On March 4, following the budget announcement, the Department for Health and Social Security (DHSC) revealed that it had recommended to the NHS pay-review body only a 1% lower than inflation increase for NHS staff for 2021-2022 [1]. This decision follows an upsurge last year of health workers against pay inequality, when the government gave an above-inflation pay rises to 900,000 public workers but not health workers [2]. Now, the government says they will "wait for the response from the independent pay review bodies before we announce the pay settlement".

In the days following the announcement there has been increasing opposition from health workers and their trade unions that this not only fails to recognise the contribution of all health workers during the pandemic, but also, because the government has recommended a lower than inflation pay offer, the pay "increase" will amount to a cut in pay for NHS staff in real terms. In addition, the government has now frozen the pay of other public sector workers. To add insult to injury, all the carers and those playing a vital role in the pandemic have had their pay and conditions ignored as well.

Speaking out in opposition, one health trade union branch pointed out in their post that it was the people who have been taking up responsibility for the health care team and not the government. "The 1% pay offer for NHS staff is disgraceful. It's a missed opportunity to recognise the work of all NHS staff throughout the pandemic. We are ONE TEAM and we all play our part. Our amazing Nurses would be the first to say they couldn't do their job without the rest of the support team behind them. Domestic, Porters, Catering, Administrative, IT, Supplies, Estates, Medical Records staff and many, more. Not forgetting our Human Resources and Occupational Health staff who have supported all staff throughout this crisis. The public has gotten behind the NHS staff with gestures of kindness hand cream, chocolates, coffee, pizza and much more. This Government offer is equivalent to one cup of coffee per week!"

The recommendation by the government to the Pay Review body covers some 1.5 million health staff in NHS England, Scotland, Wales and the north of Ireland. The recommendation does not cover over 160,000 staff who work for agencies, or who have contracted out employment. It also does not cover an estimated 1.65 million staff working as carers in care homes and in adult social care. Doctors, dentists and very senior managers in the NHS have separate pay review arrangements.

The recommendation says that, during the pandemic, "the government announced a pause in public sector pay rises for all workforces, with an exception for employees with basic full-time equivalent salaries of £24,000 or under and for the NHS. In settling the DHSC and NHS budget, the government assumed a headline pay award of 1% for NHS staff. Anything higher would require re-prioritisation." Whilst the government claims that this is because Covid-19 "has placed a huge strain on both public and NHS finances", it is in reality a direction of using "both public and NHS finances" to pay the rich that is the issue. The present and previous governments have cut NHS services and public services whilst contracting out more and more services to private corporations. During the pandemic, this has seen vast sums being paid out to private individuals and corporations, private interests which the government have been keen to include more and more in the health and social care system. This i s the capital-centred prioritisation that the government is following and which it is trying to justify over their lack of investment in the human resources of a publicly provided NHS service.

In fact, on March 8, Helen Whately, who is a Minister of State at the Department of Health and Social Care, in answering an Urgent Question on NHS pay in the House of Commons, could only taunt the Opposition as to what their priorities would be in funding a pay rise for NHS staff. Only Jeremy Corbyn, now an independent MP, really highlighted the necessity to pay NHS staff properly and highlighted the scandalous payments to private corporations. He said: "Nurses have seen us through this crisis and have saved many lives, yet they are offered a pay cut as a result of it. Some are already having to resort to food banks to survive, and a third are thinking of leaving the profession unless they get a decent pay rise. Surely to goodness, if £37 billion can be found to pay Serco for a failed track and trace system, the money must be available to pay NHS staff properly."

That the government's thinking was in a completely different direction was reflected in the Minister's answer to Kevin Hollinrake, a Conservative MP, who said that "every 1% increase will cost the taxpayer £750 million" and how would the government pay for that and health and social care. He suggested it should be done by means of a "German-style social care premium" [3]. The Minister replied that the government would indeed "bring forward proposals for social care reform" and that Hollinrake "is absolutely right that we also need to look at the whole health and social care system as we consider these difficult questions". In other words, the government is already planning further tax hikes and other ways of charging to pass the burden of the crisis onto the people, whilst they continue to pay the rich. They are also planning to push through further legislation on the NHS as set out in the government's NHS White Paper [4] which has the same aim.

These latest developments have done nothing to alleviate the concern among health workers about the conditions they face, their well-being both before and during pandemic with their jobs and the services they provide. Health workers have made so many sacrifices to provide the best possible health care under the circumstances of the pandemic and where many have died. Health workers also require the time and space to exchange views on the situation, speak in their own name and assess what can be done to block these increasing attacks on and privatisation of NHS services whilst protecting their own conditions. They are determined that solutions be implemented that can alleviate the crisis for the benefit of all.

Notes
1. The Department of Health and Social Care's written evidence to the NHS Pay Review Body (NHSPRB) for the 2021/22 Pay Round
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/966702/DHSC-written-evidence-to-the-NHSPRB-2021-to-2022.pdf
2. Nurses Upsurge Against Pay Injustice: Support Health Workers in their Ongoing Campaign for Safe Working Conditions and Pay Equality - Workers' Weekly September 19 2020
http://www.rcpbml.org.uk/wwie-20/ww20-36/ww20-36-03.htm
3. German-style tax on the middle-aged 'could solve social care funding crisis' December 7 2018
https://www.publicfinance.co.uk/news/2018/12/german-style-tax-middle-aged-could-solve-social-care-funding-crisis
4. NHS White Paper: Continuing the Wrong Direction for a System of Health and Social Care - Workers' Weekly February 27, 2021
http://www.rcpbml.org.uk/wwie-21/ww21-07/ww21-07-03.htm

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