Lansley pushes for lower paid NHS staff in poorer areas

Regional pay bargaining supported by internal Department of Health document.

The Observer reports today that the health secretary, Andrew Lansley, is planning to introduce regional pay bargaining into the NHS, meaning that staff in poorer areas will be paid less than those in London and the south east. Astonishingly, the only proposed exception to the new policy would be already highly-paid managerial staff working to deliver Lansley's unpopular reforms to the health service.

Defending the special arrangements, the Department of Health argues that they are necessary in order to:

Attract and retain high-calibre leaders and staff responsible for transforming delivery.

The department fails to explain why such measures are only needed to attract staff responsible for transforming delivery, and not also to attract staff in other important roles in the NHS such as doctors, nurses, hospital porters, cleaners and paramedics.

The move by the health minister comes in response to a wider government programme to introduce regional pay bargaining into all parts of the public sector. In his budget last month, George Osborne announced:

We're also looking to see whether we can make public sector pay more responsive to local pay rates. It is something the last Government introduced into the Court Service. London weighting already exists across the public sector. Indeed, the Opposition have proposed the interesting idea of regional benefit rates.

So we should see what we can do to make our public services more responsive, and help our private sector to grow and create jobs in all parts of the country. We've asked the independent Pay Review bodies to look at the issue. Today, we publish the evidence that the Treasury are submitting to them. And some departments will have the option of moving to more local pay for those civil servants whose pay freezes end this year.

Responding to the news, Labour's shadow health secretary Andy Burnham told the paper:

National pay is part of what underpins a truly national health service. Labour will defend it, as it is fair to staff, helps control costs and brings stability to the system.

It is often harder to work on the NHS front line in more deprived parts of the country and yet this government wants to pay those staff less and reinforce the north-south divide. It will infuriate NHS staff to see senior managers arguing for one rule for themselves, and another for staff. They are seeking to insulate themselves from these changes, while driving down pay for thousands of front-line staff across the country

Regional pay bargaining is particularly controversial in the health service due to its status as the largest single employer (verging on monopsony) of health professionals in the UK. Without the opportunity to take their labour elsewhere, employees are unable to ensure through normal market forces that the wage they are paid is competitive.

Arguing in favour of regional pay, the departmental document suggests:

Setting a national basic pay rate at a "minimum level necessary" and paying additional supplements in particular geographical zones.

It says: "Current rates of pay in the NHS do vary geographically, but significantly less so than the pay of comparable staff in the private sector. The introduction of more sensitive market-facing pay would therefore enable more efficient and effective use of NHS funds."

It further argues that "where the NHS pay premium is relatively high there is the potential for private sector enterprise to be crowded out with adverse impact on the prospects for local economic growth."

Andrew Lansley. Photograph: Getty Images

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

Photo: Getty
Show Hide image

The campaign to keep Britain in Europe must be based on hope, not fear

Together we can show the world a generous, outward-facing Britain we can all be proud of.

Today the Liberal Democrats launched our national campaign to keep Britain in Europe. With the polls showing the outcome of this referendum is on a knife-edge, our party is determined to play a decisive role in this once in a generation fight. This will not be an easy campaign. But it is one we will relish as the UK's most outward-looking and internationalist party. Together in Europe the UK has delivered peace, created the world’s largest free trade area and given the British people the opportunity to live, work and travel freely across the continent. Now is the time to build on these achievements, not throw them all away.

Already we are hearing fear-mongering from both sides in this heated debate. On the one hand, Ukip and the feuding Leave campaigns have shamelessly seized on the events in Cologne at New Year to claim that British women will be at risk if the UK stays in Europe. On the other, David Cameron claims that the refugees he derides as a "bunch of migrants" in Calais will all descend on the other side of the Channel the minute Britain leaves the EU. The British public deserve better than this. Rather than constant mud-slinging and politicising of the world's biggest humanitarian crisis since the Second World War, we need a frank and honest debate about what is really at stake. Most importantly this should be a positive campaign, one that is fought on hope and not on fear. As we have a seen in Scotland, a referendum won through scare tactics alone risks winning the battle but losing the war.

The voice of business and civil society, from scientists and the police to environmental charities, have a crucial role to play in explaining how being in the EU benefits the British economy and enhances people's everyday lives. All those who believe in Britain's EU membership must not be afraid to speak out and make the positive case why being in Europe makes us more prosperous, stable and secure. Because at its heart this debate is not just about facts and figures, it is about what kind of country we want to be.

The Leave campaigns cannot agree what they believe in. Some want the UK to be an offshore, deregulated tax haven, others advocate a protectionist, mean-hearted country that shuts it doors to the world. As with so many populist movements, from Putin to Trump, they are defined not by what they are for but what they are against. Their failure to come up with a credible vision for our country's future is not patriotic, it is irresponsible.

This leaves the field open to put forward a united vision of Britain's place in Europe and the world. Liberal Democrats are clear what we believe in: an open, inclusive and tolerant nation that stands tall in the world and doesn't hide from it. We are not uncritical of the EU's institutions. Indeed as Liberals, we fiercely believe that power must be devolved to the lowest possible level, empowering communities and individuals wherever possible to make decisions for themselves. But we recognise that staying in Europe is the best way to find the solutions to the problems that don't stop at borders, rather than leaving them to our children and grandchildren. We believe Britain must put itself at the heart of our continent's future and shape a more effective and more accountable Europe, focused on responding to major global challenges we face.

Together in Europe we can build a strong and prosperous future, from pioneering research into life-saving new medicines to tackling climate change and fighting international crime. Together we can provide hope for the desperate and spread the peace we now take for granted to the rest of the world. And together we can show the world a generous, outward-facing Britain we can all be proud of. So if you agree then join the Liberal Democrat campaign today, to remain in together, and to stand up for the type of Britain you think we should be.