Politics Explained

How can Boris Johnson resolve the NHS pay dispute?

The government’s plans for a 1 per cent pay rise for NHS staff have been widely derided by nurses, unions and MPs. But with funds in short supply, Sean O’Grady considers what can be done to resolve the dispute

Wednesday 10 March 2021 13:35
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<p>Boris Johnson will have to balance fiscal probity with the demands of public opinion</p>

Boris Johnson will have to balance fiscal probity with the demands of public opinion

You might not believe it by the long-running and often vicious arguments about the incomes of junior doctors and nurses, but the issue of NHS pay was supposed to have been taken out of politics long ago. The NHS Pay Review Body dates back half a century and was designed to bring a rational, fact-based approach to arbitrating annual pay awards, with the aim of avoiding industrial action, which all concerned agree would have some detrimental effect on patient care. The heat was to be taken out of the arguments by delegating them to experts. It hasn’t always happened.

The concept is a typically corporatist one, and made into reality through a tortuous bureaucratic procedure. This has the disadvantage of being complicated and cumbersome; yet it has the great advantage of being flexible enough to allow for the shifting positions of government, health trusts and the unions to be accommodated in the process of agreeing an eventual messy compromise.

Thus, all interested parties involved submit a “recommendation” about a pay increase to the Pay Review Body around now. (This is all the government’s “offer” of a 1 per cent rise represents – the very first stage in a long rigmarole. It may be an “insult”, but it is not the final insult.) Similar pay review bodies operate for the police, armed forces and civil servants.

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