The Socialist Unity Network

Let’s fight for our agenda for a change.

Jim Jepps and Harry Sloan

In mid-August UNISON hailed what it described as a major breakthrough in the long-running saga of the restructuring of NHS pay, known as Agenda for Change.

After more than a year of stalemate on three key contentious issues, the Department of Health climbed down on one – by agreeing an uplift for the lowest of the nine pay bands – and agreed to defer the other two.

The controversial changes to payments for unsocial hours, which threatened tens of thousands of staff, especially those working regular unsocial hours and weekends, with a reduction in pay – and thus raised the need for “protection” for a period of up to five years – have been shelved for a year, and will be subject to a review in the autumn of 2005.
And new rates of payment for staff working “on-call” have also been postponed –for at least four years, after it became clear that no agreed solution is in sight.

Despite the fact that they resolve nothing, and leave the new system in chaos, these changes, together with additional fudges to avoid some staff losing out under the new percentage-based London Weighting payments, seem to have knocked the stuffing out of some of the UNISON activists who had previously argued that the package was fatally flawed and should be rejected.

The government still hopes to introduce Agenda for Change (AfC) into the NHS by 1st December. They have said that it will result in NHS workers being considerably better off. By this they mean 12.5% over three years (which in anyone’s money is not that great anyway).
The new concessions on the lowest pay Band 1 creates a new minimum wage of £11,135 per year in the NHS: taken together with a reduction in the working week, and an additional week’s holiday this appears to be a considerable increase for ancillary staff: however few NHS ancillaries are on the very lowest pay band, and many more currently receive bonus payments above the basic Whitley rate, which means they stand to gain little or nothing from AfC.
Many ancillaries also depend for their pay upon unsocial hours payments – and stand to lose out under the AfC formula.

It would be a mistake to see AfC as a pay deal which you can improve or tinker with in order to make it palatable. AfC is about restructuring NHS workers – and at its heart is deeply problematic.

Twelve NHS Trusts were designated as ‘Early Implementers’ for AfC (or Guinea Pigs perhaps) in order to pilot the scheme and iron out wrinkles. Despite the fact that the Department of Health has bluffed saying it has gone very well, the results are disturbing.

UNISON estimated that before the latest concessions around 15 percent of workers in these areas required pay protection (which would translate to 150,000 workers across the NHS) which is significantly up on the 75,000 that the government was aiming for (they don’t mention that in the press releases!)

The latest documents on AfC suggest that even after the changes 7.5 per cent of the NHS 1-million workforce could require protection, 5 per cent of them for more than a year.

Private Eye revealed recently that in some trusts between 30 per cent and 40 per cent of the workforce were downgraded under AfC. These job re-evaluations have led to significant disruption in trial areas. For instance 200 staff in Sunderland walked out in protest at being downgraded. In James Paget Hospital near Lowestoft, 29 per cent of admin staff required pay protection.

The Dept. of Health admitted that “the numbers of staff requiring pay protection because of harmonisation of unsocial hours payments was higher than expected, particularly among the low paid”.

Once you’ve decoded the management speak for cuts in pay and reducing the night work rate you begin to realise that everything was not rosy in the garden – but then managers don’t ‘work’ anti-social hours so it’s not so bad is it?

Bizarrely UNISON’s response was to say that they welcomed changes because AfC “will go some way to putting more money into the pockets of our lowest paid members.” Unfortunately this is untrue. Many jobs will end up with pay below the low pay unit’s ‘decency threshold’ and of those who require pay protection (which incidently is temporary and does not apply to those recruited after introduction) the vast majority are low paid workers.

You may find it difficult to believe that this Labour government is introducing a scheme that favours managers and top consultants at the expense of maintenance and admin but there it is.

Even the attempt to introduce this on a national level will hit severe problems. The trial areas were given £80,000 each for this process, which was still difficult and time consuming. Once the scheme goes national there will be no extra funds, meaning that existing resources will need to be diverted in order to implement this bureaucratic tosh.

AfC is part of the government’s plan to ‘modernise’ public services. Many thousands of jobs that were once done by NHS workers are now done through contractors and agencies, at an increased cost and decreased service. It’s also had an impact in some areas on union organisation. This process will be further deepened by the introduction of Foundation Hospitals.

We have a deeply flawed deal (and there is no space to detail the difficulties with on call payments, short term pay protection, increase in working hours, etc.) and no comprehensive information on the outcome of the trials for people to base their decisions on. The government cannot release these statistics because they will reveal that large numbers of low paid workers will receive significant pay cuts.

You don’t need agenda for change to do simple things like decent pay increases and reducing hours. Bring the privatised contracted services back into the NHS. Let’s try to retain staff without burning them out.

Their agenda will inevitably lead to a two tier health system with ‘choice’ for the rich and rubbish pay for the workers – Agenda for change is an integral part of that and cannot be allowed to go through unopposed.

UNISON has called a special conference for 7th October followed immediately by a national ballot of all UNISON health workers.


September 2004


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