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Too much and not enough

Too much and not enough

At the start of the week, I had a dilemma in knowing which absolutely horrifying news story to focus on this week: the cost of living crisis or the impending climate crisis. Luckily, the Government made this decision for me yesterday with its announcement that they were awarding NHS staff a 4.5% pay rise this year.

This pay award has completed the achievement of being both not enough and too much. The cost of living crisis means that it won’t be enough for the majority of NHS staff, including salaried doctors and other practice staff. Inflation is now at 9.4%, so a 4.5% pay rise does little to help NHS staff. For junior doctors, they won’t even receive this as they have a multi-year deal, and we can look forward to the prospect of justified industrial action from them (and nurses too).  

But it also manages to be too much for GP partners. They would love to honour the pay rises – partly because the vast majority think their staff have earnt it and need it, but also because we are in the middle of a recruitment crisis. Yet, in England, they are still bound to the multi-year deal signed in 2019, which provides a 2.1% increase per year. So, for them, honouring a 4% rise in pay – at the same time all their other expenses are increasing – will be impossible.

The solution is clear. The 2019 contract had a ‘pay balancing’ mechanism, which stipulated that the parties would review the uplift if inflation or deflation was exceptional. We are certainly at that point, but I personally have heard nothing about that being enacted yet.

Yet there is a further sting in the tail. Before the pay announcement, NHS England had said that they couldn’t afford anything above a 3% increase. And where would they find cuts if a larger increase was awarded? Yes, it’s primary care, of course. So, instead of getting a funding uplift as the 2019 contract suggested, it may be more likely that funding to general practice as a whole will decrease.

There is one culprit for this mess, and it is not NHS England. It is this Government. I am no economist, and they can’t be blamed for this whole cost of living mess, but having been in power for 12 years, they certainly contributed. So it is up to them to find the funding needed for the NHS. But, with the Tory leadership in an arms race to cut taxes, we are more likely to have a mild summer in 2050 than we are a solution to this mess.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at



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Patrufini Duffy 20 July, 2022 5:25 pm

Imagine how many urine bottles and stool pots with their plastic little floppy bags are churned out to under 30 year olds in the UK. And then binned. Then repeated. NHSE still working on a GP beuracracy. Like Boris’ obesity campaign, still trying to figure that one out, lip service. Long live convenience medicine, and antibiotic resistance. Long live climate change and cost of living. All their orchestrated plan, until made anarchy, riots and underground retaliation. Imagine if Polly or Henry were told, we need you for a war. They’d say, I need a Fit note, I get anxiety and IBS diarrhoea, sorry I can’t help the nation, plus I was hoping to go Bali next week. The local pharmacist has tripled his cabinet space for sertraline. Get them through it “all”.

Christopher Ho 22 July, 2022 10:44 am

“I am no economist, and they can’t be blamed for this whole cost of living mess, but having been in power for 12 years, they certainly contributed. ” – You are right there – you are no economist. They can’t be blamed for this whole cost of living mess? Go look at the World Economic Forum agenda, the entire “green” lobby of the left, the influence on the Tory (more accurately Labour-lite) govt and its expenditure, the breakdown of where your energy costs go, and tell me big govt is not to blame…

Dylan Summers 23 July, 2022 1:45 pm

I can’t help seeing this as more evidence that the partnership model doesn’t work any more.