IN MY opinion, which as you know is synonymous with fact, the States of Guernsey is fully aware that it pays nurses and other health care workers a pittance.
In fact, our own beloved chief minister, long may he reign, referred to it as such in the Concrete Over The Valley Field debate not that long ago.
For this column I will focus on nurses.
Nurses are in short supply globally. The main country we look to recruit from has a shortage of nurses. We have a shortage of nurses or people wanting to be nurses.
The law of supply and demand says that if supply cannot meet demand then the price increases. We are seeing this in the price of houses and the increase in rents.
We are also seeing it in the true prices of nurses. If we have a vital nursing vacancy then we fill it by employing an agency nurse. The agencies have nurses. I would suggest it is because they pay them a market wage and even with a profit margin attached for the agency the States will pay the high fee demanded.
Unfair of the agencies, you may say, by tempting nurses to defect with money when they should be happy with their pittance because it is a calling. I say it’s unfair to condemn nurses to a lifetime of financial struggles just because they do wish to care for others.
And the States does just the same as agencies by tempting nurses away from the NHS with packages, including rental assistance, which seem very generous until they get here and find out just how expensive living here is.
It is necessary to look outside of the island because we no longer have a nursing tradition here. Decades of the UK being our recruiting ground for nurses has completely killed off any chance of growing our own. I think we are overjoyed having 11 locals training on-island. Wowee, 11, that’s good, eh?
The bar has been raised for entry into nursing over the years. Three A-levels to get into a nursing degree course and a three-year degree. All right, a nursing degree is more than 90% likely to get you a job within six months and not one flipping burgers in McDonald’s like humanities grads. Problem is you can get a great job, with great responsibilities and personal satisfaction, but with money not that much better than a burger jockey’s.
Going back to a nursing tradition and why we’ve lost it, I can’t but point the blame at our key worker system and the way we remunerate key workers.
I’m no expert, but that’s never stopped me having an opinion, and so I put it down to the turnover of staff. A similar problem exists in education, but that’s a subject for another day.
Wouldn’t it be nice if we attracted nurses here who wanted to make Guernsey their forever home? To be part of the community and to be role models for the next generation? But what do we do? We bring them in and initially shelter them from the reality of the cost of living in Guernsey for a couple of years and then shock them by removing the subsidies. What do they do? Why, go home of course.
This alone tells us that nurses are not paid enough to be able to survive in Guernsey without ‘help’. Over time we have come up with the strangest of models. We see no reason to go overboard with pay for local nurses. I can only imagine this is because we see that any local foolish enough to train as a nurse probably isn’t doing it for the money and anyway there are so few that increasing pay won’t attract many others.
But once we have low pay set for locals, which we know will not attract UK nurses, and we can’t discriminate by paying non-locals more, we have had to come up with migration assistance packages. This could be extra money, not pay but a rental allowance, or the offer of below-market-rate rental accommodation.
This week the Discrimination Ordinance has been published, but even if, as an employer, you believe the States is discriminating against nurses with a Bailiwick origin, now defined as a protected national origin, the States has built in a get-out clause for anything that is policy which will allow such discrimination.
What is the answer? Well, obviously we need to pay nurses enough to allow us to avoid having to fall back on even more expensive agency staff. That pay needs to be enough for a nursing professional not to need assistance to enter our housing market, which would possibly mean we don’t need to build specifically key worker-designated accommodation.
The pay needs to be enough to encourage roots to be planted here and a nursing tradition rekindled. It’s a fine calling and we must raise its standing locally once again.
Sounds simple, but there is one problem. Possibly two problems. One is money and the second is the closed mind of the States.
As we are today, we cannot afford to pay nurses what they are worth. As we are today, the States believes that money isn’t the answer but staff flats in the Valley Field is. And it probably is for a young nurse who plans to stay here no longer than a couple of years. But is that what we want?
If we are going to pay more to nurses, then we have to source more money. The taxpayer is already stretched and the States has come up with the ‘user pays’ idea in several places. We, the user, already pay for most of our primary care, with the States chipping in a few pounds to assist. We, the user, now pay for emergency treatment.
Our health system is not based upon the failing UK National Health Service but many believe our secondary health care mirrors the NHS. It doesn’t. It was brought in as medical procedure costs rose and there was a real fear of people avoiding treatment or having to sell their home to fund it.
They were good reasons and it should be retained. The scheme was funded by social security payments, which have not kept up with the rising costs.
There is no reason why users should not pay for elements of their secondary care. A reasonable proportion of people here have health insurance but because our free service is so good choose to pay nothing. We have a fairly wealthy population, some of whom would not be bankrupted by making a three-figure contribution to their procedures.
Somehow we have to pay nurses a fair wage and that wage should apply to all, no matter where sourced. Somehow we have to find the money.
And that’s why we pay deputies big bucks to come up with solutions.
In the meantime, my advice to nurses is to reject the 5% plus £500 offer.