Planned “pay cartel” in southwest England is condemned by BMA and Unison

Authors: Jacqui Wise 

Publication date:  18 Jul 2012

Nineteen trusts in southwest England want to break from national pay, terms, and conditions for healthcare workers, a leaked document obtained by the Sunday Times indicates.

The document suggests terminating all staff contracts and reoffering them on different terms. The new terms could include pay cuts of up to 5%, an end to overtime, and reduced holiday leave.

The terms would be aimed initially at employees on Agenda for Change contracts, which cover all NHS staff apart from doctors and senior managers, but the BMA has warned that medical staff members are not outside the target group. The document states that the review “must be all-encompassing and across all staff groups.”

Health unions and professional organisations have labelled the consortium a “pay cartel” that would push through regional changes that would not have been possible on a trust by trust basis.

Labour’s shadow health secretary, Andy Burnham, described the move as a “drastic step.” “This is an insult to staff who are working hard to keep the show on the road.”

The 19 trusts involved have formed the South West Pay, Terms and Conditions Consortium to examine ways to deliver savings. The consortium has appointed a director, and all members have agreed to contribute £10 000 (€24 000; $30 000) each to allow the procurement of professional advice and legal and human resources support. Unions and professional associations have said that this money would be better spent on working with staff locally to identify viable strategies for making efficiencies without risking the quality of patient care.

The Royal Devon and Exeter NHS Foundation Trust, one of the members of the consortium, said in a statement, “It is important to stress that this project is not about establishing pay based on where staff live, or introducing a system that reflects the health or otherwise of local economies, but about a region-wide approach to pay, terms, and conditions.

“Consortium members believe that rather than watch national negotiations on this issue from a distance, we should, as responsible employers and healthcare providers, work together within the South West region now to give all of our respective organisations the best opportunity to be sustainable in the years ahead.”

A BMA spokesman said, “Doctors raised concerns at the BMA’s recent annual meeting about the potential development of a sizeable ‘pay cartel’ of NHS employers in the south west of England and the wider issue of more isolated attempts at applying local terms and conditions for NHS staff. This is not how successful and sustainable efficiencies are going to be achieved; effective recruitment, retention, and movement of doctors across the UK is essential.”

The spokesman added, “We understand that in these tough economic times savings do have to be made. The focus should be on NHS staff and managers working together to find more efficient ways of working and of shaping services, while improving or at least maintaining quality.”

Christina McAnea, head of health at the public sector union Unison, condemned the plan. She said, “Not only are their plans unfair—health workers are already facing years of pay restraint—they also threaten to derail ongoing national negotiations, covering pay and conditions for health workers across the UK.

“Breaking national pay agreements will undo years of work creating a level playing field for pay and conditions across the NHS.” She added, “Patients will pay the ultimate price, as workers who can move to areas where wages are higher will do so, leaving NHS trusts in low wage areas struggling with staff shortages.”

The consortium’s steering group met for the first time on 29 June and agreed to develop detailed plans to identify options to reduce the pay bill in the south west. The full business case is expected to be completed by the end of 2012 and will then be presented for consideration at each consortium member’s board.

Jacqui Wise London

Cite this as BMJ Careers ; doi: