NHS staff look set to get a pay rise of barely half the rate of inflation, a move that will force the health service to make more than £1bn of cuts and could trigger a wave of strikes.
Senior NHS figures expect ministers to award staff an increase of between 4% and 5% when they announce on Tuesday how much the public sector workers will receive in 2022-23.
However, they have warned that even that higher figure could still spark strikes, because health unions have threatened to ballot their members about possible industrial action if this year’s settlement is below inflation, which is running at 9.1%.
The government is due to unveil on Tuesday afternoon details of pay increases for a wide range of public sector workers, including judges, police officers and senior civil servants, as well as specific deals covering NHS staff, doctors and dentists and senior NHS managers.
Ministers originally planned to give NHS staff an uplift of 3%. But the soaring cost of living is thought to have persuaded them to make an award of something between 4% and 5%.
The NHS Pay Review Body, which advises ministers, is understood to have recommended that all 1.5 million NHS staff across the UK covered by the longstanding Agenda for Change agreement – which covers everyone bar doctors and dentists – get a 5% rise.
However, the government is likely to provoke a row with NHS England by refusing to cover the cost of any award over 3%, a ploy that could cost the service up to £1.8bn.
Earlier this month, NHS England took the unusual step of warning publicly that any such move by the Department of Health and Social Care (DHSC) and the Treasury would compel it to reduce investment in key areas, including cancer and primary care.
“Whether NHS staff get 4%, 4.5% or 5%, the unions won’t wear it, given they’ve been pressing for rises that at least match inflation. They will have to follow through with ballots for possible industrial action,” said one senior NHS official.
Danny Mortimer, the chief executive of NHS Employers, said an award of 5% would damage the service’s attempt to retain and recruit staff. “The government must go into this decision with their eyes open about the potential consequences of a lower-than-inflation increase,” he said.
The British Medical Association (BMA), the doctors’ union, made clear that it wanted the increase for medics to at least match inflation, given the real-terms erosion of their salaries in recent years.
“Anything less will be met with severe and justified anger from our members, who are running out of patience with the government’s continued failure to recognise their efforts, not just throughout the pandemic, but for many years before,” a BMA spokesperson said.
The Scottish government has already offered its NHS staff 5%. However, several unions rejected that as too little and have begun moving to ballot their members.
Sara Gorton, head of health at Unison, said: “The government says it’s committed to the NHS, but a pay increase falling far short of prices won’t take the heat out of the staffing crisis.
“Ministers must avoid stumbling into an unnecessary dispute by giving a fair pay rise that protects patients and the NHS too.”
The DHSC was approached for a response.
Teaching unions are expecting Tuesday’s government announcement to confirm an increase of up to 9% for new teachers, to help bring starting salaries up to the £30,000 promised in the 2019 Conservative election manifesto, but just 5% for the vast majority of teachers, which could lead to them balloting for strike action in the autumn.
Patrick Roach, the general secretary of the NASUWT teachers’ union, said: “The messages trickling out from the government in recent days haven’t come close to addressing the real-terms impact of the massive cuts to teachers’ pay over the last 12 years and the worst cost of living crisis for 50 years.
“If the government hopes that teachers’ anger will dissipate over the course of the summer break, they are wrong. A pay award that is below inflation will be yet another pay cut for hardworking teachers.”
Last month, the National Education Union, the country’s largest teaching union, warned the then education secretary, Nadhim Zahawi, that ministers should support higher “inflation-plus” pay for teachers or face industrial action in the autumn.