Playing the percentages

Ever since the election, more and more people have been calling for an end to the 1 per cent cap on public sector pay rises – often with an emphasis on frontline NHS staff.

Last month, Jeremy Hunt hinted that he could lobby for an end to the policy, while NHS grandees such as Stephen Dorrell and Sir Mike Richards have also called for staff to be “fairly” and “properly” rewarded.

The prime minister has apparently declared the age of austerity over and cabinet members have suggested the government could consider ending pay restraint in the autumn budget – though the Conservatives voted against a Labour amendment challenging the cap last week.

But what does the man overseeing the provider sector’s finances think?

NHS Improvement chief Jim Mackey was typically to the point on Wednesday: “If and when the pay cap is lifted, there needs to be money to back it.”

When pressed by HSJ if that meant “new money” for the NHS, Mr Mackey said: “I’m not making the decision but in my view… I’m not sure how we would generate that level of internal efficiency to get that.”

Speaking at the Patient Safety Congress in Manchester, he was the first national NHS chief to comment on the issue since calls for a pay rise increased after 8 June. (Though when announcing a bunch of new measures to improve staff retention last month, NHSI nursing director Ruth May also told us: “Pay is part of the equation. We can’t ignore it. Having seven years of a freeze on pay is having an impact on retention.”)

Mr Mackey was clear that ending pay restraint alone would not be enough to improve staff morale – echoing the views of Sir Robert Francis, who was speaking at the congress a day earlier.

The Mid Staffs inquiry chair even said a pay rise may be a “mirage” in the drive towards improving NHS staff morale – because “if the economy collapses it might not be worth more”.

“We need to do whatever it takes to recruit more people and make the job more attractive for them. That may involve more pay but also involves better conditions such as not working extra hours without being paid for them,” he added.