Nurses' Pay: Review Body Report (Hansard, 21 February 1996)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, the Government have welcomed the review body's report and have accepted its recommendations in full.

§ Baroness Cox
My Lords, in thanking my noble friend for that Answer, I must declare an interest as a vice-president of the Royal College of Nursing. Is my 1052 noble friend aware that her Answer will give little comfort to a profession which feels that the 2 per cent. recommended increase is derisory, particularly compared with the large increases for teachers, social workers and other professions? Does my noble friend accept that there are real problems of morale among the nursing profession and of acute shortages in many clinical specialties, and that the recommendation will do nothing to alleviate those problems, but will instead exacerbate them?

§ Baroness Cumberlege
My Lords, following my noble friend's example, perhaps I should declare an interest also as I, too, am a vice-president of the Royal College of Nursing. I think that my noble friend has misunderstood the award from the review body. It is not a 2 per cent. increase; it is a 2 per cent. basic level increase plus local pay. The review body took wastage rates into account and concluded—I quote from the review body: We have carefully weighed all the evidence presented to us and we are not persuaded that there is a general nationwide shortage of nursing staff at the moment. There are clearly local difficulties and problems with particular specialties, and we believe that local pay may be part of the solution to these problems".

§ Lord Winston
My Lords, can the Minister say whether that miserable and inadequate increase in payment will be provided for in new funds from the Government, or will it come from the existing funds of already hard-pressed health authorities? Can the Minister give us an assurance that patient services will not suffer in consequence?

§ Baroness Cumberlege
My Lords, the Government have been very honourable to nurses. There has been a 52.2 per cent. increase in nurses' pay since 1979—that is more than for any other group of health worker, so I think that we have an honourable record in that regard. As to where the funding is coming from, your Lordships will be aware that there is an increase of£1.3 billion in growth moneys for the coming year. We would expect the National Health Service to use some of that, as well as savings through efficiencies and other economies.

The Earl of Halsbury
My Lords, when nurses' pay was my responsibility as chairman of what was going to be the review body, then a departmental committee of inquiry, the pay of ward sisters was equated to that of station sergeants in the police force. Can the noble Baroness tell me how that equation corresponds today?

§ Baroness Cumberlege
My Lords, I am afraid that I cannot give an exact equation. All that I can say is that nurses' pay has increased considerably. A senior nurse can earn up to£46,000 a year and an experienced ward sister can expect to earn around£22,000 a year.

§ Lady Kinloss
My Lords, will the. Minister ask the Government to look again at nurses' pay in view of the fact that they receive roughly less than 21 per cent. of teachers' pay and roughly less than 31 per cent. of a social worker's pay?

§ Baroness Cumberlege
My Lords, nurses fought hard for a pay review body to be established. The Conservative 1053 Government gave them that review body. Every year nurses make representations and give evidence to the body. The review body considers their evidence and that of the Government and others involved, and comes up with a decision. The Government have always honoured that decision. However, it is different now in that the review body is increasingly giving local autonomy to local employers to pay local pay. That makes sense because if 70 per cent. of the costs of running a hospital are wages and if the majority are nurses' wages, it is right that the employers should have some control, especially as they may want to increase some of the remuneration packages or to tackle shortages. They need that flexibility and they need to tailor it to patient care.

§ Lord Rea
My Lords, perhaps I may quote from the review body's statement something that the Minister did not quote. The review body said that it believed: there are some signs that more general shortages of nurses may emerge in the future".
Does the Minister believe that giving nurses the task of negotiating their pay locally, thus distracting their attention from their patient-care role, is the right way to go about this? Surely the Government would have enormously increased morale in the nursing profession if they had given a generous central increase in pay.

§ Baroness Cumberlege
My Lords, I do not believe that it is right that trade unions should decide nationally the exact pay of individuals on the wards and in the community. It is much more appropriate that those who know the local situation should be involved in those negotiations. We are firm believers that local pay is the way forward. It is interesting that when we look at those who want to go into nursing, the number of suitable applicants has increased. For this coming year, there have been 21,000 applicants—an increase of 2,000—for 12,000 places. We are seeing more people wanting to come into nursing.

§ Baroness Jay of Paddington
My Lords, if the Government are relying upon locally determined pay to raise the levels above the 2 per cent. recommended, is the Minister aware that there are still several thousand nurses whose pay agreements at the local level have not been agreed since last year? Is the round in which nurses receive their national pay at low levels, and find it difficult to establish local pay agreements, to continue? That surely is unsatisfactory.

§ Baroness Cumberlege
My Lords, last year was the first time that we entered into local pay negotiations, and 90 per cent. of nurses received local pay settlements in addition to the national award. I am sure that nurses will become increasingly more skilled at this, so will employers. Any noble Lord who has run an organisation, and who has been involved in a company, will know that one has to tailor reward packages for staff to meet local circumstances. It is a nonsense to pay the same in a big city as in a rural 1054 area; it is a nonsense not to take into account local market forces; and it is a nonsense not to take into account the skills of those whom one employs.