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Where did this week's Budget leave nursing?

Pat Cullen 29 Oct 2021 Chief Executive and General Secretary

Pat Cullen, General Secretary and Chief Executive, explains how this week’s Budget fails to address the challenges facing the nursing workforce

For those of us working in health and social care, the Chancellor’s Budget was bitterly disappointing. He missed an opportunity to address health inequalities and sustainable social care, and to improve patient safety by investing in nursing staff.

There were headlines of new hospitals, hospital upgrades and community diagnostic sectors. With these announcements, he raises public expectations too. But any new centre or clinic requires skilled staff to work within it and there was no commitment for a funded strategy for England to address the tens of thousands of vacant nursing positions in health and care.

Across the UK, the impact of staffing vacancies on health and care services are significant and nothing in the UK Budget announcements will help to address these underlying issues. The devolved governments in Northern Ireland, Scotland and Wales must take the opportunity in their budget setting to address nursing staff recruitment and retention in a meaningful way, including through fair pay.

Recent polling shows that the public's greatest fear for health and care services is the current lack of staff. I know you share that concern too. Without much-needed investment in the nursing workforce across the UK, care will continue to be delayed as waiting lists continue to grow.

The Chancellor’s statement made much of the Government’s commitment to levelling up – including lifting the public sector pay freeze - but failed to address a fully funded, fair and meaningful pay rise for all nursing staff, investment in nursing education, moves to tackle health inequalities or sustainable social care. With inflation set to hit 4.9% this year, your monthly pay will be stretched even further – and this is before you start to feel the impact of increased National Insurance contributions.  I am sure many of you will consider whether you can afford to remain in our profession.

When the pay freeze was announced a year ago, many thought all nursing staff were exempt from it. Much was made of an NHS exemption. But this overlooks the fact that many of our members work in social care, community or local government services and they are just as much in need of a pay rise. They should be paid at least the same as the NHS.

Staffing vacancies will not be addressed overnight by increased pay but the first step is for governments across the UK to value experienced nursing staff and recognise your value with fair pay.

At the moment, our members working for the NHS in Scotland are taking part in an indicative ballot to see what further action members are willing to take in the fight for fair pay. Ballots for eligible members in England and Wales open on 4 November too. A pay award for NHS staff in Northern Ireland is due soon and members will be consulted once it is announced. I urge you to take part in these ballots and to encourage your colleagues to vote too.

Patient safety must be the primary concern of every politician. Only when governments recognise the true value of nursing and our safety-critical role in patient care will they then take steps to credibly address the challenges facing the nursing profession.

The fight for fair pay and safe staffing will not end until the profession is respected and protected. Vote in the NHS pay ballots to have your say for yourself, your profession and the safety of your patients. 

And finally, the independent review into the organisational culture of the RCN continues, being led by Bruce Carr QC. Members now have until 21 November to engage with the review so please do read more on our website about the scope of the review and how to engage. I am determined that this review gets to the truth, provides clear recommendations and supports us in getting the RCN into a shape that all members can be proud of again.

Further information

RCN responds to UK Budget 

RCN representation to HM Treasury Spending Review and Budget 2021

Ipsos Mori Global Health Service Monitor 2021

Fair Pay for Nursing 

Staffing for Safe and Effective Care

Transforming the RCN: Independent review into the culture of the RCN

Pat Cullen

Pat Cullen

General Secretary and Chief Executive

Pat has worked at the RCN since 2016. Before being appointed General Secretary and Chief Executive, Pat was Director of RCN Northern Ireland from May 2019 to April 2021.

Page last updated - 30/03/2022