I agree with Dr Mullan that pay is difficult to sort out because it is often systemic, but it needs to be fair.
I speak today solely about contract staff in the NHS, although I associate myself with the comments made by Munira Wilson about the similar situation in the social care sector. I am not talking about those who are directly employed; I am talking for myself and on behalf of my right hon. Friend Ms Abbott, who is unable to speak because of shielding, about the thousands of staff working on outsourced contracts who are paid considerably less—often lower than the minimum wage—and who have fewer rights to sick leave; who have much less job security, if any; who are often on zero-hours or uncertain contracts; and who are disproportionately from black, Asian and minority ethnic backgrounds. I pay tribute to the GMB trade union for highlighting how many agency workers were going to work sick because they had to choose between working and paying their basic bills. The move to a secure sick pay is a start, but it is not enough and it is not yet firmed up for the long term.
Homerton University Hospital in my constituency is an excellent hospital that does great work, but it is now in the throes of agreeing a five-year extension to a contract for hospital cleaners and other ancillary staff employed by ISS. My right hon. Friend the Member for Hackney North and Stoke Newington and I are concerned about such a long extension leaving key workers on low pay without the protection and recognition that NHS employed staff have, but the real issue is systemic: it is not about the individual trusts but about how the Government choose to fund hospitals, such that from day one they cannot fund their full staff complement. The NHS systemically is funded such that it bakes in the assumption of low-paid, insecure workers on outsourced contracts. As of 2018-19, for which we have the most recent figures to be audited, the combined deficit of trusts in England was £844 million—up £86 million from the year before. That is the heart of the problem.
My right hon. Friend the Member for Hackney North and Stoke Newington and I are really clear that the Government need to foster a system that is not reliant on low pay. So low-paid are these workers, the irony is that their pay is topped up by taxpayer-funded universal credit and other benefits. We are both clear that if people are facing the same risk, they should have the same reward. This inequality cannot continue, and if we are to learn anything from the covid-19 crisis, it is that we need to level up so those who work for the lowest pay—poverty pay—are getting a fairer deal.