With no devolved government or direct rule ministers, who are Northern Ireland’s health workers striking against?
Nurses have voted to walk out from the start of next month - the first such action the Royal College of Nursing (RCN) will have taken anywhere in its 103-year history. The union wants a five per cent pay increase and the hiring of 3,000 more nurses.
Unison’s health members will also strike from the end of this month for the same demands.
Both have been negotiating with civil servants and that is where they are directing the blame. Unlike other unions, they seem reluctant to get into an argument about Stormont’s return, so in effect they want their demands met via indirect rule.
Health officials say they have no extra money and in any case would need ministers to sign off the necessary decisions.
Looking at this more closely reveals what an absurdly grey area indirect rule has become.
Setting Stormont budgets slipped quietly into full direct rule shortly after devolution collapsed. The latest annual budget was rubber-stamped through Westminster two weeks ago and contained no uplift for health. Stormont’s in-year reallocations of unspent funds - the so-called monitoring rounds - are also performed by Westminster. These routinely find sums on the order of £100 million, or more when extra spending in England puts additional funding our way via the Barnett formula. Last November’s round reallocated £265 million. Half was given to health, partly for a three per cent pay award.
RCN’s latest pay demand would cost £108 million or 1.8 per cent of the health budget (not 0.018 per cent as the union stated)
Hiring 3,000 nurses at their average salary in Northern Ireland of £33,500 would cost £100 million, from which most of the £53 million spent last year on agency staff could be subtracted.
So the money for the unions’ demands could readily be found. It would be direct rule budgeting but this is ‘good’ direct rule, of the type that is apparently acceptable.
The question is whether civil servants could decide how to spend it.
Hiring more nurses should be within the remit of indirect rule. The last Stormont executive left a 10-year strategy for health, Delivering Together, that requires hiring more nurses to meet both short-term pressures and long-term demographic trends. Under indirect rule we pretend the last executive’s policies are still valid, so the civil service could simply enact this one. Of course, Delivering Together also requires rationalising hospitals but that is ‘bad’ so must not be mentioned.
Pay rises are less clear-cut. In 2010, Stormont decided to shadow public sector pay awards in Britain, which meant observing a one per cent cap until that was lifted last year, enabling the three per cent rise for nurses in Britain to be copied over.
But NHS staff in Northern Ireland were paid less than their counterparts in Britain in 2010 so that gap remains. Closing it is the basis of RCN and Unison’s pay demand and it seems unambiguous that a minister would need to take that decision. On the other hand, officials at the Department of Finance have interpreted a 2018 direct rule law as giving them the power to negotiate public sector pay settlements, yet not interpreted it as allowing them to break shadowing.
A judicial review might take a different view, then an appeal could take another view. Indirect rule is such an arbitrary mess you can make a case for almost anything. Second-guessing complaints and the courts must be what guides much official action or inaction.
In the meantime, local parties are deflecting. The DUP has accused Sinn Féin of valuing an Irish language act over the NHS, although the DUP could as easily be accused of placing the same value on blocking an act. Republicans are jeering at the DUP for voting against lifting the pay cap in Britain in 2017, although that is now completely irrelevant.
What both parties need to say, or at least indicate, is that NHS pay and recruitment would be ‘good’ indirect rule if Westminster intervened, as many MPs wish to see.
Failure to say so is playing with people’s lives.
The same could be said of strikes with no minister to target.
