Is more pay the solution? Why and how we should ask NHS and Social Care professionals what they want.
I wholeheartedly agree with giving health and social care professionals fair pay, better contracts and of course exemptions from bastard home office immigration stings; I’ve signed the petition, but... we can’t be satisfied with just that when that argument is won. We also can’t assume that better pay is the thing they want.
This Coronavirus pandemic has shown up how woefully ill-equipped our health and social care systems are. We don’t have enough ICUs, enough beds, enough PPE, enough testing capacity, enough ventilators, enough hospitals even; and the list goes on. This crisis has made clear what should have been obvious to many before, but sadly wasn’t. We need to invest in equipment and facilities so that doctors, surgeons, nurses, care workers and all their colleagues have world class facilities to work in and all the equipment they need. When they’re not being gagged, that’s what they are crying out for right now and it’s not just so they can do their job properly, it’s so they can stay alive to do it at all*.
Give them the pay rises they deserve yes, pay them fairly, show them respect in monetary terms, but remember if you work in health and social care just for the salary, you’re probably not in the right job. The vast majority of health and social care professionals aren’t in it for the money alone; they’re in it to care for others and to do that they need equipment.
Money will be thrown at both health and social care after all this; it is guilt money, but we shouldn’t allow Ministers and Chief Execs to decide how it is spent. What I’d love to see is post pandemic health and social care assemblies, like citizens assemblies, where a large representative sample of professionals from all levels of both sectors are convened to discuss how to spend the new money. The result of this process will be a series of recommendations that are put to decision makers - and hopefully listened to. There is a Government led precedent for this sort of approach and if done well it can lead to better policy and improved outcomes for us all.
There should be conventional citizens assemblies on these issues too and they should have more depth, breadth and gravitas than previous ones - it might be time to wrestle some of the decisions making process (and maybe even power) back from Whitehall to the people. We may find some surprising outcomes.
My hunch would be that more pay for themselves won’t be the thing that is most strongly prioritised by health and social care professionals. They will likely want fair pay, better contracts and less shithousery from Priti Patel; but these are selfless, compassionate, intelligent people. What they might want more is an NHS and Social Care system that provides a brilliant service. That might be where they’ll want the money spent. After all, increasing a Nurses pay by 3% right now isn’t going to kit them out in PPE by next week.
The Golden rule says ‘do unto others as you would have them do unto you’ and it guides our thinking a little too much sometimes. We shouldn’t assume that because better pay is how we would like to be valued, that better pay is how others would like to be valued too. This is us projecting our values onto others and assuming they share them. Is it not better, as Carne Ross puts it, to treat others how they wish to be treated, not as we wish we were treated? Salary might be super important to us (unsurprising in a society where the ‘material wealth = happiness’ myth is so strong), but it might be a less of a priority for someone else.
There is more than one way to show our health and social care professionals that they are valued, clapping is one, better pay is another, but giving them the opportunity to tells us what it is they want - and then giving it to them - is surely better; it might be that access to the tools they need to do their job well is the thing they value the most. We should ask them.
*A few more examples of calls for more and better equipment and facilities:
’[Prime Minister], you have destroyed our capacity to provide a multitude of services in the community to keep people healthy and out of hospital.’ https://www.theguardian.com/commentisfree/2019/dec/10/doctor-johnson-thousands-deaths-nhs-patient
’From showers to rest areas, we are expected to exist in areas that are fatigued and often quite grim. We are all working incredibly hard and it would be great to take a much-needed break in areas that are nice – I’m not expecting David Lloyd style facilities, but money to update our environment would be a huge boost to morale.’
https://www.marieclaire.co.uk/opinion/nhs-doctor-frontline-coronavirus-692919
’Our members are telling us that their confidence to carry out patient consultations is being impacted by uncertainty over the quality of PPE being supplied to their surgeries. This is particularly relevant for aprons and eye protection, which many believe to be providing inadequate protection.’
https://www.rcgp.org.uk/-/media/Files/News/2020/RCGP-SoS-letter-PPE-march-2020.ashx?la=en
‘This is an immensely difficult position to be in, but is ultimately down to the Government’s chronic failure to supply us with the proper equipment.’
https://metro.co.uk/2020/04/10/doctors-sceptical-ppe-pledge-frontline-nhs-staff-continue-die-12541226/
’But staff on the front line tell a very different story – with some having to make their own gowns from cut-up curtains, reusing goggle or using bits of plastic.’
https://www.mirror.co.uk/news/uk-news/nhs-staff-still-putting-lives-21861100