The NHS pay campaign: where we are and where we need to go

Submitted by martin on 10 January, 2022 - 3:02 Author: Edd Mustill
NHS workers say no to 3 per cent

The #NHSPay15 campaign has been a significant feature of the industrial relations landscape of the UK since it emerged not long after the beginning of the Covid-19 pandemic. At its core the campaign demands a 15% pay rise for NHS staff on Agenda for Change terms, based on calculations that a similar amount to this has been taken from our pay packets by the imposition of successive public sector pay freezes since 2010. The campaign has also raised other demands including opposing the continuing fragmentation and privatisation of health services, but has been mainly focused on the issue of pay.

The campaign represents an example of rank-and-file trade unionism on a national level that has been very rare in recent years in the UK. The initial impetus came from the ‘NHS Workers Say No’ campaign, which began on social media and is led by a horizontal and informal network of NHS workers belonging to the various trade unions in the health service. This campaign ballooned through a rapidly-expanding Facebook group in the summer of 2020 which spawned national and local networks.

Those involved vary from very experienced trade union reps to those with almost no experience of trade unionism in the health service before now. Also involved have been Nurses United, an organisation of frontline nurses built around full-time organisers, that is heavily influenced by the ‘organising model’ popular in US trade unions over the past couple of decades. NU have organised mainly among members of the Royal College of Nursing and played a role in the Northern Ireland nurses’ strike in the winter of 2019–20 and the general shift towards the RCN behaving like a trade union as well as a professional association. There is also a burgeoning network of junior doctors in the BMA taking up the 15% demand.

The achievements of the 15% campaign so far have been significant. Two of the major health unions, Unite and GMB, took up the 15% demand in their submissions to the ‘independent’ Pay Review Body and other unions were pressured into making significant claims. This came in the context of a three-year pay deal made in 2018 that many NHS workers, particularly Unison and RCN members, felt was mis-sold to them by their union leaderships. The GMB was the only union to reject this deal at the time.

The campaign has also helped to politicise a broader layer of NHS workers and brought new union reps into unions across the board. Demonstrations have been held, as and when Covid-19 restrictions allowed, which have successfully garnered media coverage and put the issue of NHS pay on the national agenda. Questions have been raised in Parliament and pressure put on the Labour frontbench to support the campaign’s demands. Green Party activists successfully committed their party to back the campaign at their national conference. That this has been done largely by newly-organised rank-and-file networks with limited input and resource from trade union officialdom is a testament to the hard work and energy of the activists involved.

The fate of the pay claim

The 2021–22 pay process was deliberately slowed by the government who time and again postponed the submission of their ‘evidence’ to the PRB. In the end the government’s position was that they could only afford a 1% increase (i.e. another pay cut). The PRB, after much further prvarication, recommended 3% which was accepted by the Health Secretary. It is worth pointing out that this process of submitting evidence to the PRB and waiting for a recommendation is not genuine collective bargaining and negotiation; rather it is the imposition of a pay award by a supposedly independent panel of ‘experts’.

In the summer of 2021 the unions conducted consultative ballots on the 3% offer which returned large majorities rejecting it. Regardless, the offer was imposed in staff’s September/October pay packets, back-dated to April. The relevant union committees met to determine their next steps. Among the biggest unions, the Unison and RCN decided to hold another, ‘indicative’ ballot before moving to a statutory industrial action ballot. Unite decided to ballot select branches, presumably based on numerical and organisational strength. Only the GMB moved directly to a full statutory ballot, although there was by no means a full consensus on this within the union. The ballot was to be ‘disaggregated’ Trust-by-Trust, so that mandates could be achieved for industrial action at individual employers where the legally-required 50% turnout threshold is reached.

The RCN and Unison ballots returned majorities in favour of action (although only a fairly slim majority for strike action in the RCN) on turnouts of around 25%. While historically this is quite a good turnout for a national ballot, the imposition of the turnout threshold under the Trade Union Act 2016 makes these results appear disappointing, and gives those in the unions’ apparatus who do not want to organise industrial action the perfect excuse to divert the campaign away from this and towards just lobbying politicians.

At the time of writing, the GMB ballot has just closed and the results are yet to be announced. While it is possible that the GMB will meet the threshold in some employers, it is unlikely to lead to any sustained action. GMB members comprise a small minoirty of staff in most Trusts and any action ‘going it alone’ would be essentially tokenistic. The union officialdom knows this and revels in being able to pose as the most radical NHS union in the knowledge that it will probably not have to organise any industrial action separate from the other unions.

What now?

This puts the campaign in the position of having to acknowledge that it is extremely unlikely that any industrial action will take place during this pay round. Submissions for the next pay round, however, begin in January 2022, so the dispute is essentially still ongoing. This means the campaign is faced with the following tasks, some of which will be a matter of urgency:

Co-ordinate cross union action to get the 15% demand taken up again by as many unions as possible in the 2022–23 pay round. In fact, we should discuss whether 15% is even enough, given that inflation is now running at over 5%. This will involve pooling our knowledge to create a timetable of the internal workings of the unions. When do the relevant sector committees/ conferences meet? Can we draw up model motions in time mandating our unions to push for specific demands? These should also commit the unions to declare a permanent state of dispute on pay until we achieve a restorative pay rise.

We need to map our strengths and weaknesses and weakness as a campaign. We should identify all the main health union branches in the country, where the campaign has activists and where we need them. Are there parts of the country where we can put up candidates who support the campaign for the relevant regional and national lay bodies of the unions?

We need to identify and develop a broader activist base to strengthen the campaign and prevent burnout. This means going through local contact lists, sitting down with people for one-to-one conversations to talk about what needs to be done and prevent demoralisation.

We need to identify any prospects for local disputes while we build the national pay campaign. These could be on health and safety or a myriad other issues. If there are discrepancies across Trusts between terms and conditions that are not negotiated nationally, we need to be aware of these and identify where we might be strong enough to pro-actively initiate some local disputes to ‘level up’ our working conditions. Local cross-union groups should meet and discuss what they could campaign on, using tools similar the Sheffield Healthworker bulletin to spread our ideas among staff.

We need a discussion around whether we want our unions to withdraw from co-operation with the PRB on the grounds that it is a barrier to genuine collective bargaining on pay. The GMB has included questions about the PRB in its latest membership consultation and junior doctors in the BMA have already proposed that their union withdraw from their relevant pay review body (which is distinct from the NHS PRB).

It has been an incredibly frustrating two years for NHS staff but we should not lose sight of the progress we have made. We know that colleagues are willing to take action on pay but there is still a general reluctance among health service staff to commit to strike action, especially during a pandemic. We know a layer of staff have been drawn into action on this issue but we are still some way away from getting the sort of level of engagement necessary for a successful national dispute, given how the anti-union laws stack things against us. We know that NHS staff are divided among a dozen or more different unions but we have also achieved an impressive level of cross-union unity on the ground over the last 18 months.

There is no short cut around these obstacles. We need to strengthen our organisation ward by ward, union branch by union branch. The suggestions I have laid out here a hopefully a useful starting point for further discussions among activists.

• Cross-posted with thanks from medium.com

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