29E. Nurses subsidising health services

That RCN Congress calls for an end to nurses subsidising health services.

Progress reports

Submitted by: North of Tyne Branch
Council lead and committee assigned: Tracey Budding (until October 2011) and Anne Wells (from October 2011), Membership and Representation Committee
Committee decision: Existing work addresses this issue
Members involved: None

Final summary update at May 2012

This debate largely focused on concerns from members about costs they incurred while working in the NHS, such as car parking charges and mileage reimbursement rates.

For staff in the NHS there are three main issues which the RCN has been monitoring and lobbying on via Staff Side at the NHS Staff Council.

A new system for car mileage reimbursement is proposed for introduction in July 2013 with current rates remaining in place until then. Discussions have continued on this new harmonised system and the impact of a new 3,500 mile threshold. At the time of writing, the aim is to achieve resolution at the Staff Council meeting in March 2012. The RCN was pleased to note that in the Budget 2011 Government increased the tax free component of reimbursement from 40 to 45p.
Recent changes to AfC mean that those offered a lease car will, if they wish, be able to accept it on the basis of ‘business use only’ rather than having to accept it for personal use as well.
The impact of car park charges on staff also continues to be a concern.

The RCN is continuing to monitor and raise these issues through the NHS Staff Council.

Update at November 2011

The Congress debate on this agenda item covered concerns from members about costs they incurred while working in the NHS. These included car parking charges to park at work, the concern that mileage reimbursement rates did not reflect the actual cost of motoring and that lease car schemes offered by employers to those who drove significant miles were either complex or costly.

For staff in the NHS (the main focus of the debate) car mileage reimbursement is covered by Agenda for Change (AFC), Section 17. A new system has been agreed, for introduction in July 2013, with current rates (last updated in July 2008) remaining in place until then.

In the Budget 2011 Government increased the tax free component of reimbursement from 40p to 45p. The Annual Mileage Allowance Payment had been at 40p since its introduction in 2002/3. The increase of 5p means that those who are reimbursed over 40p and up to 45p will be able to keep all of their reimbursement rather than suffer a tax liability.

Recent changes to Section 17 and Annex M of AFC mean that in future those offered a lease car will, if they wish to, be able to accept it on the basis of ‘business use only’ rather than having to accept it for personal use as well. NHS organisations are allowed to charge for car parking on their premises. Staff who have a requirement to use a vehicle at work, e.g. community nurses, will often have special arrangements in place to ensure that they are able to park at their workplace without significant additional cost.

These issues have been taken forward by the RCN Employment Relations Department and the RCN in the NHS Staff Council.

At its meeting on 21 October 2011 the NHS Staff Council noted progress on the Review of Mileage Arrangements; Staff Side had presented a paper to the NHS Staff Council on 8 July 2011 which set out their concerns about a particular aspect of the new system of reimbursement for travel expenses (the impact of the 3,500 threshold). At the Executive on 9 September 2011, Joint Secretaries agreed to have further discussions about this issue and report back at the Executive in December.

Debate report

Proposer Lee Ranyard of North of Tyne branch urged Congress to put an end to nurses subsidising health services through the everyday costs of fuel, lease cars and car parking. He stated that the car was an essential piece of equipment for community nurses and wondered what would be next, “Rent a chair? Pay-as-you-go defibrillators?”

Lisa Falconer pointed out that hidden costs are not just in the community, reminding Congress that every extra minute spent after a shift and every lunch break missed was just another way nursing staff are subsidising health care debates.

Congress was very much behind the proposal that every nurse deserved to be fully recompensed for their work and the vote was passed by an overwhelming majority.