Health secretary pushes through NHS pay rise with ministerial direction

Perm sec Sir Chris Wormald gets ministerial sign-off as pay award breaches approved budget
Health secretary Steve Barclay. Photo: Zuma Press/Alamy

By Tevye Markson

09 May 2023

Steve Barclay has directed the Department for Health and Social Care to push ahead with pay rises for NHS staff that would breach previously agreed spending budgets.

DHSC permanent secretary Sir Chris Wormald sought a ministerial direction from the health secretary for the pay award, which includes a 5% pay rise for 2023-24 plus one-off additional payments for last year.

Wormald said the pay deal, which received the backing of the NHS Staff Council last week, would cause the department to breach its budget set by parliament for 2022-23. This would “contravene the principle that expenditure is contained within agreed spending budgets”, which is set out in the Treasury’s Managing Public Money guidance.

As DHSC's accounting officer, Wormald is responsible for ensuring the department adheres to the Treasury guidance.

However, he said Barclay had “correctly concluded” that “the wider public interest outweighs the considerations of Managing Public Money in this case”.

“To ensure this does not delay our ability to agree a way forward with the unions, I am seeking your confirmation that you wish the department to proceed irrespective of the impact on the department’s compliance with Managing Public Money,” Wormald added.

In his response, Barclay said he agreed with Wormald’s assessment about the wider public interest taking precedence.

“On that basis, I am content to direct you to continue with the pay offer, despite the impact on budgets for 2022 to 2023,” he said.

“I am also content for you to make the agreed cash payments in advance of the 2022-2023 excess vote, if required.”

Excess votes give retrospective authorisation for unauthorised departmental spending in the previous financial year. If a department exceeds spending limits authorised by MPs, the National Audit Office writes to the Public Accounts Committee, which examines the reason for the excess expenditure and reports its opinion to the House of Commons. The Treasury then seeks the House’s approval for the excess spending. If PAC raises no objection, the question is put to parliament without debate.

The NHS pay offer was backed by 27 to 17 by the NHS Staff Council – which brings together the 12 health unions. Each union’s vote is weighted according to the size of its membership.

NHS staff will get an average 5% pay rise for 2023-24, plus a one-off award of 2% of their earnings for 2022-23 and a one-off "backlog bonus" worth up to £1,600.

The pay award, which was finalised by the government in March after negotiations with unions, does not include doctors, dentists and the most senior managers in the NHS, whose pay is negotiated separately.

Civil service unions have accused the government of treating civil servants unfairly compared to other public sector workers, with civil servants offered an average 4.5% pay rise with no backdated pay for 2022-23.

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