Thank you for contacting me about industrial action being undertaken by staff in the NHS.
The independent pay review bodies provide a recommendation on the level of pay for NHS staff, doctors and dentists and the Government has accepted their recommendation in full.
The Independent Pay Review Body process is the established mechanism for determining pay uplifts in the public sector, including for staff working in the National Health Service. The Pay Review Bodies consist of industry experts which consider a range of evidence when formulating its recommendations, including the cost of living, inflation, recruitment, retention, morale and value for the taxpayer. The Bodies receive evidence from stakeholders, such as the Government, NHS system partners and trade unions. The Government then considers the recommendations of the Pay Review Bodies before responding. I am pleased that in 2022/23, the recommendations were accepted in full and backdated to April 2022.
This means that over a million NHS staff will benefit from another pay rise this year on top of the three per cent increase they received last year when pay was frozen in the wider public sector. Staff including nurses, paramedics and midwives, will receive a pay rise of at least £1,400 with the lowest earners set to receive an increase of up to 9.3 per cent. Doctors and dentists will receive a 4.5 per cent pay rise.
The NHS’s workforce, which includes nurses and paramedics, has received a cumulative pay rise of over 18 per cent in the last five years while consultants have received a cumulative pay rise of around 15 per cent. The average nurse’s salary has increased from £32,385 in 2018/19 to £37,000 in 2022/23.
Governments must deal with the world as it is. Pay claims, however justified they might be, have to be seen in the context of a difficult world economic situation and the need to ensure that the UK economy is powering ahead again so that we can pay for the public services we all want and need.
In the last two or three years, fresh problems have arisen in the global economy including the return of inflation as a problem, and, of course, the pandemic and the measures judged necessary in response to it and Putin's barbaric war against Ukraine have added massively to the economic instability of recent times.
Every economic, financial or fiscal measure has costs as well as benefits: especially in the current world economic climate, the balance needs to be carefully judged. Moreover, every increase in spending in one part of the public sector needs to be paid for at the outset and into the future and the implications for spending elsewhere considered in depth.
Pay should deliver value for the taxpayer and we must be be careful not to drive inflation even higher. The independent pay review bodies take into account a range of factors when determining pay uplifts including cost of living, recruitment and retention. The Secretary of State for Health and Social Care has formally commenced the 2023-24 pay round and wrote to the Chair of the NHS Pay Review Body on 16 November to ask for recommendations for the Agenda for Change workforce from April 2023.
Nurses
Let me start by saying that I am extremely grateful for the dedication of nursing staff in very difficult circumstances over the last three years.
During the pandemic, nurses were on the frontline of caring and treating for patients affected by Covid-19, and we owe every nurse a debt of gratitude for the care they provided.
I appreciate that the challenge of working in the NHS during the pandemic, and through the current period when the demand for patient care is very high, has taken a significant toll on nurses.
And I am fully aware that the last few years have amplified existing challenges in the nursing workforce, such as the ability to retain experienced nursing staff to continue working in the NHS.
Extending flexible working is one way to alleviate these challenges in a number of different professions, so that NHS staff have greater choice over their working patterns and achieve a better work-life balance. It is important that local NHS bodies follow guidance from organisations like NHS Employers and the NHS Staff Council in this area.
In relation to NHS pay more broadly, the Government fully recognises the cost-of-living pressures facing NHS staff, and this is reflected in decisions about pay increases.
Recommendations around pay for nurses are made by independent pay review bodies, who take into account a range of factors including the cost of living, recruitment and retention.
This year, most nurses have received around a 4-5 per cent pay rise, dependent on where they are in their band.
Full-time basic pay for newly qualified nurses starting at the bottom of Band 5 will increase by £1,400 – equivalent to a nearly 5.5 per cent pay rise – to £27,0255 from £25,655 last year. This means that newly qualified nurses will typically earn over £31,000 a year including overtime and unsocial hours payments. More experienced nurses at the top of Band 6 will see pay increase by £1,561, to £40,588 from £39,027 last year.
Ultimately, it is a decision for nurses to decide whether to take industrial action. However, whilst I sympathise with the issues facing the nursing workforce, I cannot support the proposed industrial action because of the potential impact on patient care.
I note that Labour's Shadow Health Secretary has also so far refused to commit to pay rises for nurses above the Independent Pay Review Body's recommendations.
Junior Doctors
The passion, commitment, and specialist knowledge of our junior doctors, is part of what makes our NHS so special.
This is reflected in the pre-existing multi-year pay and contract reform deal agreed with the trade union in 2019 and due to end in March 2023. The upcoming pay round is the appropriate time to discuss pay when the multi-year deal ends.
By the end of the current deal, all junior doctor pay scales will have increased by 8.2 per cent. Around £90 million is being invested to reform the contract, including the creation of a new, higher pay point to recognise the most experienced doctors in training.
This package also provides funding to enhance eligibility for night shift pay and increased allowances for those working the most frequently at weekends. In addition, a new £1,000 a year allowance will be available to support training for junior doctors working less than full time.
It should also be noted that salaries for all trainee doctors were increased from 1 April 2022.
While I note your comments around the inclusion of junior doctors in the pay review process, I understand the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) has not been asked to make a pay recommendation due to the current multi-year agreement in place.
Ultimately, it is a decision for junior doctors to decide whether to take industrial action, however, whilst I sympathise with the issues facing junior doctors, I cannot support the proposed industrial action because of the potential impact on patient care.
Ambulances (Strike Action and Waiting Times)
I recognise that ambulance services are strained.
The Government is working to reduce ambulance waiting times and took strong action to prepare the NHS for this winter. NHS England has allocated an additional £150 million to address ambulance service pressures in 2022/23 and support improvements to response times through call handler recruitment and retention.
The Department for Health’s policy paper ‘Our Plan for Patients’ outlined the aim of increasing the number of call handlers in NHS 111 and in 999. This will help with the answering of 111 calls and dispatch of ambulances for those in greatest need following a call to 999.
The Government is focused on delivering shorter response times for Category 1 and 2 incidents, enabled by quicker handover of patients so ambulances can get back on the road and respond to 999 calls.
This objective is being backed by a plan to train and deploy more paramedics, and Health Education England has been mandated to train 3,000 paramedic graduates nationally each year, which is double the number of graduates accepted in 2016.
Furthermore, the Government has agreed a £30 million auxiliary contract with St John Ambulance to provide surge capacity of at least 5,000 hours per month to help bring down ambulance response times.
Action is also being taken to reduce the time it takes for ambulance handovers once patients reach hospital. Waiting times for transferring ambulance patients to A&E will be reduced as facilities are upgraded and the NHS increases capacity by at least 7,000 general and acute beds.
Ultimately, it is a decision for ambulance workers to decide whether to take industrial action. However, whilst I sympathise with the issues facing ambulance workers, I cannot support the proposed industrial action because of the potential impact on patient care and ambulance response times.
Please be assured that the Government fully recognises the cost-of-living pressures facing ambulance workers, and this is reflected in decisions about pay increases.
The Government makes decisions on annual pay increases for ambulance workers based on the expert advice of the independent NHS Pay Review Body. In making their recommendations, the NHS Pay Review Body considers a range of factors including the cost of living, recruitment and retention.
Before Christmas, my colleague Steve Barclay, the Health Secretary, repeatedly called on ambulance providers to respond to category 2 calls, including incidents of stroke, during strike action in December 2022 and January 2023. Regrettably, it has not been possible to secure agreement for this at a national level, and the availability of ambulances to respond to category 2 calls during the strike was dependent on whether there is an agreement between unions and the local Ambulance Trust in place.
Whilst the dispute continues, the Government remains committed to keep talking with the unions to resolve these issues, as well as working with the NHS to improve patient safety and reduce ambulance response times.
General Practitioners' Pay
The pay for salaried General Practitioners and doctors and dentists in training has been agreed in multi-year pay and contract reform deals. This means that the Doctors' and Dentists' Remuneration Body (DDRB) was not asked to make a pay recommendation for 2022/23 for these groups. The DDRB was, however, asked to provide recommendations on the minimum and maximum pay ranges for GPs. It recommended that the range increase from £62,268 to £93,965 in 2021 to £65,070 to £98,193 in 2022.
Thank you again for taking the time to contact me.
Craig Whittaker MP
January 2023