Health unions hailed a historic victory on Thursday, after Steve Barclay made a significant new pay offer aimed at ending NHS strikes in England, in a climbdown that could embolden other unions at loggerheads with the government.
After months of rolling strikes involving thousands of NHS workers including nurses, ambulance staff and physiotherapists, the government ditched its claim that this year’s pay deal could not be reopened and offered a one-off bonus worth up to 8.2%.
The offer – which most health unions are recommending to their members – also includes a permanent 5% pay rise from April, with the lowest-paid receiving a bigger boost, to lift minimum pay in the NHS to £11.45 an hour.
Nevertheless, questions later emerged about whether the chancellor, Jeremy Hunt, is prepared to set aside new money to fund the pay rise.
A Treasury source suggested existing budgets allowed for a rise of 3.5% increase, and the Department of Health and Social Care (DHSC) would have to pay for the rest through efficiency savings or bid for more funding in the coming months.
Ben Zaranko, senior economist at the Institute for Fiscal Studies, said: “There must be a risk that the NHS is asked to make heroic efficiency savings to absorb these costs, struggles to do so, and instead has to be bailed out in 6 months or a year’s time. That would hardly lend itself to sensible financial planning.”
The health secretary and his officials have been in intensive talks with unions to try to end months of industrial strife.
The government and the NHS staff council, which includes the unions, released a joint statement on Thursday which said: “Both sides believe [the offer] represents a fair and reasonable settlement that acknowledges the dedication of NHS staff, while acknowledging the wider economic pressures currently facing the UK.”
Unions including Unison, the GMB and the Royal College of Nursing (RCN) said they would recommend the new offer to their members, who would then vote on whether to accept it.
Rachel Harrison, the national secretary of the GMB, said: “Thanks to the strength and hard work of GMB’s NHS members, the government has gone from refusing to talk about pay, to putting an extra £2.5bn on the table for this year.
Unison’s head of health, Sara Gorton, said: “It’s a shame it took so long to get here. Health workers had to take many days of strike action, and thousands more had to threaten to join them, to get their union into the room and proper talks under way.”
The RCN, which infuriated some of the other health unions by unilaterally entering talks with Barclay last month, said it had also secured a new pay structure for nurses, to come into force from 2024-25.
The RCN general secretary, Pat Cullen, said her members’ historic decision to take strike action had been vindicated.
“After tough negotiations, there are a series of commitments here that our members can see will make a positive impact on the nursing profession, the NHS and the people who rely on it,” she said.
Unite, however, which represents fewer NHS workers than most of the other unions involved in the dispute, said it would not be recommending the offer.
NHS employers welcomed the announcement – but stressed that it must be properly funded by the treasury. Matthew Taylor, chief executive of the NHS Confederation, said: “Any funding for the award should not come out of already stretched NHS budgets, otherwise it will be a situation where we are robbing Peter to pay Paul with patients bearing the costs.”
Strike action continued across other vital public services including education, with many schools shut down on Wednesday and Thursday as the National Education Union demands higher pay.
Other NHS staff not covered by Thursday’s offer, including junior doctors, also remain in dispute with the government, as well as 100,000 civil servants.
A government source insisted there was “no direct read-across” from the NHS deal to other ongoing disputes, however, highlighting the high levels of public support for nurses, and the severe retention problems within the NHS workforce.
On Thursday night Hunt said he was “confident” that the offer would not worsen inflation. “What we’ve done throughout this is tried to be reasonable,” he told LBC’s Tonight With Andrew Marr. “We had an independent process that happened last year. But we also recognise there was a lot of cost-of-living pressures … I’m confident that the award that we’ve given will still allow inflation to follow its downward trajectory.”
Separate NHS disputes in Scotland and Wales appear close to resolution. GMB members in Scotland narrowly voted to accept the pay deal the Scottish government had offered, which equates to an average 6.5% increase in 2023-24. Other unions are recommending their members accept.
In Wales, many strikes were paused in February, after the Welsh government offered an additional 3%, (half in the form of a one-off payment, half added to salaries) on top of the 4.5% that had already been paid.
