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NHS Strikes
06 February 2023
Lead MP
Will Quince
Debate Type
Ministerial Statement
Tags
NHSEmploymentForeign Affairs
Other Contributors: 21
At a Glance
Will Quince raised concerns about nhs strikes in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
In response to today's walkouts, which are part of a series of strikes affecting around 88,000 procedures and outpatient appointments over the past eight weeks, Minister Will Quince emphasised the need for all unions to adhere to national-level derogations. He highlighted efforts by unions to keep people safe during these strikes but stressed that industrial action is detrimental to patient care. The minister acknowledged efforts made by unions to ensure safety measures are in place but noted that adherence to a set of derogations at a national level is crucial for planning and certainty. Quince also addressed the collective challenges faced by the NHS due to the pandemic, reiterating the government's plan to recover urgent and emergency care as part of broader efforts to reduce waiting times in the NHS.
Wes Streeting
Lab
Ilford North
Question
This week will see the biggest strike in the history of the NHS, with nurses, ambulance workers and physiotherapists all driven to walk out. Some 88,000 appointments, including 10,000 operations, have already been cancelled, with much more disruption to patients expected this week, yet Government Ministers still speak as if they are mere observers or commentators, not leaders key to solving this dispute.
Minister reply
I am not going to engage in the playing of party politics on this. The Secretary of State is due to attend a Cobra meeting, and Members will have seen his media coverage this morning across multiple outlets. NHS staff received significant pay increases last year, including a 9.3% rise for those on the lowest salaries and a 3% increase despite public sector pay freezes.
Question
The longer this process goes on, the slower the resolution will be for those on Agenda for Change. Does the Minister agree that an earlier remit letter would have been helpful, and when does he expect the Department to produce its evidence to this year’s pay review body round?
Minister reply
We are committed to the independent PRB process but decided to engage with unions on our respective evidence so that it can be as informed as possible. We need to wait for discussions with unions to finish across Government, and we hope to complete this process shortly.
Martyn Day
SNP
Westbury
Question
What does the Minister think when he looks across the border to Scotland and sees that Unison, Unite and other unions representing the majority of NHS Agenda for Change staff have accepted the 7.5% pay rise offer? There are no planned strikes in Scotland while pay deals are being considered, which clearly illustrates that negotiating with the unions is a better way of ending strikes than picking fights with them.
Minister reply
I remember another Scottish National party Member making a similar comment in a previous urgent question. Pay is devolved for Scotland and Wales; I will not make unfunded promises or pledges from this Dispatch Box but want to have an honest and open dialogue with the unions about what is affordable.
John Redwood
Con
Wokingham
Question
Can senior managers of NHS England and its various trusts make more use of pay gradings, job evaluations, promotions and increments, using pay flexibilities so that staff who are doing a good job feel valued and can be paid more?
Minister reply
That certainly is an option. However, the entire Agenda for Change workforce is 1.245 million people, which equates to £700 million for every 1% pay rise. Pay is a factor but not the only one; we also focus on working conditions and environment.
Rachael Maskell
Lab Co-op
York Central
Question
Taxpayers want NHS staff to be there when they need them, but as more and more staff leave the service due to low salaries, their money is being spent in the wrong way. Why will the Government not negotiate with unions?
Minister reply
I thank the hon. Lady for her question but disagree; I was at Darent Valley hospital today and Watford hospital last week and have the utmost respect for NHS workers. The independent pay review process has been used for over 40 years.
Philip Hollobone
Con
Kettering
Question
Due to the covid pandemic, the NHS has a large care backlog; will the Health Minister confirm that spending on the NHS is at record levels and that the Government have a plan to reduce NHS backlogs, which are disrupted by strikes? For every day of NHS strike action, how many NHS operations and procedures are lost?
Minister reply
I can write to my hon. Friend on specifics; he is correct that NHS spending in England this year is 11.4% higher than in 2019-20. We have invested £8 billion over three years, opened community diagnostic centres and surgical hubs, and aim for 9 million more treatments by 2024.
Paul Blomfield
Lab
Sheffield Central
Question
Ministers are hiding behind the independent pay review process. The Minister says it is time to come together in the interests of patients, so why do the Secretary of State and Prime Minister not negotiate with unions?
Minister reply
I have met employers and believe in open dialogue but cannot ignore budget constraints; every 1% pay rise costs £700 million. The independent pay review body process is essential.
Hayes and Harlington
Question
The Minister says that opposition is the easiest job, but would it be more worthwhile if he negotiated with unions himself? Unless negotiations are started soon, the Government could do irreparable damage to the NHS.
Minister reply
I spend every day worrying about patients and ensuring the NHS has necessary resources. I have a budget of £153 billion, which includes a 4.75% average pay award; I encourage unions to engage in April’s independent pay review body process.
Barbara Keeley
Lab
Worsley and Eccles South
Question
There were no strikes in the NHS over 13 years of the last Labour Government. Why will the Government not adopt the Chancellor's suggestion to train a new generation of NHS staff paid for by abolishing non-dom tax status?
Minister reply
The hon. Lady suggests unfunded pledges; there is an independent pay review body process for a reason, and I encourage unions to engage in it.
Luke Evans
Con
Hinckley and Bosworth
Question
We have spent time talking about pay but making working conditions much better is key; what are the Government doing to focus on improving simple things for frontline staff such as testing, prescribing, and reducing admin workload?
Minister reply
I agree with my hon. Friend; measures like wellbeing champions, training for line managers, occupational health services and flexible working are important. Conversations with unions about pay review body process and working conditions should continue.
Honiton and Sidmouth
Question
The workforce crisis in the NHS is mirrored by vacancies in adult social care, now over 165,000. The Liberal Democrats are calling for a carers’ minimum wage of £12.42 per hour; will the Minister support doubling tax on online gambling profits?
Minister reply
The hon. Gentleman got a plug for his policy but I am not sure how relevant it is to this statement. NHS staffing includes 10,500 more nurses and 4,800 more doctors than last year; adult social care represents one of the biggest challenges.
Valerie Vaz
Lab
Walsall and Bloxwich
Question
The Minister will know about ministerial code and keeping the House updated; when did the Secretary of State for Health meet Pat Cullen of the RCN? Will he write to us?
Minister reply
Of course I am happy to do that. These things are put on public record anyway; I have met unions on 9, 12, 25 and 31 January.
Zarah Sultana
Your Party
Coventry South
Question
I have just come from the nurses’ picket outside St Thomas’s Hospital, on the other side of Westminster bridge, where nurses made the point that they were not striking against the NHS but to save the NHS. They have been underpaid and overworked for too long; their pay is down 20% on what it was when the Tories came into power, and now there are a record 50,000 nursing vacancies in England. That is not just unfair but incredibly unsafe. As one nurse said, “Patients aren’t dying because nurses are striking. Nurses are striking because patients are dying.” Will the Minister finally listen to NHS staff, get around the table to talk about pay and give them the pay rise they deserve?
Minister reply
Despite what the hon. Lady says, there are 47,100 more nurses this year than there were in 2010 and 10,500 more than last year, and we have 72,000 nurses in training. The Government hugely value the work not just of nurses—I remind the hon. Lady that she is also talking about the 1.245 million people who work on the Agenda for Change contract. She is right that we have to get pay and other matters right, and that is why we have an independent pay review body process where we look at affordability, reward and recognition, and pay, alongside recruitment and retention and achieving a package that is fair to taxpayers. That independent pay review body will make a recommendation, and it is then for the Government to look at it and accept it or reject it.
Question
I stand in solidarity with nurses and other NHS workers who are taking action in their fight for fair pay and improved patient safety. Miriam Deakin, the director of policy and strategy at NHS Providers, has said that its key ask is that “the Government does sit down around the table with the unions for formal negotiations on pay, and for that to be applied to pay this year.” She has described the absence of formal negotiations as “very worrying”. Does the Minister accept that responsibility for the continuation of strike action by NHS staff lies firmly with the Government? Does he agree with Pat Cullen, the general secretary of the RCN, that “this government has chosen to punish the nurses of England instead of getting round a table and talking…about pay”?
Minister reply
I thank the hon. Lady for her question, but nothing could be further from the truth. We accepted the independent pay review body’s recommendation of an average of 4.75% in full. That is over and above a 3% pay award last year, when the rest of the public sector saw a freeze. The hon. Lady, like me, will have lots of other public sector workers, and indeed private sector workers, in her constituency who will also earn between £30,000 and £50,000 a year. They will also have seen pay awards this year of between 4% and 6%, but they will not have 20% pension contributions or up to 33 days of annual leave a year. We have to keep these things in context, and any award also has to be fair to taxpayers more broadly, which is why we have an independent pay review body process.
Liz Twist
Lab
Blaydon and Consett
Question
Our NHS staff—all of them—saw us through the pandemic, many without proper protective equipment. They have now seen us through the catch-up exercise, and they are working hard, but they are at the end of their tether. Meanwhile, the Minister says there is no money, but the Government wasted £15 billion on personal protective equipment—money that could have given everyone a 20% pay rise. Is it not time that the Government understood the issues in this strike, got around the table and talked about pay to the nursing unions?
Minister reply
First, let me correct what the hon. Lady said about PPE. I was not a Health Minister at the time, but let us not forget that 97% of all PPE was usable. Despite being a Minister in another Department, I remember that those on the Opposition Front Bench rightly agitated on this issue, saying, “Do anything, strain every sinew and take a risk, but make sure you get PPE as quickly as possible.” It was the most desired global commodity, and Governments around the world were fighting for it. Nevertheless, the hon. Lady raised a good point, and of course NHS staff got us through the pandemic.
Question
Just over two hours ago, I joined Lorraine and other colleagues from the Royal College of Nursing over the bridge at St Thomas’s Hospital. They do not want to be on strike and they do not want to be on a picket line, but they want a fair day’s pay for a fair day’s work. A key message from them to the Minister is to get round the negotiating table and give them a fair deal.
Minister reply
Opposition Members keep saying, “Get round the table and negotiate.” I encourage the next one who says that to tell me exactly where each block of 1%, each £700 million, will come from out of our NHS budget. [Interruption.] They point at me, but I remind the hon. Gentleman that we accepted the independent pay review body’s recommendations in full. We stand ready to look at the independent pay review body’s recommendations for next year, which of course is only two months away, because it starts in April.
Question
What is the Minister’s estimate of the number of people in England who have had their appointments or operations cancelled today, compared with Wales and Scotland where there are no strikes? Why are the Conservative Government so indifferent to the suffering of patients in England that they refuse to do what the Governments in Scotland and Wales have done, which is to get round and negotiate a settlement?
Minister reply
We do not, as yet, have the details of today’s and tomorrow’s industrial action, but we will certainly be able to publish that information in due course. I can tell the right hon. Gentleman, as I mentioned in my opening response to the urgent question, that over 88,000 appointments have been rescheduled so far and over 58,000 shifts have been missed. Of course I deeply regret that and wish that there was no strike action.
Andy McDonald
Lab
Middlesbrough and Thornaby East
Question
I have more than enough cause to thank my local NHS for the lifesaving treatment it has given me, but so has every single family in this country. Why do the Government not get it, as the public clearly do, that our health workers, like all public sector workers, are at the end of their tether? Get round the table to resolve these disputes and give them the proper wage rise they so desperately need and deserve.
Minister reply
First, let me agree entirely with what the hon. Gentleman said about NHS staff and how we all owe them a debt of gratitude for the service they have given, not just to us but to all our families. Again, he may have missed it when I asked that if any Opposition Member was going to raise the same question, they might also stand up and say exactly where each block of £700 million would come from, out of my £150 billion budget.
Jim Shannon
DUP
Strangford
Question
I thank the Minister for his answers. For nurses and many others in the NHS, striking is not what they want to do: all they want is dialogue and to try to move forward with an agreed wage structure. They have been left vulnerable by understaffing on the wards, and the pressure that adds is repugnant to them. The Government must move from their entrenched position to find a workable solution. Will the Minister commit to reopening dialogue and looking at the situation, not from the angle of enshrined principle but from a safety angle, which concerns us all?
Minister reply
I thank my hon. Friend for his question. We accepted in full the independent pay review body’s recommendation this year of 4.75%, which was over and above last year’s figure of 3% when the rest of the wider public sector was frozen. He asks about dialogue. Of course I am happy to have dialogue with the unions; my door has always been open and it will continue to be so.
Question
Half of the successful revised offer by the Welsh Government is in the format of a one-off payment. Will the British Government confirm that that element of the pay settlement will be recognised as cost of living support and not as income, and treat it as such for tax and benefit purposes?
Minister reply
Pay is a devolved matter and I understand that the full details of the Welsh offer are yet to be finalised. They will include a number of non-pay commitments, and I understand that the cost of those measures could be substantial. I will look carefully at what the hon. Gentleman says. In any event, it would not be a matter for me as a Health Minister but for the Treasury.
Shadow Comment
Wes Streeting
Shadow Comment
Shadow Minister Wes Streeting criticised the government for its failure to negotiate with nurses, ambulance workers, and other NHS staff. He pointed out that there has been no negotiation on pay issues despite calls from NHS leaders and unions for a resolution through dialogue. With strikes expected this week, Streeting argued that the power to stop these strikes lies within the government's hands and urged the Prime Minister to engage in negotiations with NHS staff to find a fair solution.
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