Health Staff: Pay Recommendations (Hansard, 2 February 1999)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman)

We are responding on behalf of my right honourable friends the Prime Minister, the Secretary of State for Wales and the Secretary of State for Scotland to the reports of the Review Body on Doctors' and Dentists' Remuneration (DDRB) and the Review Body on Nursing Staff, Midwives, Health Visitors and Professions Allied to Medicine (NPRB), which had been published yesterday. Copies are available in the Printed Paper Office and the Library. We are grateful to the chairmen and members of these Review Bodies for their hard work.

Nurses are to get their biggest real terms increase for 10 years, and for the first time in five years the award is being paid nationally in full with no staging. The NPRB have recommended an across-the-board increase of 4.7 per cent. for nurses, midwives and health visitors. Around 70,000 D grade staff nurses will receive 8.2 per cent.-8.4 per cent., worth an extra £1,100—£1,200 a year. In addition, minimum starting pay for newly qualified nurses wil rise to £14,400, an increase of 12 per cent. In inner London, starting pay for a newly qualified nurse will be at least £17,325 including London Allowance. The guaranteed London Allowance affecting 50,000 nurses will 190WA increase by 15.4 per cent. On top of these pay increases, almost half of all nurses will receive pay increments worth at least a further 3.4 per cent. With these increases, more than two-thirds of qualified nurses wil earn £20,000 or more per year.

The NPRB have also recommended an across-the-board increase of 4.7 per cent. for physiotherapists, radiographers and other professions allied to medicine (PAMs). Starting pay for basic grade PAMs with a degree after four years' training will increase on 1 April from £14,180 to £15,405, a rise of 8.6 per cent., with similar rises for other basic grade PAMs. The maximum of scale for highly skilled Senior 1 grade PAMs will increase from £21,485 of £23,130 from 1 April, a rise of 7.7 per cent.

The Government have decided to accept all the NPRB pay recommendations for 1999–2000, with no staging. The headline settlement of 4.7 per cent. for nurses and other NPRB staff groups is significantly higher than for any of the other Review Body groups announced today, and more than we would expect for pay settlements in the public sector generally or elsewhere in the National Health Service. However, this is justified by the exceptional problems of nurse recruitment and retention which result from the failure of the last Government to put in place an adequate training and pay system for the profession. We are pleased that the NPRB have recommended an exceptional increase for an exceptional problem.

The Doctors' and Dentists' Review Body (DDRB) has recommended a general pay increase of 3.5 per cent. for salaried doctors and dentists and for the pay element of fees for general medical practitioners. General practitioners will also receive the £60 million additional income recommended by DDRB last year for payment from 1999–2000. General dental practitioners' fees will also increase by 3.5 per cent. once the 0.9 per cent. addition to the feescale, awarded in 1998–99 only, has been removed. The DDRB has also recommended an additional £500 per year on the consultant scale maximum. The Government have accepted these recommendations for the coming year in full, with no staging.

The DDRB also recommended an extra £50 million a year from 2000–001 to reward individual consultants for increases in workload and intensity of work. Our negotiations with the profession on a new consultant contract are covering these issues. We will consider this recommendation very carefully in the context of the negotiations, and are willing to make an investment in rewards and incentives if the negotiations deliver a better service for patients. We will, therefore, decide on the level of any extra funding for future years, and how such funding might be allocated, when the negotiations are complete.

Health authorities and NHS trusts can now use these opportunities to support a modern approach to recruiting, retaining and motivating key staff. We can announce today that we are backing this with an allocation from the Modernisation Fund of £100 million already earmarked for staff, which will go to all health authorities in England. This is in addition to the 191WA 6.5 per cent. increase in allocations to health authorities; and it will not affect the sums already announced within the Modernisation Fund for waiting lists, capital, mental health, primary care and information technology, which already come to almost £1 billion for the coming year. The pay increases are therefore affordable both nationally and locally.

The extra funding will help us to get the nurses and other staff in place to take forward effectively the Government's programme for modernising the NHS. My right honourable friend the Secretary of State for Scotland will be releasing an additional £20 million to Health Boards from his Modernisation Programme. My right honourable friend the Secretary of State for Wales is making £6 million available as a contribution to modernising the service including recruitment and retention initiatives.

In its evidence to the Nursing Pay Review Body, the department drew attention to recruitment and retention concerns and asked for changes to address this by starting to modernise the nursing pay scales. The Review Body has responded by improving starting pay for nurses, as well as continuing the discretionary points for staff at the top of pay scales.

We are supporting local recruitment plans with a high-profile, recruitment campaign for nurses which started last night on television. The aim is to attract more people into nursing and encourage qualified nurses and midwives to come back to work in the NHS. The focus of the campaign is on the value and rewards of a career in nursing and is intended to help recruit the extra nurses and midwives the NHS needs. The TV campaign will run for a month, backed by activity through to March in the national and regional press, in magazines and on the radio.

These settlements are fair and are being paid in full. They provide a platform for us to move forward on pay modernisation. We will publish detailed proposals for modernising the NHS pay system shortly. The kind of pay system needed in a modern NHS will:

enable staff to give their best for patients, working in new ways and breaking down traditional barriers;
get away from the rigid and outdated grading structures which restrict career progression for experienced staff;
pay fairly and equitably for work done, with career progression based on responsibility, competence and satisfactory performance;
simplify and modernise conditions of service, with national core conditions and appropriate local flexibility.

These changes are crucial to the modernisation of the NHS. They respond directly to concerns expressed by the Review Bodies, and are the only realistic way to satisfy nurses' aspirations for fewer pay ceilings and better reward for the job done. They provide the essential background for future investment in pay and staff development.