The pay dispute wreaking havoc in the NHS is often framed as the government versus nurses. 

In fact, it’s a bit more complicated than that. The government is only responsible for nurses’ pay indirectly. The group that makes the recommendation is the nominally independent NHS Pay Review Body.

And Rishi Sunak continues to keep his distance. Indeed, the Prime Minister has once again repeated his unwillingness to negotiate with nursing unions on pay to prevent future strikes. Speaking in Belfast, the Prime Minister said the government “accepted the recommendations of an independent pay body about what fair pay would be”.  The body recommended staff were given a £1,400 uplift, which the Nuffield Trust say amounts to a 4.3% rise.

Some claim the government uses the NHS Pay Review Body as a useful shield to avoid direct negotiation, stressing its independence at every turn. But is this really the case? 

The body makes recommendations on NHS UK staff pay, with the exceptions of doctors, dentists and very senior managers. Annual reports are submitted to the Prime Minister, Health Secretary and devolved administrations. 

According to the Cabinet Office, the role in 2020 involved 15 meetings a year, paying £300 a day. The appointments are “on merit and political activity played no part in the decision process” with the Cabinet Office Code of Governance for Public Appointments adhered to. 

Anyone considering applying needed to have senior leadership experience in the NHS and “be able to gain respect and keep the confidence of others including Ministers and senior Government officials through effective communication and influencing skills”.

So who are the eight members of the body who have a mix of skills from the private and public sector?

Philippa Hird is the chair and has been a member since April 2017. Alongside her role, she is senior independent director and remuneration committee chair of Ordnance Survey and a non-executive director of UK Strategic Command. Formerly group human resources director of ITV Plc, she is, some might say, a signed-up member of the establishment.

Its other members follow a similar pattern. Patricia Gordon worked in strategic planning, information and general management roles relating to health care in Northern Ireland, serving as a CEO of hospital trusts. Neville Hounsome worked as a HR director developing pay strategies, alongside being non-executive director for the West Suffolk Hospital Trust. 

Stephanie Marston was, for seven years, a senior official at Prospect, a trade union representing specialist and professional staff, developing a career in collective bargaining. Richard Cooper, meanwhile, left a senior role at BT before taking on non-executive Board Director roles in the NHS and the Health Research Authority at the Department of Health & Social Care. 

Stephen Boyle worked as an economist for more than 35 years in the public and private sectors, Anne Phillimore has a long-standing career in Human Resources and worked as a Director of Personnel in an Acute NHS Trust. Finally, Professor Karen Mumford CBE works at the University of York, specialising in labour economics. 

Yet the general secretary of the Royal College of Nursing Pat Cullen said the body was not independent, arguing “it’s out of date, and it needs to be reviewed.” With the high-flying positions its members have on their CVs, groupthink is certainly possible, not least given the medical unions are not represented on the body. If further strike action takes place, the government – and the board – may have no option but to change direction. 

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