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After nearly a decade of austerity, NHS workers finally have a real pay offer

UNISON members must now decide whether the plan meets their needs and those of the health service. 

Today we can say with absolute certainty that the government’s self-defeating pay cap has been scrapped in the NHS. That is to be welcomed.

The NHS pay offer unveiled today has certainly been a long time coming. Seven years of pay freezes and wage increases well below the cost of living have pushed many of those working in our most vital institution – the National Health Service – close to the brink. As a result, the NHS has struggled to hold onto experienced staff or recruit many of those needed to fill vacancies. The jewel in the crown of our public services was tarnished, deliberately, by making NHS workers pay for a crisis they didn’t cause.

Throughout this time, UNISON has campaigned to break the cap, to win for all NHS workers the pay and conditions that these public service champions deserve. We have lobbied and marched, debated and cajoled. We demanded that the government give all NHS workers a pay rise – not just cherry picking certain professions or pay grades.

And in recent months, long and complex negotiations between the government, NHS employers and health unions (of which UNISON is the largest), have thrashed out the proposed agreement on offer today.

As a result, more than a million people working in our health service are being offered a long overdue pay rise. Every NHS worker on Agenda for Change terms – from the hospital porter to the NHS manager – will benefit. And no-one will lose any holidays as a result of this proposed agreement.

UNISON has fought off attempts to give pay rises to the few and won a pay offer for the many. Better still, the £4.2bn needed to fund the offer comes from the Treasury – meaning it’s not funded through cuts to existing NHS services.

Under the proposed agreement – hospital caterers, cleaners, porters and other staff on the lowest pay grade would get an immediate pay rise of over £2,000 this year (an increase of between about 10%), lifting tens of thousands of NHS workers out of poverty pay and ensuring that every single NHS worker in England will be paid more than the real living wage, and over the next three years, more than 100,000 of the lowest paid health workers would be in line for wage increases of between 15 per cent (£2,300) and 17 per cent (£2,600).

Other NHS staff would receive pay rises between 9 and 29% over the next three years, thanks to changes to the existing pay structure, with most staff moving to the top of their pay band more quickly. Most health workers already at the top of their band would get a 6.5 per cent pay rise between April 2018 and April 2020.

If the pay offer is accepted, every NHS workers’ wages will go further, and the lowest paid will get a significant income boost. Meanwhile, starting salaries for nurses, midwives and other health professionals will also become more attractive to people considering a career in the NHS. That’s something which benefits all of us.

Now it is those NHS staff, who have suffered through the long years of so-called “pay restraint”, and who still struggle with the effects of cuts and austerity, who must decide whether to accept the offer. Every NHS worker must weigh up whether or not what is being offered meets their needs and those of the service where they work. UNISON has built a pay calculator so all members can see for themselves what the proposals would mean for them.

After the pay cap years, when NHS workers felt their hands were tied beyond their control, it is UNISON members and members of other health unions who will decide their future for themselves.

In the meantime, UNISON will not give up our fight for better pay for all public service workers. It’s time the government properly funded public services and those who work in them, and ensured that every public servant is properly rewarded for the vital work that they do.

Today’s NHS pay offer, and the end to the pay cap, is a positive breakthrough in the fight for decent pay. But there is still a long way to go, and UNISON will keep on fighting every step of the way.

Dave Prentis is General Secretary of UNISON

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The overlooked aspect of patient care: why NHS catering needs a revolution

The NHS performs so many miracles every day – in comparison, feeding the sick should be a doddle. 

A friend recently sent me a photo from her hospital bed – not of her newborn baby, sadly, but her dinner. “Pls come and revolutionise the NHS” the accompanying text read, along with a plaintive image of some praying hands. A second arrived the next morning: “Breakfast: cereal, toast or porridge. I asked for porridge. She said porridge would be ‘later’. Never arrived. (sad face).”

Contrast this with the glee with which another friend showed me his menu at a Marie Curie hospice a few weeks later. He seemed to have ticked every box on it, and had written underneath his order for syrup sponge and custard: “extra custard please”. It wasn’t fancy, but freshly cooked, comforting food that residents looked forward to – “like school dinners”, he sighed, “but nice”.

To be fair, though budgets vary significantly between hospital trusts, a reliable estimate suggests £3.45 per patient per day as an average – only slightly more than in Her Majesty’s prisons, though unlike in prisons or schools, there is no legally enforceable set of minimum standards for hospital catering. As Prue Leith writes in the foreword to a 2017 report by the Campaign for Better Hospital Food, “this means hospital food is uniquely vulnerable to a race to the bottom in terms of food quality, and patient care”.

Plate after plate of disappointment is not only demoralising for people who may already be at a low ebb, but overlooks the part food has to play in the recovery process. Balanced, appetising meals are vital to help weaker patients build up strength during their stay, especially as figures released in February suggest the number of hospital deaths from malnutrition is on the rise. According to Department of Health findings last year, 48 per cent of English hospitals failed to comply with food standards intended to be legally binding, with only half screening every admission for malnutrition.

The Campaign for Better Hospital Food’s report, meanwhile, revealed that only 42 per cent of the London hospitals that responded to its survey cooked fresh food for children – even though the largest single cause of admissions in five-to-nine-year-olds is tooth extraction. Less than a third of respondents cooked fresh food for adults.

Once the means to produce fresh meals are in place, they can save trusts money by allowing kitchens to buy ingredients seasonally, when they are cheaper. Michelin-starred chef Phil Howard, recently tasked by the Love British Food organisation to cook their annual lunch on an NHS budget, explained that this, along with using cheaper cuts and pushing vegetables centre stage, allowed him to produce three courses rather than the two he’d been asked for. Delicious they were, too.

Andy Jones, a chef and former chair of the Hospital Caterers Association, who was there championing British food in the NHS, told me the same principles applied in real healthcare environments: Nottingham City Hospital, which prepares meals from scratch, saves £6m annually by buying fresh local ingredients – “I know with more doing, and voices like my small one shouting out, we will see real sea change.”

Unusually, it’s less a question of money than approach. Serving great hospital food takes a kitchen, skilled cooks and quality ingredients. But getting every hospital to this point requires universal legal quality standards, like those already in place in schools, that are independently monitored.

Nutrition should be taken as seriously as any other aspect of care. The NHS performs so many miracles every day – in comparison, feeding the sick should be a doddle. 

Felicity Cloake is the New Statesman’s food columnist. Her latest book is The A-Z of Eating: a Flavour Map for Adventurous Cooks.

This article first appeared in the 18 April 2018 issue of the New Statesman, Enoch Powell’s revenge