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‘Ello ‘Ello ‘Ello, what’s going on ‘ere then?

May 29, 2015

“…and then I’ve got two weeks on nights, so I should get a decent pay packet for once. Just in time for my holiday as well!”

“Oh I know! My pay was rubbish last month coz I had to have them weekends off when my mum was away and she couldn’t look after the kids…”

If you’re a nurse, you can bet your butt that a conversation very similar to this one will taking place every hour of every day in a staff room near you. Highly valued and often heavily relied upon, unsocial hours payments are the lifeblood of the profession. Especially after five years of wage restraint, they are the one perk that not only keeps the wheels turning at night and over weekends, but also – to steal the politicians’ favourite phrase – keeps hardworking families on track by making the difference between living and merely existing. And they are under threat.

The government’s plans for nurses’ pay are not a secret. Their submission to the NHS Pay Review Body last December, while they were still in coalition, make it very clear that the goal is – as I said then – ‘abolishing, or at the very least, radically reforming, unsocial hours payments’. And if anyone doubts their resolve to do so, they should take a look at the speech Home Secretary Theresa May made last year to the Police Federation.

The Police Federation is the trade union for rank-and-file police officers. As is true of British policing generally, it has serious issues it needs to confront – and, to be fair, it had already started to confront them even before May’s intervention. But what was really striking was the uncompromising language she used when addressing its annual conference in 2014. Citing scandals such as the Stephen Lawrence case and the Hillsborough disaster, she said – according the The Guardian – that ‘problems appeared to lie with a significant minority of officers rather than just “a few bad apples”‘. She then pledged ‘to break the powerful federation’.

The question is: if this is what the government thinks of the police, could it also be what it thinks of health care professionals, including nurses? Think about it. While the issues are very different – with the Police Federation, it’s about overweening power and the potential to abuse it; with nurses, it’s about pay and conditions – in both cases, falling public approval and recent history of scandal has, rightly or wrongly, handed the government an excuse for confrontation. Could it really be that in post-Francis NHS, Jeremy Hunt privately thinks that ‘problems appear to lie with a significant minority of [nurses] rather than just a few “bad apples”’?

In both cases there is also a parallel agenda in play. For the police, the continuing austerity programme will mean further cuts, to which the government naturally wishes to mute opposition. For nursing, in a PR master stroke, the acceptance of new pay and conditions is tied to the electorally popular instigation of NHS seven-day services.

The case for seven-day services is pretty much unanswerable. Frequently-cited statistics suggest that outcomes for seriously ill patients who are admitted to NHS hospitals at weekends are significantly worse than for those admitted during the week; others, admitted on Friday, may find themselves hanging around until Monday for investigations or discharge home. Nurses want to see an end to this as much as anyone.

The government’s interest however, is in painting nurses as being opposed to it (and in this context, let’s hear it for Midland Metro, which last week did Jeremy Hunt’s work for him with its ‘Nurses will fight seven-day NHS’ headline) so that it can then paint itself as the public’s champion.

But all of this is based on a lie. And the lie is that nurses, like the Police Federation, are powerful. In political terms, nurses are not powerful at all. Year after year, we have seen real terms cuts to our wages. We have seen posts cut not because there was less need, but because it was politically expedient. And with next-to-no debate, we have seen our role change from bedside nurse to throughput-manager-cum-risk-assessor. But after all this, now it suits the government to portray us as behemoths standing in the way of progress, that’s what they’ll do.

To nail this lie, nurses must be absolutely clear with the public that they are not opposed to seven-day services. How could they be? They already provide them. But they are worried that seven-day services have become a government obsession partly because they represent an excuse for yet another attack on pay and conditions.

Yet the solution here may not be yet more shrill rhetoric. Rather than dismissing proposed new pay structures out-of-hand or portraying them as the ‘loss of unsocial hours payments’ and pure and simple, the union side would look more dignified and get better PR out of listening and considering. The danger is that with the government determined to ratchet up the tension, confrontation becomes more likely. According to The Guardian ‘[Police] federation leaders who backed modernisation believe the conference would have voted for change regardless of May’s speech’.


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