Wage determination

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Wage determination, using examples of UK healthcare

Wage determination, using examples of UK healthcare

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  • Read slide – this what I’m covering I’m looking at: Wage determination Because it is a key source of worker discontent and struggle and, An area of personal interest. I’m looking at NHS BT Because: Public sector is an underdeveloped area. An area of continual change, e.g. commercialisation. Relatively large: number of employees; diversity of roles; geographical coverage. Industrial relations history suggests underlying conflict. In this presentation I want to cover: The organization I’m studying; The theory; The methodology; Some findings so far…
  • It became a state service in 1946 (NHS in 1948) 15 different regional employers until 1994. It has three main parts: Different economic basis: NBS: provides blood and tissues to 310 hospitals at a fixed (DoH) cost; BPL: sells products at commercial prices on an open market. Turnover £60 million; operating loss £30 million, per year; UKT: service with no cash transactions.
  • Geographically diverse across England and Wales 6,500 employees Almost 70% female; of whom 60% are part-time. Recent exercise showed 250 listed occupations 50% of staff are in occupations found in mainstream hospitals 50% are in grades unique to the service, like blood donor carers The latter groups featured in local pay reforms, in two waves, 1987 (all BPL) and 1994 (NBS London bandings); and a range of locally determined occupations. Pay is a combination of national and local determination e.g. shift and on-call rates also set locally. Recent pressures for cost reduction and change: Impact of Lyons, Gershon and ALB reforms Decline in red cell demand to hospitals Privatisation threat to BPL Regulatory issues e.g. vCJD Global trends in competitive blood market.
  • By relatively low I mean: Median around £15,000 Mean around £19,000 Compared to national median pay (currently close to £24,000 [ €36,000] as per National Statistics) Within the organisation when lower and upper deciles are compared or the pay range. Largest low paid group are the donor carers, laboratory support and process staff. Mainly female (90%). Low pay is not the same as fair or comparable pay. This is further shown in the next slide.
  • This is the pay distribution. Figures in £’s. Highlight key groups. This is pro-rata pay.
  • Six recognised unions (in order of size) UNISON, Amicus, RCN, TGWU, GMB, BMA Density ~ 60% Institutional IR structure: NJSC 18 local JCCs Six broad occupational committees Health and safety committee
  • Decided upon Marxist approach, where: Work relations between employers and workers are naturally and inevitably conflictual. This arises from the class structure and the exploitative nature of the capitalist political economy. Pay is a primary example of workplace conflict in that: Employers seeking to drive pay to lowest price to reduce costs and maximise profit; and Workers seek to drive pay to its highest price So, wage determination is a result of: The social structure, principally class divisions and exploitation; plus internal to the organisation: division of labour; gender divides; status divides around occupation. Horizontal and vertical segmentation. AND The interplay between social actors. The key ones are: workers, unions, management, and the state; Relations ARE characterised by: Antagonism Differences in power and its distribution Conflict and worker of resistance OF COURSE Actual systems are more complex and variable; differences: professional groups and worker groups; variation of behaviour, motivation, and goals of actors; organisational history; different environmental and economic triggers.
  • These are some key quotations which I think capture the theoretical position. The quotations capture: Link to class based social structure and social relations That power and struggle are key processes That conflict at work is permanent, natural and inevitable These processes are dynamic and historically centred The interplay between structure and agency is one that I am grappling with.
  • The research will centre upon: Mapping the wage structure and examining patterns The behaviours of key actors: employers and unions; looking at strategies (or lack of) of actors in wage determination I’ll acknowledge the role of the state (in acting in the interests of capital) Take into account a multi-dimensional view of these relationships Horizontally: across various occupational groups and unions Vertically: the interplay between local and national organisations; bodies and officials I aim to do this through: Documentary There is a rich archive of documents; committee reports; medical and technical articles Interviews Trade union lay and national officials Personnel managers General managers Board members
  • So far I have: Looked at pay and occupations to identify patterns. Reviewed several internal documents, including: minutes and working papers relating to the local pay scales and job evaluation schemes in the 1980s and 1990s Minutes of joint consultative committees union memos Working papers, management notes and official publications Conducted some preliminary interviews
  • Things that I have picked up so far, which relate to the theoretical approach – of structure and agency - are: Class / structure: Occupational groups, and worker pay, is hierarchically and unequally distributed. Pay is delineated around professional group boundaries and the wider low paid workforce. There is a gender divide, with majority low paid being female. The dynamics of pay determination have moved from national level bargaining to the local level. Leading to: An increase in new roles, pay rates, and terms and conditions, developed outside of national frameworks. Changes to the boundaries of traditional professional groups. Widening of pay inequality.
  • And finally : The influential actors are: trade unions, professional associations, local managers and the state. Focus on two key ones: employers and unions . Employer strategies have included: A recent so-called “multi-skilling” programme, targeted at reducing demarcations and establishing generic grades. This resulting in some grade compression. A strategy of labour substitution: donor carers for nurses; nurses for medical officers; laboratory assistants for BMS’s. State led financial pressures to reduce costs have led to strategies like outsourcing. Union strategies and responses have included: Contesting changes in certain areas e.g. job cuts; backing changes in others e.g. donor carer ‘modernisation’. Largely fragmented unions based on occupational groups – reflecting and creating the division of labour = Unions have been divided in their tactics and have battled each other esp. UNISON v Amicus v RCN The payment of allowances, shift premia, on-call rates and so on, differs for staff groups and outcomes and appears to correlate to the organisational power of the different groups, with stronger unionised sectors receiving more. Possible sign that some unions are developing more heterogeneous pay strategies and developing policies to tackle low (and even fair) pay. Therefore, the wage determination in NHS BT is complex, dynamic and multi-dimensional. END