What's the point of spending a fortune on nurses and teachers?

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The Independent Culture
LET US construct a new monetary unit for the payment of salaries, and call it the Nurse. A Nurse would be the equivalent of the annual average pay for a full-time nurse in a British hospital, and would therefore be worth around pounds 13,000-pounds 14,000.

When the minimum wage kicks in on 1 April this year, those who get the statutory pounds 3.60 an hour and work a 36-hour week will earn about 0.6 of a Nurse per annum. A surgeon with a decent private practice will expect to be earning 10 or more Nurses. Robbie Fowler's new contract at Liverpool FC amounts to 1,500 or so Nurses per annum (or 5 Nurses a day). This week, cabinet ministers have heard that they may have to forgo salary increases worth a casual 1.3 Nurses.

It is hard not to feel guilty about this. When I took my first job in television, at the age of 28, I started out on a salary twice that of my fifty-something mother - who was at that time a head occupational therapist dealing with mentally disturbed patients at an inner-London hospital. There must be many in my profession who, like me, reflect upon how unfair the world is, and upon how they benefit from that unfairness.

That guilt may explain why we talk about nurses and (to a lesser extent) teachers in the way we do. We are less essential than they are, yet we are often paid more, and it must be someone's fault. An example of this appeared on the front page of yesterday's Express in the headline, "Blair's Insult to our Nurses". Now, most of us think of an insult as being when you call someone a rude name, question their parentage, or curse them. Had the PM really done any of these things? Well, no, he had in fact described public sector workers as "awesome", idealistic, hard-working and caring.

What had really got the goat of The Express (whose talented and mercurial editor is on a salary, I would imagine, not unadjacent to 20 Nurses - or, for that matter, two Prime Ministers) was Mr Blair's suggestion that money might not be the only, or main factor drawing people into public service. This was construed as an invitation to continue to be exploited by a government unwilling to find yet more resources to fund a whacking pay increase across the board.

Cynicism about the notion of the "giving age" is not confined to newspapers. The leader of Unison, Rodney Bickerstaffe, ever a fighter on behalf of the low-paid, has argued that if this is a giving age, then it ought to start with his members. And Rodney Bickerstaffe's members are to be found, in large numbers, throughout the public sector.

What helps Rodney's case is the recruitment crisis in both the nursing and the teaching professions. According to the conventional wisdom, this crisis is a function of low pay added to low esteem. The solution is to pay more and praise more, avoid criticism, and - gradually - they'll come trickling back. The only problem is, where do you find the money for this move, and the usual answer is, by increasing direct taxation.

I wonder. For much of the post-war period, many vocational jobs in our public services were done by women who expected to get married and leave, or who had had their children and wanted to return to work. Either way, they did not necessarily expect to be, or to remain, the main breadwinners in their families. In those circumstances, the idea of pure vocation could flourish.

A lot of things have changed, not least working culture. Most women now see their careers as being as important and economically necessary as those of men are. With unemployment very low by recent standards, they are not forced by necessity to go into nursing (or, if they are better educated, into teaching). The pool of labour, available at a certain low price, has contracted.

So, too, have some of the non-cash benefits of working in the public sector. Job security has diminished (though nowhere near as much as in the private sector); for the upwardly mobile, large public institutions lack the dynamism that they seek; and - over the last 20 years - the public sector (save for nursing) and those in it have come to be regarded as hidebound and inefficient.

And here comes the insult. The consequence of this, over time, has been to create a public service in which the selflessly excellent rub alongside the chronically inefficient. Those too dim, too inflexible, too bolshie to succeed elsewhere can find a (comparatively low-paid) billet in the public sector, where they act as a chain around the feet of the others. Often, as in the case of my local authority, they have the Socialist Workers Party dominating the union structures, and fighting tooth and nail against any changes proposed by the employers.

Vast sums of public money are spent these days on unnecessary and vexatious claims at industrial tribunals. When, last year, I spent some time walking the corridors of a hospital, I was as shocked by the demeanour and attitude of some of the ancillary workers as I was hugely impressed by the work of the nurses in intensive care.

So it is into this very mixed situation that the Government is increasingly being invited to pour huge sums of extra dosh. The key question - assuming that it is more willing than its predecessor to find that cash - is, how does it ensure that the money doesn't just reward poor workers and sloppy practice? And how can the additional amounts be used to optimise recruitment and - just as important - retention, in areas of shortage?

This is where the second part of Mr Blair's speech came in. Extra money would be found, he suggested, but it should go to good workers and good practice. To help in getting and keeping excellent staff, more rewarding career paths have to be found within the public services - thus the creation of the new superteachers and supernurses. That's why he also beat the drum for local negotiations of contracts, which allow employers more flexibility, and why he warned against the maintenance of differentials.

It's easy to understand why those involved in the public services, like Rodney Bickerstaffe, are suspicious of this approach. Many teachers and nurses will be worried about favouritism, and falling victim to the arbitrary judgment of unsympathetic bosses. The move to local negotiations could leave weak local unions at the mercy of unscrupulous and exploitative management.

Maybe. But I cannot see what the alternative is. Just paying a bit more money to everyone currently in the public sector will do little for recruitment or for better services. And to end up spending a lot more money for marginal beneficial results would not only be a waste; it would represent the loss of a historic opportunity. Since May 1997, the country has been willing to put its collective hands in its pockets. If, however, it doesn't see real improvements, then that willingness may disappear for a long, cold, Thatcherite time.

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