The Royal College of Nursing has over 410,000 members who work as nurses and healthcare assistants throughout the UK. As the RCN Regional Director for the South West I want to focus on the recently formed South West pay 'cartel' because I strongly believe it could have a very serious impact on the care that patients will receive, and also on our local economy.
Twenty NHS trusts in the South West joined together with the aim of cutting their running costs by reducing staff pay terms and conditions. Together they have ploughed £200,000 of NHS money into a fund to take this forward. This money should be used for patient care, but instead it will be used to employ people to develop a plan to reduce pay, terms and conditions of NHS staff. The pay cartel's project initiation document stated that if workers will not agree to the proposals then it may be necessary to dismiss them and re-engage them on lower terms and conditions. We estimate that this could affect around 68,000 NHS workers.
The RCN recently published a report "The South West Pay Cartel – the health economy and workforce context." It uses information from government on workforce numbers to show how serious this will be. The South West already has a real shortage of registered nurses, because we have lost the highest number of nurses of any region in England. At the same time we have the highest proportion of older people who inevitably have more complex health needs.
We already know that other NHS Trusts that border our region are having difficulty in recruiting and have said that they see the pay cartel's plans as an opportunity to attract nurses from the South West to them. South West Trusts also have difficulty filling vacant nursing posts and some have recently had to recruit from Portugal and Ireland.
If the pay cartel forces staff to accept poorer terms and conditions than elsewhere, then nurses that can move to other areas with normal NHS terms will go, and it is difficult to see how they will be replaced. If Trusts are unable to recruit nurses with the right skills then the care that patients receive will be affected. The Royal College of Nursing has raised this concern with each and every Trust that has joined the pay cartel, we have also written to every MP in the region to highlight this to them.
The long-term impact on our region's economy will be significant. The NHS is a major employer in many areas, and if people have their salary cut they will then have reduced ability to buy goods and services. This will have a devastating impact on local businesses. It is also unlikely to stop at the NHS. Once lower pay levels are imposed on NHS workers, other health care providers in the private sector will also peg their salary levels lower.
The Royal College of Nursing is well aware that the NHS is under financial pressure, but any organisation operating with the belief that a move to regional pay will reduce staffing costs and lead to efficiency is, quite frankly, labouring under an illusion. The increased bureaucracy and need for Trusts to develop new systems and employ more managers to take forward repeat pay negotiations every year will, in reality, increase their costs, not decrease them.
Reducing pay, terms and conditions for frontline staff is not the only choice that Trusts have. We appreciate these are difficult, uncertain times but there are other solutions that would not impact negatively on patient care. Our members have told us about their frustration about the waste of money by NHS Trusts. For example we hear of equipment bought at great cost that doesn't do what staff need it to do and agency staff being brought in from the West Midlands, with travel and hotel costs paid by the Trust so that they can work several shifts.
The Royal College of Nursing has urged each of the 20 Trusts in this cartel to withdraw from it and return to working in partnership with staff – their most valuable asset in ensuring delivery of excellent care to patients.