Clearing up the NHS pay debate

12 March 2021
What was claimed

Last year, Tory MPs promised, budgeted and voted into law a 2.1% pay rise for NHS staff.

Our verdict

Not quite right. Parliament passed a law which committed the government to providing a minimum level of funding for the NHS each year until 2023/24. But it didn’t specify how exactly that money would be spent.

What was claimed

Keir Starmer voted against a 2.1% NHS staff pay rise.

Our verdict

False. There has never been a vote specifically on raising NHS pay by 2.1%. The NHS Funding Bill which committed to minimum total levels of NHS funding was passed unopposed.

“Last year, Tory MPs promised, budgeted and voted into law a 2.1% pay rise for NHS staff.”

“[Keir Starmer] voted against the document in question [which pledged a 2.1% pay rise for NHS staff].”

Following the government’s proposal to increase pay for many NHS staff by 1% this year, some politicians including the shadow health secretary, Mr Ashworth, have suggested that the government committed in law to a 2.1% pay increase.

This isn’t quite right. Parliament has passed a bill which commits the government to minimum levels of funding for the NHS over the next few years, but it doesn’t say where the money should be spent. 

Additionally, earlier this week the Prime Minister suggested that the leader of the Labour party had voted against that bill. This is misleading—the bill passed without opposition. 

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Background to the law

In June 2018, the Prime Minister Theresa May announced a multi-year pay deal for the NHS in England which committed the government to increase funding by 3.4% per year in real terms, meaning after inflation had been factored in.

Ms May said that “in return for this increase in funding, the government will agree with the NHS later this year - a ten year plan for its future.”

That “Long Term Plan” laid out what the NHS planned to do with the money and budgeted for increasing pay by 2.1% per year, without accounting for inflation. 

Does the law promise NHS staff a 2.1% pay rise?

In early 2020, Parliament passed a bill which committed in law to providing a minimum level of funding for the NHS in each year to 2023/24. 

But the NHS Funding Bill didn’t say anything about committing to the specific spending plans outlined in the “Long Term Plan”, including the 2.1% pay increase. 

So it’s not quite right for Mr Ashworth to claim that the government promised and voted into law a 2.1% pay rise for NHS staff. It only voted into law the minimum amount of funding the NHS should get as a whole. The government ultimately controls the pay awards given to the NHS each year, and there is no law that states how much of this funding should be spent on pay rises.

The government has said that Covid-19 and its impact on public finances has limited the amount that it can spend on pay. 

One fairly technical point to note is that the 2.1% referred to was a budgetary assumption that the NHS would increase its spend per member of staff by 2.1% this year. This might not directly translate into a 2.1% total pay rise if promotions, departures or hirings changed the seniority of the workforce.

Did Sir Keir Starmer vote against NHS pay rise?

The bill was passed without a vote because it was unopposed, despite the suggestion of the Prime Minister earlier this week that the opposition had voted against it.

At Prime Minister’s Questions on 10 March, Labour leader Keir Starmer held up a document claiming it showed Conservative MPs had, two years ago, for a 2.1% NHS pay rise and were now reneging on it. 

It’s unclear what document he was referring to at this point and we have asked Labour for clarification. Mr Ashworth later suggested that Mr Starmer was referring to the NHS Funding Bill, though this didn’t commit to a 2.1% pay rise and was voted on last year, not two years ago.

Mr Starmer could have been referring to the “Long Term Plan” itself which was published two years ago, budgeted for a 2.1% pay increase, but was not voted on by MPs.

That aside, the Prime Minister said in response that the Labour leader voted against the document in question. This is misleading as Labour did not oppose the NHS Funding Bill and there was no vote on the “Long Term Plan”.  

The Prime Minister’s spokesperson has since been reported as claiming that the Prime Minister was actually referring to the Queen’s Speech, which announced the government’s total future legislative programme, including the intention of the government to bring forth the NHS Funding bill.

The opposition did vote against approving the Queen’s Speech in January 2020 but this preceded them agreeing to the NHS Funding Bill in question.

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