I have been reflecting recently on the lessons I have learned over my life and those I have learned the most from. At Keele and Manchester Universities (and earlier at Rossall School), I learned about economics and finance. Before university, I learned about nursing and caring from my mother who was an enrolled nurse. Before following in my mother's nursing footsteps, I served in the army and learned about fighting from my father who was a career soldier and the boxing coach of the army championship team. In many ways I learned how to fight long before I learned how to nurse.
Recently I have been drawing on many of those lessons. As Chair of Council of the Royal College of Nursing (RCN), I wanted to set out our position on the economics of nurses' pay, the impact on nursing and how we plan to fight the Government.
Government mistakes on economics
The Government announced in its March budget a reduction in NHS funding and no allocation for a pay increase for nurses. We then found that the Government's recommendation to the Pay Review Body was that nurses should receive a 1% pay award.
This decision is fundamentally flawed from an economics perspective. Paying NHS nurses 12.5% would cost the exchequer £4.25 billion. Although this seems like a huge amount, £2.0 billion of this returns immediately to the Government in the form of tax receipts and National Insurance contributions. So this would only cost £2.25 billion.
Some argue that the country cannot afford £2.25 billion. This is simply not true. The Government is spending more than £25 billion on their ‘super deductions tax’, which is designed to help large companies invest in plant and machinery. So companies such as Amazon are going to receive £25 billion to buy machinery despite the evidence that they pay very little tax in the UK and that there is nothing to stop this money flowing overseas. On the other hand, putting £2.25 billion in the pockets of nurses would result in this money being spent locally, providing much more economic stimulus.
Government mistakes on nursing
Throughout the pandemic, the country has witnessed incredible displays of nursing care. Without the nursing profession, many of us would not be alive today. The reason we are fighting so hard for pay is because we need to make sure that a safety-critical profession can reach safe staffing levels and fill tens of thousands of unfilled nursing jobs.
Pay and safe staffing are intrinsically linked. Our data and research shows that more and more nurses are getting into debt and are looking at better paid jobs with less stress, less trauma and less pressure. Nursing is tough enough at the moment even if we were paid properly and had the staff we need.
In our members' survey last year, more than a third of nurses were considering leaving the profession, with almost two thirds citing pay as a key factor. There are at least 50 000 registered nurse vacancies in the NHS in the UK and this impacts safety, morale and wellbeing.
Pay awards for nurses have been dwarfed by the rise in the cost of living for years. Nurses earn significantly less now in real terms, than in 2010.
Government mistakes on fighting the RCN
Our members and officials cannot believe that, after everything we have been through, after hundreds of nurses have died providing care, that the Government is recommending a desultory 1% pay rise. At an emergency meeting the RCN Council decided to allocate £35 million to an industrial action fund—the largest strike fund the UK has ever seen. This is a reserve to provide some compensation for members' loss of pay when they take strike action or for other strike-related activities. This fund would enable us to support every member who works in the NHS in the UK to strike for an entire week. We can support members across the UK to withdraw over 750 000 shifts of strike action.
The Government is sending us a clear message about their intentions on pay. The RCN is sending a clear message that we feel that industrial action is becoming much more likely. Over the next few months we will be announcing a series of steps to ensure that if we have to ballot for industrial action in August that we fully intend to win.
Funding our health and care system, so it can safely and effectively meet the needs of the public, is a political choice. After years of inadequate support for the largest health and care profession in the UK, and a growing workforce shortage, the UK Government should make the right choice now.