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?

But we can still afford billions for the olympics and a World Cup bid.

I'll second that thought. I have no idea why the last Govt and the current Govt are so desperate to spend tax payers money on loss making sports events when we are trying to save money buy cutting things like child benefit.

"But we can still afford billions for the olympics and a World Cup bid"

Very different things....

Paying for the Olympics is a bit like treating yourself to buying something on a credit card, it's a one off expense. Plus there's a good chance that it might also turn a profit both directly and through the financial benefits of regenerating some very run down areas of London.

Wage bills are a continual expense and relying on borrowing money to pay them is a bit like using a credit card to pay your monthly bills, not very clever basically.

The Government has been living beyond it's means for years and it has to get the normal day to day expenses back within it's normal income.

Emoo

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.

I'm unclear what proposal you think I'm supporting?

Also the intial point of increments was that people had to demonstrate they were getting better in order to get it - KSFs and gateways after appraisal etc. The reality is that virtually no trusts are really applying it this way and increments happen automatically. I love the fact I get more money every time I pass the 1st October, but is it deserved? No-one checks, I've had one and half appraisals in six years, yet six increment increases.

adelaidegirl if you are moving from being an SHO to a registrar, I thought you had to apply for a registrar job and go through a recruitment process. Is that not the case?

Apologies, Queen, reading between the lines of your original post, I had assumed that you were in favour of the increment freeze proposed by NHS Employers. You did not actually state that. I am wrong .

I'm frankly alarmed (but sadly not surprised) at the fact that an NHS manager has so little idea of the realities of what is going on in their workforce.

Just because managers get their increments with 1.5 appraisals per 6 years, it doesn't mean that the same applies to the rest of the workforce.

Junior doctors, for example, have regular meetings with educational and clinical supervisors, where their progress is discussed in detail, and the doctor is required to keep an electronic portfolio containing evidence of any assessments, observed clinical encounters, peer-feedback, courses attended, exams passed, new skills learned, teaching done, audit, research, etc. etc. This is extremely time-consuming, and done outside of paid hours. If the doctor is not progressing at the expected rate, a plan is agreed to remedy this, and the doctor may have to jump through several hoops to prove that improvement has indeed occurred. It is a much more thorough process than annual appraisal. The aim is that the majority of doctors get through this process successfully, because improving their knowledge, skills and clinical decision-making is ultimately what is best for patient care. At the upper end of the specialty payscale, increments can indeed be withheld if there is no evidence of satisfactory progression.

As of 2007, and the introduction of 'Modernising Medical Careers' and run-through training, the SHO-registrar pathway has been renamed 'specialty training' and doctors at all levels of this pathway are on the same incremental payscale, which takes people from >2 years after graduation to just before consultant level. However, the rotas still usually refer to SHOs and registrars for convenience, because their roles and responsibilities are very different. For some specialties, there is no requirement to reapply at 'registrar' level providing that the doctor can demonstrate they are exceeding the required performance standards (see paragraph above). For other specialties, there is a further competitive recruitment process 2-3 years into the pathway.

If you are not aware of these changes, which were after all only implemented just over 3 years ago, you would do well to google it.

I would suggest that consultants and GPs should bear the largest pay cuts because someone earning £100k plus can clearly take a £20k pay cut without being on the breadline. For NHS employees earning say £25k a 10% cut of £2.5k could potentially have a serious impact on their family lifestyle.

I just don't buy into the line that consultants deserve to be paid such a HUGE amount more than nurses deserve to be paid.

I don't think SHOs earn excessive pay but I do think that consultants and GPs do. I agree they often do a great job, are highly skilled and have high levels of responsibility but do they really deserve the level of pay that the NHS provides from our tax revenues whilst others are working just as hard and struggling so much more?

"I would suggest that consultants and GPs should bear the largest pay cuts because someone earning £100k plus can clearly take a £20k pay cut without being on the breadline."

That sounds like the politics of jealousy.

People live according to their means, a 20% cut to someone's income is going to quite obviously "have a serious impact on their family lifestyle".

I doubt that people earning that much money have that 20% sluicing around their ankles every month and can just afford to see it vanish. No, they've got mortgages, loans and bills to pay just the same as everybody else.

So if you're going to protect people from cuts that "have a serious impact on their family lifestyle" you've got to protect everybody. You can't just say that once you earn over a certain amount your family lifestyle is fair game.

As said, that comes across as jealousy.

You can dismiss as jealousy if you like.

I would simply say that it is wrong for the state to value the work of doctors at such a high multiple as compared to the work of nurses.

Of course people live according to thier means but my view is that the gap between rich and poor is far too wide and that our whole society is the poorer for it. If you personally are one of the beneficiaries of this gap then I wouldn't expect you to agree with me.

FattyArbuckel
"I would simply say that it is wrong for the state to value the work of doctors at such a high multiple as compared to the work of nurses."

Junior Nurse starting salary: £21,176
Junior Doctor starting salary: £22,523

Nurse consultant starting salary: £54,454
Doctor consultant starting salary: £71,000

Really such a huge difference?? Particularly given the very different roles and responsibilities. Get your facts straight before uttering nonsense.

And whilst I'm at it, why are the salaries of doctors always compared to nurses (usually in The Daily Wail); with doctors being the evil fat cats, what with their Mercedes and all.
They are very different jobs; we work together in a team in the same hospital, but are not interchangeable.
Why do we never hear of the salaries of pharmacists compared to porters, or radiologists to HCA's??

Rant over.

Consultants earn over £100k excluding private work - fact - I'm not sure what you mean by "doctor consultant???"

Number of nurse consultants at our hospital (ie nurses earning >£50k - fewer than 10 - so few of them that it is pointless talking about them really)

Most consultants and GPs earn > £200k - fact

I have already said that I do not think that Junior doctors are overpaid

I would quite happily say to you that I think consultants are paid too much in comparison to HCAs

Nobody thinks doctors are evil, its just that a society that values the work of a consultant 5 times as highly as the work of an HCA is dysfunctional in my view.

Clearly if you are on one of these super high salaries you are going to be protective about it

clearly FattyArbuckel, you spend too much time reading the daily wail and too little actually considering the reality of the NHS.

If you really think 'most' consultants and GPs earn over £200k then you are sorely deluded.

Additionally, why shouldn't a consultant be paid more than an HCA - I'm not sure that to be an HCA (although a highly valuable job) you require 5 years of full time specialist training at university, membership and fellowship examinations, expensive GMC and speciality college membership, and, oh yes, taking FULL responsiblity for patient care. I think you'll find that that's something only a doctor can do.

the ability to make life and death decisions for human beings takes years of experience, and huge amounts of personal sacrifice.

Unless you have done the specialist training, and know the reality of giving up your life in order to to provide patient care, often to the detriment of friends and family, you're really not qualified to comment on this issue.

Since it is my job to know what nhs professionals earn I am certainly qualified to talk about it.

As I have said all along, it's not my opinion that HCAs, nurses, consultants etc should all be paid the same, rather that the difference between the salary of a consultant and an HCA is far far too great and that society is the worse for it.

I don't read the DM btw

zhivago your post was slightly patronising. If you have been working with primary care and building up provider services etc., Modernising Medical Careers will not have had such a big impact. The NHS workforce consists of a lot more than hospital doctors.

fattyarbuckel I actually think a consultant should be paid about 5 times more than an HCA. Both are valuable jobs, but utterly different. Also most consultants and GPs I know do not earn £200k. You say it is a fact, please show us where it comes from.

"You can dismiss as jealousy if you like."

Well I'll dismiss it as something because it's quite clearly nonsense.

Saying that someone on £25k can't have a 10% cut because it "could potentially have a serious impact on their family lifestyle" while suggesting a 20% cut for someone on £100k means that either:

A) You haven't considered that a 20% cut will definitely "have a serious impact on their family lifestyle", the excuse of ignorance and lack of consideration.

Or

B) You know full well that it will "have a serious impact on their family lifestyle" but you don't care about them, the excuse of victimisation and jealousy.

"If you personally are one of the beneficiaries of this gap then I wouldn't expect you to agree with me."

It would be nice to be able to dismiss the objections to your plan as being self interest, but unfortunately it's not true. I earn no where near that much money and wouldn't be affected by any pay restructuring within any public service yet alone the NHS in particular.

So if anything I should support this idea, it doesn't affect me or my families lifestyle and it will reduce the costs I face as a tax payer.

However I will not allow ignorance, lack of consideration, victimisation or jealousy to guide how I think the public sector should deal with it's salaries.

I'm very concerned if it's your 'job' to know what NHS professionals earn that you're stating blatant untruths about earnings.

Either you're pretending to be an authority in this area to try gain the upper hand, or you have been given information that is false, and more worryingly, believed it without researching facts.

Either way, the real issue here is that this governmental tactic is just another way to push through the privatisation of the NHS. The politics of it will probably pass most people by as it's been well padded in the White Paper, however it's a real threat.

Is this any different to what happened to privatge sector workers who suffered paycuts? Can't remember any outrage from anyone when me and my colleagues lost 10%. But then we weren't unionised...

Maybe you should have been?@ Widow...if you don't stand up for yourself who the heck is going to stand up for you?

Look at the department of health website
consultant basic nhs salary £75k to £100k
add up to 2 additional PAs (another 20% of salary)
add clinical excellence awards can be up to £75k extra
add private work £100k plus

What element are you challenging, whyohwhy?

Also add in up to 8 discretionary points at £2,700 additional salary for each point

Sorry this has been old news outside of the NHS for some time.

My dp was promoted 2 years ago and still not had his promised pay rise. It's shit but it's going on/has been going on everywhere. Just because it's the NHS doesn't mean it's more shit.

It's just the way it is and it's tough basically-the message most people in all sectors are having to stomach at the moment.

Maybe NHS workers are fortunate that they're only just beginning to feel the bite many others have felt for some time.

Badger I respect your right to hold a different opinion to me but I happen to think that the extent of the rich/poor gap in this country is a major problem.

If you choose to dismiss this opinion as jealous, ignorant, victimising and Inconsiderate then that is your perogative.

this is interesting as I raised this possibilty at work and was roundly shouted down - sadly i appear to be instinctively correct. I have never quite believed the promises and pledges made by political parties (not bitter just very pessamistic! mainly as (as we have seen over recent months) words tend to mean nowt compared to actions.

Dont get me wrong- I am very grateful for my job and I hope that I provide a good and vital service but I do worry about the future of health care services.

Most NHS workers do want to provide the best patient care they can. If frontline staff are not replaced (through `natural wastage') services do get spread more thinly which ofcourse can affect service delivery. You never know the value you may place on a service until you are in need of it. Dont forget we have an ever growing and aging population that will access health services and that will mean that we will need the staff available to deal with such a demand.

I also worry that public services are more closely interlinked than we may realise. A cut in one service may have an adverse effect on another serivce that we may not be aware of. For example if the social care and support is not in place an elderly person may fall/become malnourished/become unwell therefore need to access a related health serivces which could have been prevented.

We need to maintain good quality staff in the NHS and reasonable terms and conditions are all part of good business. The NHS has a structure in place for regular appraisals and `performance management' reviews to ensure it is meeting care standards and this should continue and should be enforced.

for what its worth I am due to draw my pension in 28 years time - somehow i doubt if I will be eligable for anything and if it will still exist by the time i get there.