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Union Leader Questions Independence Of NHS Pay Review Body

Striking ambulance workers gather on the picket line. (Alamy)

6 min read

The leader of a union representing thousands of NHS staff has questioned the independence of the pay review body responsible for recommending rates of public sector salaries, suggesting it is “farcical” that government appoints its members.

NHS pay rates are recommended to government by the independent NHS Pay Review Body (NHSPRB). As health unions and ministers remain deadlocked in a dispute on pay, the government argues it is following the pay recommendations made to it by the body. 

Andy Prendergast, national secretary for the GMB union, told PoliticsHome he believes that because members of the NHSPRB are appointed by ministers, and approved by the prime minister, it is impossible for their decisions to be truly independent. He believes this is why the body has only suggested workers get an above-inflation pay rise once in the last 13 years.

The government strongly denies this characterisation of NHSPRB and says that all appointments “are made following an open and fair competition”, and that it is “misleading” to suggest any political interference in their decisions.

The government accepted the NHSPRB's most recent recommendation on NHS pay last July, which stated that health workers should get a pay rise of roughly £1,400 for 2022-23.

However, the rate of pay increase falls well below the high levels of inflation the country is now facing. Unions have therefore argued it in reality amounts to a pay cut, and have called for the settlement to be re-considered as its members face a deepening cost of living crisis.

There have been a wave of strikes over pay and conditions in recent weeks, including thousands of GMB union members in the ambulance service who walked out in December.

After talks with health secretary Steve Barclay failed to yield a positive result ambulance workers have announced six further dates for action, saying the government's "cold dead hands" are stopping a proper pay offer being made.

Prendergast told PoliticsHome's The Rundown podcast that he felt the NHS was "broken" and "doesn't function", placing staff under a significant amount of stress. 

“What we've seen is 13 years of pay which has gone down in real terms, we're seeing a 13 per cent pay cut amongst ambulance workers, that's led to huge vacancies right across the service," he explained. 

“Quite simply, what it means is the job that they signed up to, they simply can't do. And one of the big problems we have with the vacancies, is we need to address is pay.”

He said we have “a government who haven't listened” and have failed to engage, after Barclay has repeatedly said he must stick to the recommendation of the NHSPRB.

But Prendergast argued that “every single person [on the NHSPRB] is handpicked by the government, even the employee representative is handpicked by the government” and therefore did not believe the recommendations on pay could be truly independent.

"In the last 13 years, that has given just one above-inflation pay rise, which was 0.7 per cent above RPI. And as a result of that cumulatively you have over 130,000 vacancies," he continued.

“The idea that it is independent is farcical, the idea that it has delivered is farcical, and the result of that is being seen by our members every single day when they are dealing with massive backlogs.”

Andy Prendergast, national secretary for the GMB union
Andy Prendergast, national secretary for the GMB union (Alamy)

The Institute for Government, a leading think tank on the workings of government, defines the Independent Pay Review body recruitment process as follows:

"Each pay review body is usually made up of between six and eight members. The chair of each committee is appointed by the prime minister, while the other members are appointed by the prime minister or the relevant secretary of state, based on merit and following an open process. Vacancies are advertised publicly. 

"Members are appointed for a three-year term, which can be renewed once.

"Review body members come from a range of backgrounds and bring a variety of expertise. Each review body typically has members who provide the following range of perspectives: sector experts, human resources and remuneration experts, professional economists from academia or elsewhere, and former trade unionists."

A spokesperson for the Office of Manpower Economics, which sits within the Department for Business, Energy and Industrial Strategy and provides the secretariat to the Pay Review Bodies, told PoliticsHome: “Appointments to NHSPRB are made following an open and fair competition.

“Adverts are posted on the public appointments website. Following short-listing and interview, appointable candidates are put forward to the Minister for decision.

“This is in line with usual practice for public appointments.”

A Department of Health and Social Care spokesperson said: “It is misleading to suggest the government interferes with the operation or independence of pay review bodies.

“The pay review bodies are independent advisory bodies who carefully consider evidence submitted to them from a range of stakeholders, including government, NHS system partners, and trade unions.”

Last month Paul Nowak, the new general secretary of the TUC, told PoliticsHome he believed ministers were using independent pay review bodies as “human shields”.

“I think what they're in real danger of doing is undermining the credibility of them and undermining the credibility of some of the individuals who are trying to do good a job on those PRBs,” he said. 

The NHSPRB is one of eight such organisations, described as an “advisory non-departmental public body”, which collect and assess evidence to advise ministers on pay in the public sector.

The chair of each one is appointed by the prime minister, while the other members are appointed by the relevant secretary of state, all following an open process under the terms of the Governance Code on Public Appointments, and regulated by the Commissioner for Public Appointments.

Its remit is set by government, and health secretaries of the UK nations advise the NHSPRB. Barclay wrote to the body ahead of the settlement for 2023-24 saying they should take into account both the NHS budget, which has been set for the next three years, and the government's target to bring down inflation.

It has had the same terms of reference since 2007, when Labour was in government. Rejecting claims over its lack of independence, the Prime Minister's official spokesperson noted that pay review bodies have at times made recommendations that are at odds with the government's stated priorities.

“PRBs’ recommendations regularly exceed the upper threshold the government recommends,” they told PoliticsHome. “If they were in hock to government they wouldn’t do that.”



  • Listen to the full interview with Andy Prendergast on the latest episode of The Rundown.


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