Health and Social Care Bill

My Lords, Amendment 45, tabled by the noble Baroness, Lady Wheeler, seeks to impose on the Secretary of State, "““a duty to maintain a national pay and bargaining system for healthcare staff, to cover those staff providing””," both NHS and public health services. This would cover not only existing NHS organisations but any organisation providing services to the NHS. The amendment, as worded, goes against the Government’s view that employers are best placed to determine the most appropriate pay and reward package to ensure that they recruit and retain the workforce that they need. Our clear view is that it would be inappropriate to require independent and voluntary sector providers to adhere to NHS pay when NHS foundation trusts, as the noble Baroness, Lady Murphy, rightly pointed out, already have such freedoms. The Government believe that to deliver the best care for patients, this freedom should be extended to all NHS organisations. I also take the noble Baroness’s point that while foundation trusts have the power to apply local terms and conditions for all staff, medical, clinical and administrative, very few trusts exercise those freedoms. There are around 400 trusts, and only one foundation trust—Southend—has departed from Agenda for Change, and the differences that it has negotiated are marginal. Employers can continue to use national pay. I would just make it clear that nothing that I have said means that the Government see no role for national contracts and negotiating mechanisms. We believe that many providers will want to continue to use national contracts as a basis for their local terms and conditions. However, employers, not government, should be in the lead on negotiations on national contracts. Of course, employers who move away from national terms and conditions would need to ensure that any new system did not expose them to equal pay challenges by delivering a fair and objective pay system, as Agenda for Change has achieved nationally. We do not intend to abandon the national pay frameworks, and we will expect them to be maintained for those employers who want to continue to use them. We will discuss with the staff side and the employers in the sector the appropriate approach to the national pay frameworks. The noble Lord, Lord MacKenzie of Culkein, spoke about the pay review bodies. The Government recognise that the review bodies bring an independent and expert view, valued by the Government and those representing public sector staff and employers. In the longer term, we will work with NHS employers and trade unions to explore appropriate arrangements for setting pay. He also highlighted the risks of local pay bargaining. The Agenda for Change pay system includes all the right checks and balances—for example, the national online job evaluation system—so employers locally can ensure equal pay for work of equal value, which is of course important. When employers decide to move away from national pay frameworks, they must of course continue their legal obligations under equalities legislation. The noble Lord, Lord Rooker, spoke about the implications of pay devolution and enlarged on the theme begun by the noble Lord, Lord MacKenzie. I understand that the NHS Staff Council is engaged in constructive discussions with NHS trade unions about the challenges facing the NHS across the UK and the scale of the financial problems facing employers and their staff. NHS employers and trade unions recognise the contribution that national pay frameworks have made to the development of a modern and effective NHS and agree that it needs to be fit for purpose for employers, staff and patients in the short and longer term. Talks are continuing between the unions and employers; my understanding is that they want to work within national pay frameworks. The noble Baroness, Lady Wheeler, asked specifically about the public health workforce strategy. We have been discussing with the NHS local authorities and others how the transition for public health can be managed most effectively for staff. We are working hard to get this right; we do not envisage applying a top-down approach to determining public health teams within local authorities. We will expect good employment law principles and practices to apply and any transfer that is a relevant transfer under the TUPE regulations will engage the TUPE principles. Additionally, the principles of the Cabinet Office statement of practice may apply. I hope that, with those comments, noble Lords are reassured, although I cannot go as far as the amendment would invite me to go on imposing mandatory national arrangements across the piece. However, I hope that I have said enough to encourage the noble Lord to withdraw the amendment.