WHILE the fallout over NHS pay continues in England, medical organisations in Wales say a wage increase will not on its own be a cure-all for exhausted health staff.

A pay rise here should be followed by better support and working conditions if staff are to feel truly valued, they argued.

Adequate rest facilities, protections for staff who speak up, and more occupational and mental health support should all be "priorities" for the Welsh Government, the chairman of the British Medical Association's Welsh Council told The National.

Dr David Bailey said these improvements should go hand-in-hand with a "fair" pay rise, following what he described as "probably the most stressful period of their careers" for thousands of health workers.

“A healthcare workforce that feels valued and supported at work means staff working at their best," he told The National.

Over the border in England, a proposed one per cent pay rise for NHS staff has sparked an outcry and talks of industrial action, but UK government ministers have argued the one per cent rise was all that could be afforded, due to the impact of coronavirus on public finances.

Workers deserve a pay rise

In Wales, however, health minister Vaughan Gething said NHS workers "deserved a pay rise", adding that the Welsh Government had "tried not to set a ceiling" on any increase. He also said ministers would wait for the NHS Pay Review Body to reveal its recommendations before any wage increase was announced.

The Royal College of Nursing (RCN), which has called the English approach "bitterly disappointing," is campaigning for "a different approach in Wales" that would see the UK government bankroll a 12.5 per cent pay rise for all staff covered by the current Welsh pay agreement.

Nicky Hughes, RCN associate director of nursing, said the health service was "already struggling with staff shortages across all sectors" and would find it difficult to retain nurses, and attract new recruits, if workers "don’t have fair pay, good employment terms and safe working conditions".

Ensuring safe staffing, proper breaks, and a zero-tolerance approach to violence and aggression would all improve employment conditions, the RCN said.

The pandemic had "highlighted the professionalism and dedication of nursing staff," Ms Hughes said, adding that "nursing staff deserve to know that their skill, innovation and professionalism is valued".

Training more doctors

On Friday, The National asked the health minister about the Welsh Government's record on attracting workers into the health service.

Mr Gething pointed to increased recruitment as evidence the system was working.

"At the start of this [Senedd] term we were in a very different position on GP recruitment," he said. "We’ve made steady and sustained progress; we’re in a really good position now with GP training, including our fill of the training places during the pandemic.

"That’s really positive for us, that people want to stay in Wales who are already here, but also people want to locate themselves into Wales for the next stage of their career – the potential to stay here on a much longer term basis as well.

"On nurse training, the same with midwifery, the same with therapists, we’ve got a very good record of significant growth and record investment in every year that I’ve been the cabinet minister for health, in reinforcing the need to replenish and renew our NHS workforce.

"I think we’ve done both – we’ve made our jobs attractive to people across a range of areas, and we’ve put our money where our mouth is and we’ve invested in extra training places."

The Welsh NHS also supports recruitment via its Health Education and Improvement Wales (HEIW) special health authority, which works with universities and health boards to drive recruitment.

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HEIW said it promoted NHS roles and targeted areas that had lower uptake or applicants – recently it has focused on recruitment for learning disability nursing and healthcare sciences.

Safe staffing and more support

But as the pay debate in England goes on, The National asked the BMA what else could be done to recruit and retain medical staff in Wales.

"Fair pay will attract our best and brightest into the health service and support higher levels of retention," Dr Bailey said. "There are, however, other key areas the Welsh Government also needs to address to prioritise making the Welsh NHS an attractive and rewarding place to work."

Staffing levels are one of those priorities, he said, calling for ministerial accountability to be enshrined in legislation.

"With a system that is under severe pressure where doctors and health care staff are stretched to their limits, it has never been more important to have the right mechanisms in place to ensure that staffing levels are safe," Dr Bailey said.

"Individual doctors must never be blamed when system failures are the root cause, and understaffing of our hospitals is an issue which has plagued the Welsh NHS for years."

He also called for a improved, better-funded occupational health support for medical staff whom, he said, work in "an incredibly stressful environment with unique difficulties".

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He said adequate funding could make support services more accessible with less stigma involved.

Tied to this is the need for "adequate" rest facilities, with "proper access to catering," for staff on breaks.

The introduction of specialist support 'guardians' would help staff feel confident to speak up and raise concerns in confidence, Dr Bailey added. 

And the NHS should also create a more inclusive environment for its "diverse" workforce – something that could be achieved through more flexible working policies, Dr Bailey said.

Responding to the comments made by the BMA and RCN, a Welsh Government spokesman said: “The commitment and tireless hard work from NHS staff in Wales has been truly remarkable.

"We fully recognise the pressures they are experiencing and we will be working with our NHS union and employer partners to ensure the best possible reward package within the funding we receive as a consequential for NHS pay."

He reiterated Mr Gething's position that the Welsh Government would wait for the findings of the independent public pay review process before making "an informed decision" on a wage increase.

He added: “In October, Health Education and Improvement Wales and Social Care Wales launched a workforce strategy to ensure the future sustainability of the health and care workforce in Wales.”

On occupational health support, the spokesman said the Welsh Government would work with health boards to build on a Wales-wide review of the current services.

The NHS Wales Fatigue and Facilities Charter, launched last autumn, "sets out a shared commitment" to address the issues of fatigue for junior doctors, he added.

And on a more inclusive workforce, he said there were "many lessions to be learned from the last 12 months" including around the NHS' approaches to flexible working. This was something currently under consideration by NHS employers and union partners, he added.

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