Wage Determination in the English Blood Service

Tim Sandle

November 2006

Introduction

• The organisation to be studied (NHS BT).

• Theory.

• Methodology.

• Key analytical issues.

The organisation

NHS Blood and Transplant

• UK public sector– National Blood Service (England and North

Wales).– Bio Products Laboratory (Provides England,

Wales, Northern Ireland and Brazil; exports to 32 countries).

– UK Transplant (UK wide).

The organisation

• 18 major centres.• 6, 500 employees (5,400 WTE).

– Female : male ratio is 68: 32– 250 occupational groups;– 50% standard NHS professions e.g. nurses;– 50% unique occupations e.g. donor carer.

• Workers divided: diversity of professional groups and a large, [relatively] low paid workforce.

The organisation

• The median basic pay is £15,069*• The mean pay is £19, 019*

– Mainly relating to 2,000 donor carers and 1,000 production operators / laboratory support staff.

• Predominately female.• Drawn from local labour markets.

• Pay range is £9,799 - £65,721*– Upper end reflecting professional and managerial

groups.* Based on data as of 1st October 2005

The organisation

• Pay distribution:

NHS BT Pay Distribution Pre-AfC (1-Oct-2005)

Less than £10,000£10,001 - £15,000

£15,001 - £20,000£20,001 - £25,000

£25,001 - £30,000£30,001 - £35,000

£35,001 - £40,000£40,001 - £45,000

£45,001 - £50,000£50,001 - £55,000

£55,001 - £60,000£60,001 - £65,000More than £65,000

0 10 20 30 40 50

1

Pay c

ate

go

ry

Percent

The organisation

• Six recognised unions (in order of size)– UNISON, Amicus, RCN, TGWU, GMB, BMA.– Density ~ 50%.

• Institutional IR structure:– NJSC.– 18 local JCCs.– Six occupational committees.– Health and safety committee.

Theory

• Wage determination is a result of:– The fragmented social structure: class, gender and ethnicity.

• Horizontal and vertical segmentation;• Separation of occupations by ‘skill’.

– The interplay between social actors: workers, unions, management, and the state; characterised by:

• Differences in power and its distribution;• Conflict and strategies of resistance.

– In organisations these mechanisms are more complex and variable:

• Differences between professional associations and unions;• Variation of behaviour, motivation, and goals of actors to different

environmental triggers and socio-economic circumstances.

Theory

“The wage question…closely interlinked with the whole social and economic structure of society” (Rothschild, 1954, p171)

• “Power and struggle are fundamental determinants of distributional outcomes in capitalist societies”(Wright,1999, p27)

• The contesting of wages exists within a “dynamic conflict situation which is permanent and unalterable” (Allen, 1971, p39).

Field work• The research centres on:

– Mapping the wage structure and examining patterns and divisions;– Social action, especially behaviours adopted by key actors, with a focus

on the strategies (or lack of) of unions and employers in wage determination

– Acknowledge the role of the state (in acting in the interests of capital)• Take into account a multi-dimensional view of the relationships

– Horizontally: various occupational groups and unions– Vertically: interplay between local and national organisations; bodies

and officials• Method

– Quantitative pay data;– Document review;– Interviews (50 – 75).

Field Work: to date

• A pay and occupational analysis has been undertaken (cross-checking staff directory against payscales)

• A review of over 200 internal documents has been undertaken, including:– Confidential minutes and working papers relating to the

establishment of local pay scales and job evaluation schemes in the 1980s and 1990s

– Minutes of joint consultative committees and union memoranda– Working papers, management notes and official publications

relating to occupational development.

• Initial interviews with union stewards and HR managers

Key Analytical Issues

• Linking theory to NHS BT:– 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.

Key Analytical Issues• Social action:

– The influential actors are: trade unions, professional associations, local managers and the state.

– Employer strategies have included:• An employer led “multi-skilling” programme, targeted at reducing

demarcations and establishing generic grades. This resulting in some grade compression and work intensification for the same pay.

• A strategy of labour substitution: donor carers for nurses; nurses for doctors; laboratory assistants for scientists.

• Financial pressures to reduce costs have led to strategies like outsourcing and redundancy.

– Union strategies and responses have included:• Contesting changes in certain areas e.g. job cuts; backing changes in others

e.g. donor carer ‘modernisation’. • The payment of allowances, shift premia, on-call rates and so on, differs for

staff groups and appears to correlate to the organisational power of the different groups, with stronger unionised sectors receiving more.

• Unions have been divided in their tactics and have battled each other.