Harding shows just how out of touch she is with frontline workers. The NHS is already short of 84,000 full-time staff. Of the 1.28 million staff we do have, 170,000 are not British.

As we haemorrhage staff because of burnout, we need the next leader of the NHS to be someone who understands that it relies on its workforce — and this is what needs to be invested in, no matter the nationality.
Dr Ellen Welch, Doctors’ Association UK

DAUK responded promptly to Robert Colvile’s misinformed opinion piece about NHS pay in The Sunday Times.

Mr Colvile states that on average, pay increased by “2.7 per cent a year” between 2012 to 2017 for NHS workers, due to a “complex system of near-automatic individual salary bump[s] every year”.
What he is referring to is a modest annual pay increase for new staff joining a ‘banded’ job within the NHS (which incidentally, excludes 10% of the workforce, including all 120,000 doctors). It occurs for the first seven years of service in recognition of increasing responsibility-then stops.
The vast majority of NHS staff have over 7 years of service, and do not receive automatic pay enhancements, meaning an experienced nurse will have suffered a relative pay cut of 9% between 2012 to 2017, without even considering the mandatory costs involved in the job.
A 1% “pay rise” is not only insulting in lieu of the sacrifice made by NHS workers, it also does little to reconcile the chasm which has emerged by wages lagging far behind inflation.

Felix Brewer – Surgical Trainee with The Doctors’ Association UK

Read the letter here

Our full response is as follows:

Response to “Welcome to the weird world of NHS pay, where a 1% rise is a lot more than it seems” by Robert Colvile

Dear Editor,

I read with interest the commentary published by Robert Colvile in the March 07 copy of The Times, and would like to respond to number of the claims made.

Firstly, let’s talk about the “pay rise”. Public sector pay is for obvious reasons, an emotive issue. For now, let’s overlook the enormous physical and psychological cost this pandemic has had on healthcare workers, the lives lost and destroyed, and just focus on pay. 

Mr Colvile states that on average, pay went up by “2.7 per cent a year” between 2012 to 2017 for NHS workers, due to a “complex system of near-automatic individual salary bump[s] every year, and the national increase on top”

Let’s look at this in more detail using a hypothetical case study for a nurse working from 2012 to 2017. 

Jeff is a nurse who graduated in 2012 and started working in the NHS. His starting salary as a Band 5 nurse is £21,176¹. For now, let’s ignore professional fees, indemnity costs and other mandatory costs required for him to just be able do his job. At the end of his 5^th year, he would be earning £25,298, factoring in pay progression and national increases². That equates to approximately 3.6% pay increase each year. 

So Jeff, a newly qualified nurse, has done relatively well over this time period.

However, this simplified scenario ignores the fact that most NHS workers in their respective pay band will already have reached the maximum pay category (achieved after 8 years of service), and no longer receive automatic pay enhancements. If Jeff, a band 5 nurse with 8 years’ experience started work in 2012 his salary would be £27,625. By 2017, his salary would be £28,462. Relative to inflation, this actually represents a pay cut of just under 9%³.

So in reality, a 1% pay rise is not only insulting in lieu of the sacrifice made by NHS workers, it also does little to reconcile the chasm which has emerged from wages lagging far behind inflation.  

The truth is that the majority of NHS workers do not get annual pay increases. Most staff have seen consecutive pay cuts over the past decade and are now 8-10% worse off than their counterparts in the private sector⁴. 

If there really is a “flood of applications” for public sector jobs, it isn’t because of pay or pensions (the latter of which also incidentally took a significant hit with the lifetime allowance freeze announced this week).   

Finally, Mr Colvile states that “every job [in the NHS] is then placed in one of a dozen pay bands”. This is not correct. Over 10% of the workforce, including the 122,000 doctors, are not paid according to this banding system, and instead are paid according to an entirely different set of guidelines (which incidentally also lag far behind inflation). 

1. https://www.nsft.nhs.uk/About-us/Documents/Pay_Scales_2012_Final270312.pdf
2. https://www.nhsemployers.org/-/media/Employers/Documents/Pay-and-reward/AfC-pay-bands-from-1-April-2016_FINAL.pdf
3. https://londoneconomics.co.uk/wp-content/uploads/2021/01/LE-NHS-Trade-Unions-Net-Exchequer-impact-of-increasing-AfC-pay-18-01-2021-STC.pdf
4. https://www.nuffieldtrust.org.uk/resource/chart-of-the-week-nhs-staff-pay-and-the-cost-of-living

Mr Felix Brewer

The pandemic has demonstrated how vital the contribution of international staff is for the NHS. 1 in 7 healthcare workers is from overseas. They have carried out their jobs in extremely difficult conditions, risking their lives during this crisis despite being on temporary visas. The government made a promise that bereaved families would get permanent residency status if these workers were to die due to COVID-19. Such a bereavement scheme is hurtful for the overseas workers who have fought so bravely. These workers bring highly specialised and sought after experience in addition to contributing to our economy through their taxes, investment in property etc.Currently indefinite leave to remain (ILR) is granted to the families of healthcare workers if they die. This sends a message that these heroic people only deserve recognition in the event of their dying in service, which is simply not in keeping the British Values of Fairness. These heroes deserve the right to call the UK their home and should not have to die to have this recognised. The French have granted citizenship to key workers – the UK cannot be seen to lag behind! On 5th March 2021 we are set to celebrate NHS Overseas Workers to recognise the efforts of ALL our international staff –  which is not limited to doctors and nurses but includes huge numbers of vital clinical, laboratory, clerical and estates staff. We invite Sunday Times readers to join us in acknowledging this extraordinary group of people.

Dr Pushpo Hossain, Doctors’ Association UK

As featured in The Sunday Times

Find out more about Overseas NHS Workers Day and how you can get involved here

The legal challenge is being brought by the Doctors’ Association UK (DAUK) and the Good Law Project. Nearly 200 NHS and care workers have died after becoming infected with the coronavirus.

In a pre-action legal letter to the Department of Health and Social Care, the doctors say they support the government’s efforts to mitigate the crisis caused by the pandemic but are “deeply concerned” about the “failure to procure and supply adequate PPE”.

DAUK said the deaths of healthcare workers were a “tragedy. We had a pandemic stockpile of PPE lacking essential items like full gowns and eye protection; other equipment was out of date. There has been recurrent and systemic failure of the PPE supply chain, leaving staff in some instances with makeshift or no PPE.”

The barrister Jolyon Maugham, of the Good Law Project, which aims to use the law to improve society, said: “We must never be forced to ask NHS and care home workers to risk their lives again. We must learn the lessons from recent history. And we must learn them quickly, before the second and third waves of the pandemic.”

Read more about our legal challenge here

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Sir, I was appalled to read such frankly dangerous vitriol from Caroline Flint, the former President of the Royal College of Midwives [Top midwife: Doctors ‘hopeless at childbirth’ March 18th]. No mother should ever be made to feel like a failure for requiring medical intervention during childbirth, which could quite possibly be life-saving for both baby and mother. It appears very little has been learnt here following the tragic deaths at Morecambe Bay NHS Foundation Trust, where an investigation found that a small group of midwives were contributing to unsafe deliveries due to their desire to see women give birth without medical interventions “at any cost”.

We, as doctors, recognise that such a fringe view is not held by the majority of midwives, who are truly expert and work closely with us. Flint’s comments appear completely out of touch with the ethos of a modern multi-disciplinary team; instead of promoting dangerous and outdated views that lack evidence, perhaps she would do better to use her platform to foster a spirit of close co-operation, recognising the importance of working together to ensure that babies are delivered into this world as safely as possible.