.

I should point out that these increments are currently written into the contracts of NHS staff; they are not 'bonuses', and employees will have based their long-term financial planning on the expectation of getting them.

For newly qualified doctors and midwives, the situation could be even worse; midwives generally start on £21,176 and doctors on £22,523. Their second year pay would normally be ~20% higher, reflecting the transition from supervised to independent practice.

To me, it seems unfair and immoral that:

1. a pay cut is being termed a "freeze".
2. it preferentially affects those who earn the least.

What do others think?

Siasl - when the NHS went through agenda for change staff took a pay cut moving from the old pay scales to the new ones. But it was promised that there would be increments to progress through the bands to a defined limit partly to compensate for this.

But its not about increasing pay due to longevity. But people who have worked there longer increase their skills, do more work and take on more responsibility and are rewarded for that. When I was at the bottom of Band 6 I could just do my basic job but since then have learned loads of extra skills such as cannulation, suturing, I often co-ordinate the ward. I'm constantly improving my skills such as getting signed off to give IV drugs, etc. So yes I would expect that a more senior/expereienced member of staff recieve more pay than someone who's been qualified a year.

VivaLeBeaver - that is precisely what is being proposed.

Please note - the increments exist in all public sector jobs - teachers, military, civil service, universities... They are usually cost-neutral overall because people retire from the top and are replaced by those at the bottom.

They are not simply for "longevity" as some have suggested. They are to reflect the increase in experience and/or responsibility.

Take for example the doctors' specialty training incremental payscale, which starts >2 years post-graduation. Someone would start on this typically having had 0-4 months' experience of that particular specialty since leaving medical school. By the time they reach the top point on the scale, they would have consultant-level knowledge and experience, having passed ~3 further postgraduate exams, and attended countless educational courses (none of which are funded by employers/taxpayers).

Sorry, X-posts - I meant to clarify that stopping incremental progression is precisely what is being proposed.

And there is a ceiling to the increments, it doesn't keep going up for ever. So say someone is on Band 6 which is roughly 21-29k a year (not sure of exact figures). They will get several yearly increments till they're at 29k. They can't go higher than that unless they go up to Band 7 which would mean a different job.

I work in the NHS and I have to say I'm just thankful if I keep my job.

The hospital I work in is a mental healh unit, used to have 4 acute wards and an intensive care unit. Now down to 2 acute wards and the intensive care unit, all staff on the other acute ward have been told their jobs are at risk. This pattern of ward closures and jobs threatened is repeated across the very large trust.

I feel for the people doing their nurse training at the moment. There will be few jobs on offer when they qualify

To be honest I dont know the details of how public sector pay bands work (I'm in private sector) so I'm happy to be corrected on this.

I think the bottomline for me is that I don't necessarily feel that nurses should take a pay cut (GPs are another matter!). However, i would like nurses to lose their final salary pensions since that is creating big problems for the UK in the future. In fact I'd argue that if they moved to defined contribution pensions they should get a pay rise to compensate. This would save far more money over the long-term and stop the public sector funding their retirement out of my DD's future!

Viva - I think it's because although there may not have been top-line cuts it costs more and more every year to provide an NHS - bigger and better treatments which cost more, an aging population who are living longer and so getting more diseases etc. Not long ago someone would have had a heart attack at 60 and died. Now they are on statins from 45, perhaps still have a heart attack at 60 - but it's treated so they do't die. Expensive surgery, post op drugs etc. Then they live well into their 90's with all the other health problems that brings.

Also - NHS have to make "effiency savings" of 3% each year - and there's no fat left to cut out.

Siasl - the final salary pension scheme for new entrants has already gone. It went 3 years ago, I just missed out on it by about 2 weeks. A cohort member of mine who's CRB came back quicker just got it and we qualified at the same time.

I suppose I feel very shafted at the minute. My SUrestart job has gone so I've lost 2 days a week, I'm effectivly having a 4% pay cut every year dut to no cost of living payrise. If they freeze increments that'll be about a 10% or more pay cut every year on the 2 days a week I've got left. Though obviously as I've lost 50% of my job i personally will be having a 60% pay cut. We're more short staffed than ever at work so the stress is greater.

And I know the private sector have it bad, it looks like DH will be made redundant in the New Year.

And they've changed teh salary scheme from been based on the Retail Price Index to the Consumer Price Index or the other way round - which ever one means they have to pay out less. I read it means that it'll mean the pensions are worth about 12% less.

Please rememebr its not all fat cat managers, there are a lot of Health Care Support Workers, porters, and bottom of the rung nurses affected.

DH's salary has been frozen for the last 2 years; he's expecting his incremnents to go next year.

I personally feel that the Clinical Excellence Awards to doctors should be scrapped. They get an extra £500/month if they demsonstrate they are doing something vaguely new, yet any other staff group associated with the change get nothing.

Example - under the direction of my head of section (we're in lab NHS genetics) we've devised a database linked to the human genome map that allows clinicians to map cases of unusual genetic mutations. We're postulating that it may allow improved prognosis and planning for children. We get fuck all recogniution for this, but the clinician could put in for a CEA, and would probably get it.

Doctors also get Waiting List Initiative payments for extra clinics. DH, for example, is popular with GPs, so his waiting list is pretty huge. every couple of months he'll get paid to do extra clinics (usually 2) and gets £400/clinic, that's a half day). The out-patinet nurses and, mor importantly, his secretary get nothing. DH gives a his secretary a cash bung at Crimbo, most consultants kepp it and some (hardly any) give the cash straight back to their dept.

I think that paycuts were common in the 1930 depression. But then there was price deflation which compensated, so that those who were in work found life cheaper anyway. It feels now that life is going to get more expensive, not cheaper.

I feel sorry for graduates. There won't be jobs for them. Especially in teaching. We have too many primary school teachers as it is.

Lots of people in the private sector have taken a pay cut.

Does anyone think that nhs pensions, that are already being paid, might be cut?

In Latvia, teachers took a massive pay cut.

They are not simply for "longevity" as some have suggested. They are to reflect the increase in experience and/or responsibility.

As it stands, it appears that the increments really are automatic based on years of service though. 'increments' should not be automatic, there should simply be promotions iup a ladder based on an individuals increase in skills and responsibility.

Emoo - I totally agree with your central point.

"My point, perhaps not well made, was that we are clearly NOT "all in this together".

The proposals will hit people randomly, according to where they happen to be on their salary scale. These "incremental freezes" are pay cuts, unfairly distributed, leaving senior managers and senior consultants unscathed."

This is hapening time and gain across the public sector with people at the top end of the scale and the already retired on generous pensions suffering no cuts at all but new and young employees being forced to face cuts and adverse chages to benefits and employment contract terms.

We need to cut the deficit but we need to start cutting pay and salries from the top. I am disgusted about the way the Coalition are implementing the cuts.

Frankly, I just think they are doing the calculation each time how to avoid upsetting the older baby boomer generation of vested interests and land the cuts on the young.

Public sector senior managers, high paid consultants and quangocrats both current and retired have to have pay and benefits cut dramatically. The lower levels will have to take some pain but as a percentage far less than the upper levels.

Clearly we are not in this together. I really thought better of Cameron and Clegg. I didnt vote for a Coalition but I did vote Tory and had high hopes when Cameron put it together as a real Govt of national unity.

Not now though.

Problem is is that people will leave as pay/benefits and conditions worsen. I've seen a lot of newly qualified staff walk away all together as its so stressful in a way it wasn't only a few years ago.

I'm looking at alternatives and stuff like this makes me more likely to go. There is an administrator job advertised for the same salary I'm on now. Which is a bit sad really when I've done a 3 year degree in midwifery and have life and death responsibility for people. But I can earn teh same "providing office support, carrying out research activities and preparing high quality reports". Seems a bit wrong.

Can someone explain to me how not having an increment is a pay cut? Your salary from one year to the next is the same. I appreciate that inflation means that you have less purchasing power than the previous year, but to call it a pay cut is a bit disingenouos (sp?).

I'm NHS and understand the ins and outs of Agenda for Change etc., but have to agree that people get annual increments for doing the same job. In theory their knowledge and experience increases, but they're still doing the same job. The befits in the NHS are still second to none IMHO, 5-6 weeks annual leave, six months paid sick leave etc. Lots of people in the public sector have never worked for themselves or in the private sector and have no idea what it is like in other areas.

The biggest problem I think is that the NHS doesn't really make people redundant, they just redeploy or ringfence future vacancies. This means mediocre people just stay in the system year and year. I'm working on a theatres efficiency project at the moment and when I try and get some of the staff to feedback, they say well so and so is difficult but she'll retire in a few years which will help. Seriously? We're letting people be crap and negative, but tolerate them until they retire on a final salary pension. That's so unfair on the staff who are committed and bust a gut.

Needless to say I am a manager .

I am a doctor (and I know many of you think we are overpaid but bear with me). We normally would get a pay rise with inflation as with the rest of the country and it is entirely fair that this is frozen along with everyone else given the current financial climate.

However the increment freeze is crazy.This year I am an SHO. I am constantly supervised pretty much and always have someone to discuss problems with. Next year I would be a registrar. That means that outside 9-5 mon-fri I would be the most senior doctor in my speciality in the hospital. To do that I would have had to pass exams (that I paid for). I would be making huge decisions, supervising juniors and taking massive responsibility. Surely that deserves some pay increase?! If you worked on a check out and were asked to become the manager with all the responsibility and no pay rise would you say fine no problem?

And to the person who said everyone would not just walk out, actually a lot will. I am personally going to Australia along with a large proportion of my colleagues where we will get better training, treated like human beings and not get people trying to illegally break our contracts!

There is no way I'm doing the same job that I was a year ago. I now co-ordinate a 40-bedded ward on my shifts. So full responsibilty for the ward. I think that deserves an increment. And freezing cost of living pay rises is a pay cut in real terms and that is how it is always referred to by the media, etc.

Agree with Adelaide girl - I know 2 people who have gone to NZ and 6 who have gone to Australia in the last 3 years from a fairly small unit. Add those to the ones who have given up on the job completely then the NHS has a problem. Our unit went through a stage of not having the money to recruit and now it can't find any staff prepared to work there. The jobs are there and there are no applicants. Not very good at all.

A significant amount of the previous pay rises were to try and counteract the amount of bleed from the NHS to other countries, and to keep encouraging clinicians from overseas to come to the UK (we've always relied heavily on overseas clinicians and it is an international market where skills are relatively easily transferable if there are shortages).

In any case the central premise of that NHS Employers case is wrong. Cutting pay won't protect jobs, the two are unrelated. Over the next few years there will be significant job losses regardless of pay as large chunks of the NHS are being disbanded and lots of people will lose their jobs or have significant uncertainly for several years at best.

Sure the private sector is having a horrible time too, but dishonest statements help no one. Personally I was never totally sure about the increments, but AfC bands are so wide that far few people get promotions, so the increments really matter and compensate for significant changes in people's roles.

The NHS budget is being axed so it is inevitable that there will be fewer jobs (10 % of jobs at least are going at my local hospital ) and that pay will be axed; increments are the obvious next thing to go.

I agree that politicians are not being very honest about this, but after all they are politicians, non? It's up to us to read between the lines. And no none of it is very fair but there's not much can be done about it IMO.

My income has fallen significantly already - by almost 10%. I think huge numbers of people will inevitably find themselves worse off over the next few years, we ain't seen nothing yet.

I don't mind a pay freeze as that applies to all staff. But a increment freeze means will only apply to a portion of the staff.

I have 6 years experience as a nurse, but because I left for a while to bring up my children I had to start at the begining again. I am now at the bottom of the Band 5 payscale. I was prepared to take this knowing that over time my wage would increase to a reasonable level. If the increment freeze happens I will stuck on the lowest band, for however long.

In the future it will be unfair that after several years work that staff that do exactly the same job will be on different wages only due to their bad luck to start a job in 2010/2011.

QueenofWhatever..

It is a pay cut because it is less than people were expecting to be paid.

It is a pay cut because it is less than people are contractually entitled to be paid.

It is a pay cut because people in the future doing a particular job with a particular level of experience/skills/responsibility will be paid less than the equivalent person doing the job this year.

It is a pay cut because it will reduce the overall NHS salary bill for the same amount of work done.

I would argue it is disingenuous to suggest it is anything other than a pay cut.

Quoting QueenofWhatever:
"The biggest problem I think is that the NHS doesn't really make people redundant, they just redeploy or ringfence future vacancies. This means mediocre people just stay in the system year and year. ... That's so unfair on the staff who are committed and bust a gut."

I think you've argued yourself into a hole here.

If the above is what NHS managers believe, WHY ON EARTH do you seem to be supporting a proposal that protects the mediocre people from redundancy, whilst punishing the majority of 'staff who are committed and bust a gut'? Makes absolutely no sense to me.

As for increments being given for people "doing the same job", I think others here have eloquently stated why this is categorically not the case.

If this goes through they're going to find it causes a lot of problems. I for one will refuse to co-ordinate the ward, I don't have to, its not in my contract and if I'm bottom of Band 6 I don't see that I should take that respnonsibility. I also won't complete my IV package that I'm currently doing in my own time, nor will I finish my mentorship course that I spend hours of my own time doing and I won't start any other extra training packages such as newborn examination course that I'm meant to be doing.

This is all stuff the NHS wants me to be able to do as it saves them money. If I can do it a more expensive Dr isn't having to do it.

I won't be flexible about my shifts like I am at the minute, ie; swapping shifts at the last minute or doing extras to cover sickness. I won't be staying late when they're busy/short staffed.

Patient care will be the main thing that's affected but to be honest people are getting to the stage where they're going to stand up for themselves and put themselves first ratehr than continue to be walked all over.

There are many people in the private sector who are being promoted to more senior positions without a pay rise. People are accepting that because it is a way of guaranteeing they will stil have job next month

The plain fact is that public sector automatic incremental pay rises have to stop. The top end of the public sector seem to like to compare theselves with the private sector when it suits them to negotiate a pay rise but seem to become forgetful about the generous benefits and job security they get that the private sector dont get.

On the issue of doctors gong to NZ and Australia. The first thing to say is that this has always happened as a way to increase experience. Many go for a few years and then intend to come back. The other more important reason is that the NZ and Aussie dollar are both extremely strong currencies at the moment. I happen to know this as I have been looking at academic jobs in NZ as we are emigrating there in July. The pay levels do look quite a bit better than the UK for equivalent experience levels becuase of the currency effect.

In a few years that currency effect will reverse and doctors will no doubt flood back from NZ and Australia to the UK. Will the NHS then cut doctors pay to take account of that currency effect? I very much doubt it.

The top end of the medical profession is a closed shop. Hence it is easier for them to negotiate higher pay. I have heard it very difficult if not virtually impossible for say Eastern European doctors to get jobs here even though they are well qualified. I know my German doctor friend could not even get a job here even though she was a specialist in gastrology in Germany.

Dont get me wrong, I am grateful for the treatment I have had from the NHS and there are many commited NHS staff but their pay should be subject to budgetry and market forces like every one else. That constraint has to start at the top though and has to include management grades. I dont want to see the lowest paid NHS staff taking all the pain and strain.

(Latvian teachers took a 30% pay cut)

I know this is nhs, but I am thinking about teachers and other state employees.