Well, yes, as you say

The fact is that people also understand that public services have already been cut to the bone. They know the NHS is stretched to and beyond its limits. But they also can see that in education, the judicial system, in care services and so many others sectors.

This is in response to the idea of a public pay freeze.

OK, but it’s not exactly an argument in favour of higher public sector pay, is it? Paying the same people more doesn’t particularly improve the volume of services delivered, as an example, does it?

20 thoughts on “Well, yes, as you say”

  1. Yes it does. Economists tell us it does. For GDP, the productivity of public services are assessed at what they cost. They cost more, QED they must be more productive. You made the fucking rules. You live by them.

  2. In those parts of the public sector where there’s evidence of understaffing but where any advertised jobs get a strong response from qualified applicants, there might even be a case for a pay cut (at least for new hires) so that more staff can be taken on within current budgets.

    Not sure how much of the public sector that would actually apply to – e.g. number of nurses is below where it’s supposed to be and there’s problems along the whole training pipeline, so might be worth jacking up their starting pay / training subsidy – but, speaking purely theoretically, “wage restraint” and “service cuts” shouldn’t be treated as synonyms and it’s lazy thinking to conflate them.

  3. We need to pay more to attract a better calibre candidate.
    So will the higher pay apply to the existing people – presumably a lower quality of person?

    BiS – you made me laugh. Though for once the NAO has decided that if you pay teachers and 1/3 of kids get no education maybe we need to break the input=output metric.

  4. On the wireless somebody was putting the argument that public pay must go down because private earnings have gone down.

    Private *earnings* have gone down because we’re in a recession and private *doings* have gone down.
    Public doings have also gone down, but the public sector have still been *paid* the same, so the same amount of pay is being paid for less work, so public *earnings* have actually gone *UP*.

  5. Bloke in North Dorset

    hey know the NHS is stretched to and beyond its limits

    Yet another evidence free assertion out of that end of terrace in Ely.

    NHS England bed occupancy is at or just below 2019 levels and

    Critical bed occupancy rates are on average ~10% below 2019 levels, which in turn were at ~80% across the NHS regions.


  6. “Employers pay what they have to pay to attract and retain people who can do what they want done.” – GC

    As a Business 101 proposition, if you have all the people you need, there is no reason to pay them more. The teachers’ union claims that if you just paid teachers more, you’d have better teachers. As IP points out, the crappy teachers aren’t going to quit because you pay them more.

    Government/politics ignores business considerations. They’ll pay people more if they vote for them. Hence the 300 square mile festering sewer of civil servants around Washington, DC. “Here’s the deal: we’ll make you a GS-14, and you make nice contributions to the Democrat party every year.”

  7. Bloke in North Dorset

    I remember reading something in the ’80s for some research we had to as part of an Army course. Productivity did generally increase after a pay rise, but then quickly regressed to the mean, less than 3 moths IIRC.

    That was private industry, the problem ith those paid by the state is that they see pay rises as an entitlement so I’d be surprised if there was any increase in productivity.

    As a Business 101 proposition, if you have all the people you need, there is no reason to pay them more.

    That depends on the market. As a radio network planning engineer just as GSM licenses were granted and networks being built we did very nicely for regular pay rises to keep us from moving, thank you very much. Of course the market did its job and by about 2000 there was no longer a critical shortage and by 2005 it was just another job. By then I’d was doing other stuff.

  8. The NHS seems to have endless cash for diversity coordinators and other non-jobs that are currently being advertised for something that is supposedly cut to the bone…

  9. MBE,

    “In those parts of the public sector where there’s evidence of understaffing but where any advertised jobs get a strong response from qualified applicants, there might even be a case for a pay cut (at least for new hires) so that more staff can be taken on within current budgets.

    Not sure how much of the public sector that would actually apply to – e.g. number of nurses is below where it’s supposed to be and there’s problems along the whole training pipeline, so might be worth jacking up their starting pay / training subsidy – but, speaking purely theoretically, “wage restraint” and “service cuts” shouldn’t be treated as synonyms and it’s lazy thinking to conflate them.”

    But every training place is taken, and we have something like 2 qualified applicants for every training place. The bottleneck with nursing is the lack of places, not lack of applicants.

  10. Bom4 with regard to nurses, you should give a citation. From what I have seen, there is a severe under supply of trainee nurses. Older nurses are stressed out and leaving and the re-supply is feeble. Just quoting from the official literature. I regularly get in trouble here for quoting empirical literature so show me that there are masses of people wanting to train as nurses

  11. Spud is trying to rationalise the yoy deaths now and, of course, it is not down to fewer operations. He is trying to outdo Simon Wrong Lewis, for whom every death is down to capitalism. I guess, like the Dillow twat, he has a berth to grow his beard and spout inanities

  12. @bom4

    I put nursing up as an example where a case might be made rather than a definitive “pay them more now!” thing, but I suspect the case is pretty strong. It’s an entire pipeline issue, not just a shortage of people entering at the very bottom, but too many higher-ups leaving resulting in some specialisms (the stuff that takes additional training) being short. People having curtailed careers is a very expensive waste of all that training. That’s the kind of situation where efficiency wages to reduce turnover start making sense https://en.wikipedia.org/wiki/Efficiency_wage

    You get a misleading impression just looking at applicants per degree place for nurses, just as you would trying to judge whether the NHS faces a shortage of doctors based on how many people apply per med school place. For one thing not all candidates are suitable and even out of those selected, at the moment there’s a one in four attrition rate on nursing degrees which messes up the pipeline further on and means many of the clinical placements the NHS provides are wasted on students who don’t end up as nurses. Part of that is difficulty coping with the academic side or just deciding it’s not the right career for them, which are issues that might never be resolved in their entirety but more competitive entry would allow universities to filter better. But a surprisingly common cause of students dropping out or deferring a year is money issues. Nursing is harder than many subjects to self-fund by part-time work due to teaching hours and being sent away on placements. Better financial support for trainee nurses might (not saying will, numbers need crunching, but there is an arguable case) be more efficient than giving scarce and expensive training places to people who drop out for money reasons.

    A second kind of problem with judging by the takeup of university places is that the NHS doesn’t just decide the appropriate number of uni places and the universities set up that many positions in the hopes of attracting enough applicants to fill them. It’s actually a two-stage process – the NHS needs to attract enough universities to offer enough training places, then the universities need to fill them. The NHS can only offer a certain number of clinical placements which effectively imposes an upper limit on nurse training numbers, but due to recent issues with student recruitment and retention, university nursing schools actually haven’t set up enough course places to match the NHS offer. (Compare this to one of the challenges or controversies about the government’s commitment to expand med school places – that’s a course where universities see prestige in setting up new med schools and student recruitment/retention isn’t as challenging as nursing, so unis creating the places is the relatively easy part, but the problem has been getting the NHS to create enough meaningful student placements with adequate supervision. Many senior medics grumble about the way the new placements are being organised, often in parts of the country with little experience at providing this level of medical education, even if they approve of expansion in general.) It may take time for nursing schools to build up their capacities or for universities which have never had (or in a few cases have closed) nursing schools to open them. Here it’s less clear that nurse pay is a big issue rather than the structure of how unis are funded – though it might indirectly help if universities felt student recruitment would be easier so they could expand places, or if nursing was seen as a sufficiently high-status professional career that “posher” unis opened new nursing schools.

    There’s some discussion of the issues at https://www.independent.co.uk/news/health/student-nurses-career-job-nhs-universities-degrees-england-a9510326.html but if you want to dig deeper the Health Foundation (who do some excellent stuff) have researched the structural and economic issues around the nursing shortage.

  13. No, not the link itself, but is there an antisemitic thingy to block hebrew letters…

    מרים אביגל – בת הדייג

  14. Let’s say I could find a governmental teat sucker who did an equivalent job to mine. I’d say to him; Guarantee you permanently inflation linked (or maybe bit above) pay but on the condition we swap pensions (I keep an eye on mine and what the invented “pandemic” has done to it).

    Would I get any takers?

  15. @Jussi
    URLs using non-latin alphabets need to be encoded

    מרים אביגל – בת הדייג
    would be

  16. ‘public services have already been cut to the bone’*

    See, that’s why you can’t rely on public services: they are ALWAYS cut to the bone.

    Remember, NHS is like counting on the DMV to keep you alive.

    *The lying creeps need a new metaphor.

  17. MBE,

    That’s interesting stuff, thanks. I was reading about the shortage of paramedics. Almost no-one wants to do it and the people who do get burnt out doing it.

    The NHS really shouldn’t have a problem with staffing, though. They’re roughly speaking a monopoly employer run by the government. The shortage of skilled programmers is because people can burn through £10K of training and leave. Not really the same with doctors. And they can demand AAA grades for medicine because so many people want to do it.

    But the whole thing sounds shamolic. If you join a car factory as a trainee, there’s a whole process around initial training, support, extra learning and development. It’s goal-orientated around getting operatives on the line doing their job well. They don’t do shitty training to increase numbers.

    The state always does this though. They deliver a target without measuring quality, like Moskvitch production statistics. The minister has declared how many nurses will graduate, and you deliver that number.

  18. @bom4

    A lot of doctors do take the training and run. You can come across a surprising number of ex-doctors (very early quits, ie before making consultant) in some other professional careers like management consultancy. Few years of work on the frontline and they can say they’ve shown evidence of strong decision-making skills under pressure etc on top of the academic stuff, and there’s a few alternative careers that offer equivalent or higher pay than medicine that seem to lap that up. I wonder if @big comes across them in biotech too. (A more extreme case is Pakistan where upper middle-class women make up a huge chunk of med school places but being a female doctor is a marriage market signal – very few of them will continue to practise. They’re doing it primarily so their families can marry them off to an even upperer middle-class man…)

    Another big factor is that med school curricula are relatively standardised worldwide so international transfer is pretty common. Among developed countries (ie excluding inward flows from less developed countries) the UK is quite a big exporter of doctors. Pay is much higher e.g. in America and people also seem attracted to lifestyle factors in Aus/NZ. There is apparently an element of people thinking they’re just leaving for a few years to broaden their experience but ending up settled down and unwilling to return. Not every doctor is willing or able to migrate so it doesn’t force pay equality between countries, but so long as Britain lags far behind some other western countries for pay, doctor export is going to be a significant factor.



    Unfair to say the state doesn’t do any quality control on the training, bearing in mind nursing and med schools need ongoing validation and you can’t set up a new one without jumping through a lot of hoops, plus the power the NHS gets over the practical placements. The Department of Health has for quite some time (pretty sure at least the 80s and possibly quite a bit further back) done a lot of long-term workforce modelling, looking at how different training cohorts are expected to work their way through the health service, bearing in mind the specialist training, attrition rates and so on, and used that to gauge needs for training provision (and on occasion to nag the Dept for Education to bump up the number of science A-level students) so it isn’t a disorganised shambles in the sense of a car factory training everyone to do bodywork and nobody to do engine installation to replace those guys when they retire or whatever.

    For reasons I don’t really understand, this work hasn’t translated into having the right number of staff at the right stage of their careers trained in the right things. My limited understanding is that for nursing they’re suffering the ill effects of many years of unfilled training places and high staff attrition, and in medicine a more complicated mixture – consultants retiring earlier than expected, increased proportion of doctors being women under 40 leading to more career breaks / part-time work, not enough med school places (but eg in the 90s there was a “lost generation” of doctors where upon completing med school then their junior years, there was a shortage of specialist training places for the registrar/consultant track – that cohort is still working its way up the system, albeit with many of the “lost” doctors now emigrated or having left the profession, so it isn’t as simple as the scarring effect of a lack of med school places on previous cohorts).

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