By Anita Downs (Guy's and St Thomas's) and Nick Holden
There is mounting evidence that the proposed new NHS pay scheme, 'Agenda for Change', is bad news for health workers, and possibly unworkable.
Unison and Amicus members will be balloted later this year on whether to accept the proposed system for the whole of the NHS. But the 12 sites which are trialling it are reporting massive problems, on top of fundamental objections to the scheme that are unlikely to be resolved before the ballot.
Faced with the prospect of seeing the proposals thrown out last year, the leaderships in both unions devised the two-stage process, promising that the early implementer (EI) sites would iron out problems and enable further negotiations.
However, hardly any negotiation has taken place. Unison claims that it is waiting for 'evidence' from the EI sites. But many of the concerns expressed last year, such as the appallingly low level of pay on the new Band 1, the fact that even the government expects one in 12 health workers to face a reduction in their pay, and the increase in working hours for all administrative and clerical workers, don't need evidence.
Union negotiators don't expect to make any progress on the fundamental issues, and are hoping to make some cosmetic changes on issues arising from the EI sites instead.
In Guy's and St Thomas's hospitals, staff are finally being put onto their new Agenda for Change pay bands, making the project at least six months behind schedule.
'Job Matching' is still in progress, but the current estimate from management is that up to 30% of staff will have to have their wages protected, largely due to the inadequate (for many staff, significantly reduced) level of London Weighting.
In spite of the obvious bias towards clinical jobs, even newly qualified nurses in London will lose out. The other main losers are admin and clerical staff, who represent a large part of the workforce.
Pretty much every other group of workers have had concerns along the way: physiotherapists, speech and language therapists, medical technical officers even management stand to lose out in many cases!
Almost every decision made by matching panels could be appealed on the grounds of 'process'. We've had two different sets of guidance on how to score factors, and new job profiles are out every month. If Agenda for Change is accepted, union reps can expect to be buried under a stack of appeals for the next five years.
On the ground, staff remain confused about how they are going to be affected.
Many are concerned about unsocial hours and on-call payments. But we're also recovering from a 'budget-freeze" which almost completely put a stop to any recruitment or training for staff within the Guy's and St Thomas's trust.
Management is admitting that the high number of workers on protection in the wake of AfC could lead us into an even bigger recruitment crisis.
Around the country, other EI sites report similar problems:
- The North East Ambulance Service Unison branch is on the verge of industrial action against management intent on recouping the promised reduction in the working week by ceasing payment for meal breaks - making the workforce pay for the supposed improvement in their conditions.
- At James Paget Healthcare NHS Trust, 150 appeals have already been lodged against matching panel decisions.
- At Avon and Wiltshire there's a dispute over staff having been asked to work public holidays for no extra pay.
All the EI sites report that implementing the scheme requires thousands of hours of management and union rep time. EI sites received hefty financial support to enable this work to happen, but no money is being offered to the rest of the NHS to support roll-out, suggesting that even where branches manage to find the 40 reps per 1,000 members which Unison is recommending, their management probably won't be able to afford releasing them to do the job.
Agenda for Change is fatally flawed: under-funded and unfair. The Early Implementer sites have proved that those who argued last year for opposition to the scheme were absolutely right.
Unison and Amicus activists need to organise now to promote a positive alternative to the current proposals so, that a credible 'vote no' campaign can be launched in the summer.
To fail to do this would be to condemn health workers to low pay for a generation.