There has been much hoohar served up in the news recently with the Government accused of giving ‘pay rises to bankers and pay cuts to nurses’. Like an unwelcomed rash following a particularly uncouth night in Magaluf, the debate about nurses' pay just keeps reappearing.
Covid-19 has given the public a front-row seat into the realities of nursing. Footage of them in the heat of action regularly seeps into the media, documenting a group of people crippled by long hours, unrealistic deadlines, and an immense weight of responsibility. The public recognise this with polling data showing near 90% of people supporting a pay rise for nurses.
Yet the jury has long returned on nurses’ pay – they already receive decent wages. The average nurse earns around £35,000 each year, with starting salaries up around 20% in seven years. Not an astonishing amount, but still higher than four of the five ranks of soldiers in the army.
Headline figures of cash-stricken nurses are often misleading. Data cited only seem to consider junior ranking nurses or recent graduates. Both receive wages by no means irregular to those of a similar age. As nurses progress through the ranks pay duly increases likewise, with typical salaries around £40,000-£45,000 for Band 7 and 8 nurses, with some increasing to more than £100,000 in higher Bands still.
The essence of the argument for higher pay is to give them what is ‘fair’. But here is a radical idea – allow the market to decide what is ‘fair’. The monopsony pay structure in the United Kingdom where the NHS acts as the sole vacuum of prospective nurses drives down price competition and leaves them on far deflated wages. Subject to the forces of supply and demand, the average nurse in the United States earns nearly £70,000 each year. If you are serious about nurse wages you should begin by ushering in greater use of markets and the equity it brings.
Nurses’ pay will endure as a preeminent policy debate of our time. Yet, guided by a religious devotion to our highly bureaucratic healthcare system, the scope for change is fairly small.