I start by acknowledging just how long the constraints on pay in the NHS and across the public sector more generally have applied, and I say that fully recognising that I was a member of the coalition Government. I understood and accepted the reason why constraint was necessary at that time, because public sector pay had run quite a long way ahead of private sector pay, but the situation is very different now. Ultimately, we cannot justify year-on-year real-terms pay cuts for workers in the public sector as a way of sustaining our vital public services, but that is what they are facing and we have to face up to it.
Alongside the moral case is the fact that the cap simply will not work. The Royal College of Nursing says that the NHS in England is some 40,000 nurses short, and that has consequences. Among the doctor workforce, rota gaps are endemic—I suspect Dr Allin-Khan recognises that. It is particularly bad in some parts of the country and in some specialties. James Morris spoke about psychiatry. According to the survey published by the Royal College of Psychiatrists earlier this week, the numbers of psychiatrists vary significantly around the country, with some areas disturbingly short.
We often talk about doctors and nurses in this House, but so many other people work in the NHS. Allied health professionals, caretakers, orderlies and all sorts of other people are affected by the cap, many of whom are on very low pay. I want to give a particular shout-out to paramedics in the east of England, many of whom regularly work very long shifts and often get home utterly exhausted after dealing with traumatic events. I pay particular tribute to the 70 staff from the East of England Ambulance Service NHS Trust who have signed up to become blue light champions to highlight the importance of mental health among that organisation’s workforce. That has been done with the support of Unison and the involvement of Mind, which does really important work with frontline workers.
When we talk about pay levels in the NHS, we should also think about pay levels in social care. Non-payment of the minimum wage is endemic in many parts of the social care system, which is intolerable. Too many workers who provide care in people’s homes are still not properly paid for travel time. Information I got from Her Majesty’s Revenue and Customs recently showed that millions of pounds of unpaid wages had been recovered following an exercise in social care. When we talk about the need for a fair deal for NHS workers, we also need to talk about a fair deal for people working in social care, who do often very unattractive but vital work.