With inflation at a 40-year high, the Scottish government’s latest pay offer for NHS staff of £2,205 has been criticised by the unions representing nursing and midwivery staff as failing to address the workforce crisis or meet staff needs.

Announced by the government today as a “record pay rise”, averaging 7% across all staff, the increased offer was made after negotiations with NHS unions beginning last night and continuing into the early hours of this morning.

The government says the flat rate offer would mean the lowest paid would get a rise of more than 11% and qualified nursing staff receiving up to 8.45% more,

While the government says this is the largest pay offer to NHS Agenda for Change staff since devolution and would mean they “remain the best paid in the UK”, the immediate responses from the unions representing both nurses and midwives has been that ministers should think again.

Ministers say, if accepted, the offer will be backdated to 1 April 2022 with the aim that the additional earnings will be added to pay ahead of Christmas.

Health Secretary Humza Yousaf said:

“I am grateful to trade union colleagues and NHS employers for constructive discussions on pay.

“This has been another exceptionally challenging year for our health service and we have a difficult winter ahead, but I am pleased that we are able to recognise the service and dedication of our healthcare and support staff with this pay offer.”

However, the Royal College of Midwives (RCM), representing midwives and maternity support workers says this offer is “disappointing and deeply insulting” and is calling on the government to review its position.

It is asking the Scottish government to return with a meaningful offer because this offer will leave the vast majority of its members with a “significantly below inflation” pay award. RCM says most members will be worse off than they were a decade ago as inflation is already over 10% and rising.

Midwives struggle in cost-of-living crisis

RCM Director for Scotland Jacki Lambert said that NHS staff “will not be fooled” by the offer and that it is not right that workers are heading to food banks as they cannot afford food, heating and the petrol needed to get to work. She said:

“This is not the substantially increased offer promised by the Scottish government and it will be very, very disappointing news for midwives across the country.

“It is designed to make them and NHS staff think they are getting something, when in reality they are getting very little. They and their colleagues will not be fooled by this tiny carrot that the Scottish government is dangling in front of them.”

She added that in a survey of RCM members last year, three quarters were already considering leaving with many midwives and maternity support workers not feeling valued in their workplace.

The RCM says there were opportunities during negotiations to present a better deal to more staff but this was rejected by the Scottish government. Jacki Lambert said:

“It shows yet again that the Scottish government are dismissing midwives and their colleagues and taking them for granted, and that they do not value them, their skill, and their dedication. The initial pay offer was an insult, and the revised offer just adds injury to it.”

The Scottish government’s pay offer is worth £480m in total to reach over 160,000 employees including nurses, paramedics, allied health professionals and healthcare support staff.

In the government’s news release, it said this pay offer would mean salaries for the lowest paid will rise more than 11%, with "qualified nursing staff receiving up to 8.45%, helping the lowest paid staff through the cost-of-living-crisis".

Yet, both the RCM and the Royal College of Nursing (RCN) Scotland – the body representing the largest number of nursing staff across Scotland – say this is a “real terms pay cut”.

Nursing workforce crisis not addressed

The RCN also highlights that, though it is an improved offer for those lowest paid staff, the new offer is not doing enough and does not address the underlying workforce crisis. With a large number of vacancies existing in the Band 5 and above positions, this offer, the union says, will do very little to attract people to those roles.

RCN Scotland Director Colin Poolman said the government has again failed to listen to members’ concerns for patient safety in this workforce crisis, adding:

“Under this proposal, registered nurses continue to face a significant real terms pay cut. This is even more stark with the news that inflation reached a 40 year high. Many are making difficult decisions about how to heat their homes, feed their families and travel to work while carrying the burden of being unable to do the best for their patients due to severe staff shortages.”

He said that the RCN ballot for strike action continues and urged members to post their ballots soon to have their voice heard and receive the recognition this offer has not provided:

“This offer fails to recognise the clinical skill, expertise and leadership of registered nurses. It will do nothing to address the staffing crisis, the life-threatening delays we are seeing at emergency departments or the lengthy waiting lists for treatment across Scotland’s NHS.”

The RCM’s ballot for midwives and maternity support workers on the issue of strike action closes on 27 October.

Ballots for nursing staff members of RCN will close soon after on the 2 November and, if members vote for strike action, it will be the first time in the RCN’s history that its members will go on strike across Scotland. Earlier this year, 90% of its members in Scotland who voted to reject the government’s pay offer of 5% for the majority of staff.

Read more: RCN: Patients and staff suffering due to shortages; Staff shortage concerns in latest MWC reviews; RCN: treating patients in corridors ‘scandalous’