NHS pay rises: the end of austerity?

The Tories have “finally got the message”, said The Independent. Prompted by public frustration with austerity and the fact that some 40,000 nursing jobs are unfilled in England, ministers have agreed to find an extra £4.2bn to boost the salaries of more than a million NHS workers in England. It’s about time. The pay of these workers was frozen for two years from 2011, and annual increases have since been capped at just 1%. Under the proposed deal announced last week, NHS staff (excluding doctors, dentists and some senior managers, who have a separate pay review system) will receive at least a 6.5% pay rise over three years, with many receiving larger rises thanks to changes to the existing pay structure. The salary of a specialist nurse or physiotherapist at the bottom of the band-seven pay scale, for instance, could rise by 29%, to £40,894, by 2020-21, while the salaries of full-time cleaners, catering staff and porters could rise by 15% to more than £18,000.

Few would begrudge a pay rise for nurses and lower-paid health workers, said the Daily Mail. But this “exceptional deal must not open the floodgates to claims from other public sector workers”. While our economy may be on a better footing than it once was, we’re still paying “a record £162m a day just to service our staggering £1.8 trillion debt”. Yet even the NHS pay offer is not as generous as it sounds, said Joe Dromey in the New Statesman. Nearly half of the £4.2bn headline cost will return to the Treasury “almost immediately in higher tax receipts and lower welfare spending”. And given that nurses today earn 14% less in real terms than they did in 2011, the rise will still leave some worse off than they were seven years ago.

This pay deal may help tackle the NHS’S immediate recruitment crisis, said The Times, but health spending is set to remain a neuralgic issue owing to the growing demands on the system. Health Secretary Jeremy Hunt is among those who think the best way forward may be to separate NHS funding from general taxation through a hypothecated health tax. The theory is that this would take NHS funding “out of politics”, said Charles Moore in The Daily Telegraph, but I doubt it would have that effect. Other existing versions of hypothecation, such as the TV licence fee and the overseas aid budget, certainly haven’t prevented bitter rows over those issues. Indeed, a special NHS tax might lead people to “resent, more than they do now, the lack of relation between spending rises and better healthcare”, and prompt voters to ask the question that should have been posed at the very birth of the NHS: “Isn’t there a better way of doing this?”