The Chief Executive of NHS Improvement has suggested that the health service should be granted more funding if the government indeed decides to scrap the public sector pay cap.
This has been a hot potato issue over the last few days, with the Labour party led by Jeremy Corbyn calling for more pay for public sector workers.
And Jim Mackey, speaking at the Patient Safety Congress in Manchester, suggested that it would be impossible for the NHS to deliver efficiency savings that would match the funding necessary in order to increase the wages of staff.
“If and when the pay cap is lifted, there needs to be money to back it. I’m not sure how we would generate that level of internal efficiency to deliver it otherwise”.
Mackey also believes that more than merely raising pay will be required in order to improve staff morale.
“If everybody gets an extra 1 per cent but demand is still relentless; you have a clinical model that doesn’t work; you have a leadership that doesn’t say thank you; you’ve got angry patients – the 1 per cent is not going to do anything to how you feel about work. We have got to deal with this whole thing in the round and let’s not oversimplify it.”
It is notable that the Chief Executive of NHS Improvement has been the first major figure within the healthcare system to comment on the issue since it became a major talking point immediately after the general election.
But Care Quality Commission chief executive Sir David Behan, also speaking at the same event as Mackey, noted that there has been an increased financial burden on the adult social care system since the national living wage was increased.
“I think the debate about culture and the importance of culture is hugely important but the national living wage cost adult social care £380m. If you are on £8 an hour and you have had [a pay rise of] 1 per cent a year for the past five years and your utility bills have gone up something like 4 per cent per annum, then you are genuinely going to be struggling.”
And Mackey indicated that an adequate level of autonomy must be put in place when the existing financial constraints are brought to a close.
“We are in an overcentralised system. We are in an overcontrolled part of the cycle of the NHS’s evolution. That’s absolutely been necessary because of the financial situation but none of us should think these things last forever. We have got another couple of years of control totals and all those mechanisms that we are all using now.”
Mackey believes that developing an autonomous model should be a priority for the authorities.
“The key thing for this year is developing what earned autonomy looks like in the future – so we recognise how the world’s fourth or fifth biggest employer actually runs itself from the service point of view rather than from the centre.”