Chris Hart argues that COHSE should welcome the challenge of local pay bargaining
COHSE Journal May/June 1991
The Time when health workers will sit across the table from their managers directly negotiating for their pay and conditions of service is not far away.
Although they talk about keeping to existing arrangements for the next 12 months, the new Self Governing Trusts (SGTs) will introduce their own pay bargaining. And, with the Nurses' and Midwives' Pay Review Body under threat and the Government's expressed desire to end the Whitley system, a clear move away from national bargaining emerges.
Once the national system is smashed within the trusts — the hospitals and units that have opted out of health authority control — it surely will not be long before the newly established directly managed units follow.
National bargaining has been fiercely defended by all health service unions in recent years and many trade union officials have viewed its loss as a blow from which we would never recover.
But what will the implications of any changes be? The Whitley Councils are our current national negotiating bodies, made up of national officials and some lay members from all the unions who have members in a particular occupational group in the health service and of management representatives. They predate the NHS and were originally seen as a means of, amongst other things, by-passing militant local shop stewards' committees.'
The new NHS and Whitleyism seemed suited to one another: consensus between employer and employee were an ideal that, after all, everyone apparently wanted. While industry was wracked by serious and damaging disputes, the NHS was relatively quiescent, despite nurses' periodic threats to take action as they saw their levels of pay slipping further behind that of other workers.
Whatever consensus there was, however, finally shattered in the early 1970s. The Whitley Councils were cumbersome, remote bodies, and criticised by some in the union movement and management alike who viewed the relationship between civil servants and national officials as too interdependent and cosy.
In hospitals, staff working more closely together became increasingly aware of pay differentials, and resentment was stoked by large pay rises for medical staff and, at the other end of the scale, the introduction of incentive bonus schemes (IBSs) for ancillaries, who were facing tougher, industrially oriented managers, conscious of the need to contain costs and push for greater "efficiency". With their own stewards now directly engaged in negotiating for their wages, more ancillary workers became unionised.
Industrial unrest spread throughout the service with dispute following dispute, affecting almost all disciplines, doctors included. It peaked with the massive nurses' victory, led by COHSE, in 1974 but also included several major disputes involving ancillary staff.
The massive upsurge in trade union membership and activity at the time of the introduction of IBSs perhaps provides the closest parallel with contemporary events. For the introduction of local pay bargaining undoubtedly presents COHSE with the greatest opportunity to improve the lot of its members and increase membership it has had in years.
The Government, in seeking a hardline managerial solution to a serious problem (the NHS, as
The introduction of local competition into the labour market comes at a time when demographic changes will favour both trained nurses and untrained workers equally.
Of course, there are problems to been overcome, and these should not be minmised. Hospital managers, whether in trusts or not, will try to recognise "staff associations" rather than unions. They will also almost certainly try for no strike ideals with organisations like the RCN, promising better pay for a few staff on higher grades while bringing in more lower graded posts, but — and this is a big but — they will only be able to do that if COHSE members are willing to allow them to. For the first time, the actions of health workers, whatever occupational group they are in, will directly affect their pay, conditions of service and their position in the organisation.
The fierce competition driving hospitals will mean they cannot afford to fall behind their rivals in the contracting world of the new white paper because their staff are in dispute; nor can they hope to sack groups of skilled workers and replace them quickly if there is no agreement on terms.
Another major factor is going to be the inexperience of NHS managers in negotiating. The vast majority have had no training and lack an understanding of the principles involved and knowledge of the factors around which such crucial negotiations will take place. Furthermore, the old management trick of doing nothing and remaining intransigent will no longer work in such a situation: good managers, or those who recognise and accept the changed circumstances in which they find themselves, who are willing to look at the real issues and negotiate around them, will attract staff and retain them.
There are possibilities that managers will try and overcome these shortcomings by bringing in paid consultants to do their negotiating for them, or by setting up regional or district wide cartels, which will try to set and impose localised pay levels. But outside consultants will not know all of the local labour market factors, nor have the in-depth knowledge about who they are up against, locally, that is needed. And managers seeking to impose their will across a geographical area will, again, only be able to do so if branches are weak and disorganised, and lacking a network of links and contacts within their own union.
Fundamental and important changes will occur in COHSE as well. No longer will members be looking for things to be sorted out by a largely mythical "Head Office" or "leadership" who are too far removed from the local situation and trapped within a democratic but, there fore, necessarily cumbersome bureaucracy to meet the needs of those members who want action. The balance of the relationship between the local branch, region and head office will shift, with far greater emphasis to the branch and its members, which can only be good for the democratic process within COHSE.
Paradoxically, although branches will inevitably become much more independent, the respective roles of region and head office will increase in importance. For they will have to supply accurate, up to date information, which would include:
• Pay comparisons with health workers in other districts/regions;
• Pay comparisons with other appropriate occupational groups;
• Rates of inflation and other financial factors.
For their part, branch officials will need to find out:
• Complete breakdowns of staff, grade by grade;
• Local earnings and employment factors eg rate of unemployment, new intakes of student nurses and the number of those about to qualify;
• What the hospital's budget is and how much of that goes on pay.
Regions can also distribute information about tactics used in different areas.
Educational workshops based on bargaining issues will, obviously, keep activists up to date with the latest techniques and promote communications with colleagues in nearby branches. Supportive action will benefit not just the branch that receives it but others in the region as levels of pay are pushed up.
Undoubtedly, it will prove a great test for COHSE. Especially as a strong, logical and well developed case put across skilfully by fair union negotiators will very often not be enough. The arguments will be won by negotiators who have a tough, disciplined trade union branch behind them, who bind their success to its democratic processes, going back to the membership, involving them in every stage of the negotiations. By necessity, the branch will have to be prepared to stand behind their officials and negotiators and be ready to take action if and when the time comes.
If and when the new union becomes a reality it will, of course, only add to the strength of the workers in their pursuit of a fair wage. In fact, particularly in the trusts, there is every incentive for COHSE members to join with staff in NUPE and NALGO to begin the process of working together to co-ordinate claims and negotiations.
Local pay bargaining is about to usher in a new era for health service trade unionism. If we are prepared to grasp the challenge it could prove to be a very rewarding one
1. John Lister, Cutting the Lifeline (1987) Journeyman Press,
2. Nick Bosanquet (ed). Industrial Relations in the NHS (1979), Croom Helm,
3. Rudolf Klein, The Politics of the NHS, 2nd edition (1989), Longman,