Boris Johnson told the House of Commons today: “We’ve delivered a 12.8 per cent increase in the starting salary of nurses.”
It’s a line that several ministers have repeated in recent days as the UK government defends its decision to recommend a pay rise of no more than 1 per cent for NHS workers in England (health is a devolved matter in the rest of the country).
The main nurses’ union is threatening to strike over the offer, but the Prime Minister and others have made it sound like the profession has already had a fairly generous uplift in pay. Time for a FactCheck.
It is technically true to say that some, but not all, nurses have received a pay rise of more than 12 per cent since 2017/18.
But that’s in “cash terms” not “real terms” – it doesn’t account for the fact that inflation erodes the spending power of workers’ wages over time.
It’s a flattering figure in other ways too. It only applies to one group of nurses, rather than reflecting the experiences of all NHS workers in England. And it doesn’t take into account the years of austerity that came before 2017/18.
In real terms
A number of analysts and think-tanks have already pointed out that government is making NHS pay settlements look more generous by talking about them in cash terms rather than adjusting them downwards to allow for inflation (“real terms”).
The Health Foundation said that NHS wages were “£600 per employee lower in real terms” at the start of the pandemic than in 2011/12.
This is because NHS earnings have risen at around 1.5 per cent a year since then, whereas inflation (measured using the ONS Consumer Price Index) has averaged 1.8 per cent a year.
If inflation rises faster than wages, you get a “real-terms cut”.
The consultancy London Economics, who recently published this union-commissioned report on NHS pay, puts the real-terms pay rise for starting nurses at 4 per cent since 2017/18, using public data from NHS Digital.
The “average” nurse?
Ministers often want to focus on specific pay bands to talk about what they are doing for various kinds of NHS worker.
The figure Boris Johnson quoted at Prime Minister’s Questions refers to the cash-terms pay rise for people at the bottom of band 5 of the NHS pay scale. That’s where most newly-qualified nurses will start.
Many other people across the NHS pay bands have faced a less generous settlement. London Economics calculate that only 22 per cent of employees in Band 5 are at the bottom of that band. More people are clustered at the top, and the recent pay rise has been smaller for them.
What happened before 2017?
Dr Gavan Conlon from London Economics told FactCheck: “Choosing 2017/18 as the base year is potentially misleading as there were several years of below-inflation increases between 2010-11 and 2017-18.
“Since 2010-11, nurse starters have received a 17 per cent pay increase in cash terms but this equates to a 10 per cent reduction in real terms. In other words, nurse starters today are approximately 10 per cent worse off than a decade ago.”
While not all pay bands have faced the same reduction, there is evidence of a real-terms cut across all wage bands over the last decade:
You can technically say that some nurses have had a pay rise in recent years – but only if you ignore inflation and only if you choose the time-frame carefully to leave out years of real-terms reductions that came before.
It’s equally true to say that most NHS workers have faced significant real-terms pay cuts over the last ten years, as their wages did not keep up with the rising cost of living.
Boris Johnson repeated the point today that most other public sector workers are facing an outright pay freeze in the current economic climate.
Last week health minister Nadine Dorries said the government did “not want nurses to go unrecognised – or doctors” but said the 1 per cent offer was “the most we think we can afford”.