by Peter Watt
There was a debate yesterday instigated by Labour on the introduction of regional pay into the NHS. Labour’s argument is clear, that by allowing the introduction of regional pay into the NHS the government risks breaking it up. Of particular focus for criticism were the group of twenty trusts in the south west, the south west consortium. They are seeking to opt out of the national agenda for Change framework for pay and conditions as an element of their plans to achieve their required cost reductions. As Andy Burnham said in the debate:
“National pay is part of the glue of a national health service, part of what holds it together, and in turn the NHS is part of what holds our country together.
A one nation service bridging the social and economic divides of our country, uniting east and west, north and south. The N in NHS should be cherished, but instead it is coming under ideological attack.”
Powerful stuff and you may think hard to disagree with. But Labour has some form in this area, in both government and opposition, which makes their position a little tenuous. It may well be that there is a perfectly good reason for this apparent inconsistency but you can be sure that this inconsistency will be exploited by opponents.
First, in government it was Labour that introduced the very flexibilities and freedoms that allow NHS trusts to make decisions that ensure their responsiveness to local needs. And rightly so; as commissioners agree local priorities it was important that the local providers were able to operate flexibly and choose what they did in order to deliver on these priorities.
This didn’t mean an end to national pay and conditions but it did mean that if needed trusts could be flexible. So for instance, if there was a need for one particular service to be expanded in an area where attracting the right staff was difficult, then a trust could respond.