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NHS unions have reached a pay deal with the government in a major breakthrough that could herald the end of strikes by frontline staff in England.

The offer consists of a one-off payment of 2% of their salary for the current financial year 2022/23 and a 5% pay increase for 2023/24.

It will apply to key NHS workers including nurses and paramedics but not junior doctors, who are involved in a separate dispute over pay and conditions.

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Health Secretary Steve Barclay said the deal means a newly qualified nurse will get more than £1,800 this year on top of a pay rise of more than £1,300 next year.

He said: “I hugely admire the incredible work of NHS staff, including during the pandemic and the progress they have made to tackle the resulting backlog.

“This offer will give nurses, paramedics, physiotherapists and other non-medical staff a fair pay rise while protecting our commitment to halve inflation.”

The offer will now be put to union members for a vote, with industrial action paused during that process.

The Royal College of Nursing, GMB and Unison said they will recommend their members accept the offer – but Unite said it was not good enough.

The unions represent a wide variety of health staff including nurses, paramedics, 999 call handlers, midwives, security guards and cleaners.

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PM ‘delighted’ on NHS pay settlement

Sharon Graham, general secretary of Unite, said the decision ultimately lay with members and strikes will be paused while they are consulted on the deal.

But she added: “The offer from government is not one that Unite can recommend to our members.

“It is clear that this government does not hold the interest of workers or the NHS at heart. Their behaviour and disdain for NHS workers and workers generally is clear from their actions.

“Britain has a broken economy and workers are paying the price.”

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NHS strikes have forced govt into action due to waiting time targets


Liz Bates is a political correspondent

Liz Bates

Political correspondent

@wizbates

It looks like the government could be on the brink of a breakthrough with striking NHS workers, who will now vote on the latest pay offer.

For months, ministers insisted that they could not budge on pay because they needed to prioritise the public finances and did not want to risk rising wages fuelling inflation.

But that position seems to have softened over the past few weeks and now we see the purse strings have been loosened and some extra cash has suddenly been found.

So why the shift?

Whilst it appeared that Number 10 were – in the early stages – willing to tough out industrial action across a range of sectors, the longer it goes on the more political damage it does.

Day-to-day strikes are disrupting the public in many aspects of their lives, from getting to work to getting vital NHS treatment, and the finger of blame always tends, in the end, to point to those in power.

But the walkouts in the NHS have also created a very specific political problem for the prime minister who has made reducing waiting lists one of his five key pledges – a target he will not be able to hit whilst workers are on the picket line.

So, it is no surprise that this is the area that has been the focus of the most intense negotiations.

Ministers will now be hoping that if a deal is done with this sector others will follow and they will be able to tell voters that broken Britain is slowly but surely getting fixed.

‘Extra 2.5bn put on table’

Other unions were more welcoming of the agreement, even as they acknowledged it was “far from perfect”.

Unison said the one-off payment is worth £1,655 for staff at the bottom of band two (for example porters, cleaners and healthcare assistants), £2,009 for staff at the top of band five (nurses, midwives, physiotherapists), £2,162 at the top of band six (paramedics, health visitors, senior occupational therapists) and £3,789 for staff at the top of band nine.

Rachel Harrison, GMB National Secretary, said the offer is a “huge uplift for the lowest paid to keep them well above the Real Living Wage” as she called the offer “reasonable”.

She said the deal was reached after the government agreed to put an extra £2.5bn on the table to fund the pay increases.

“GMB members should rightly be proud of themselves. It’s been a tough road but they have faced down the Department of Health and won an offer that we feel is the best that can be achieved at this stage through negotiation,” Ms Harrison added.

She said progress has also been made on non-pay demands, such as addressing violence in the workplace.

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‘It is a decent sum of money’ says Head of Health at UNISON Sara Gorton.

Nursing staff ‘vindicated’

RCN General Secretary and Chief Executive, Pat Cullen, also welcomed the agreement, saying: “The government was forced into these negotiations and to reopen the pay award as a result of the historic pressure from nursing staff. Members took the hardest of decisions to go on strike and I believe they have been vindicated today.”

It is not clear how the pay rises will be funded, with the government previously saying money for wage increases would have to come out of the budget for frontline services.

When questioned on this Mr Barclay deferred to the Treasury, saying only that it “would not come from areas of the budget that impact on patients”.

Nurses protest during a strike by NHS medical workers, amid a dispute with the government over pay, outside St Thomas' Hospital, in London, Britain, February 6, 2023. REUTERS/Peter Nicholls

Prime Minister Rishi Sunak also insisted frontline services will “absolutely not” be affected by the pay deal to end strikes but would not say how the package will be funded.

Pressed during a visit to a south London hospital on whether patient care would be hit, the prime minister said: “Absolutely not. We’re going to be making sure we protect all frontline services with £14bn of more funding we announced at the end of last year.”

He said the deal is “fair and reasonable” and recognises the “fantastic” work NHS staff do while being affordable for the taxpayer.

“It’s a good example of this government getting things done and delivering for the British people,” he said.

Striking NHS junior doctors on the picket line outside Queen Elizabeth hospital in Birmingham as the British Medical Association is holding a 72-hour walkout in a dispute over pay. Picture date: Wednesday March 15, 2023.
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Junior doctors are not part of the deal offered by the health secretary

Ambulance members of Unison and Unite were due to strike next Monday and physiotherapists were going to walkout later this month but the action has been called off

Other strikes involving nurses and paramedics were paused earlier this month after the government finally agreed to talk about pay.

At the heart of the dispute was a demand for an increase for the current financial year, which ministers initially insisted was not affordable.

Tens of thousands of nurses, paramedics and other healthcare staff went on strike just before Christmas, then again in January and February.

Last month, the government finally agreed to talk about pay, averting several planned walkouts that would have seen thousands more operations cancelled.

The British Medical Association, which represents junior doctors, has called on Mr Barclay to meet with them tomorrow to discuss pay, following a 72-hour walkout earlier this week.

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Lammy, Cooper and Mahmood get new jobs in major reshuffle after Rayner’s resignation

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Lammy, Cooper and Mahmood get new jobs in major reshuffle after Rayner's resignation

David Lammy has been stripped of his role as foreign secretary, and given the job of justice secretary, along with the role of deputy PM.

Mr Lammy‘s move was one of the most momentous of Sir Keir Starmer‘s ministerial reshuffle on Friday afternoon, which saw a whole host of roles change hands, and two departments partially combined.

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The PM moved him away from one of the great offices of state, despite his apparently burgeoning ‘bromance’ with US vice president JD Vance. But Mr Lammy benefited from Angela Rayner‘s departure.

David Lammy arrives in Downing Street following his appointment as deputy PM. Pic: PA
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David Lammy arrives in Downing Street following his appointment as deputy PM. Pic: PA

The deputy prime minister and housing secretary resigned from government on Friday morning, after it was found she had breached the ministerial code over her tax affairs. Sir Keir regretfully accepted her resignation, leaving her roles vacant.

Thus began the ministerial reshuffle, brought forward by several weeks as a result of Ms Rayner’s departure.

Mr Lammy has been given the role of deputy prime minister, and appeared cheery on Friday afternoon – strolling up Downing Street in the sunshine with a big smile on his face.

More on Angela Rayner

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David Lammy appointed deputy PM

His move from the Foreign Office to the Ministry of Justice then allowed Yvette Cooper, the home secretary, to take on Mr Lammy’s previous job. She has never served in any role involving foreign affairs before, bar a three-month stint as shadow foreign secretary in 2010.

Her pivot to foreign affairs then allowed the biggest promotion of them all, with then justice secretary and key Starmer ally, Shabana Mahmood, being appointed as home secretary.

This means that for the first time in British history, all three great offices of state, after the prime minister, are held by women.

Shabana Mahmood arrives at Downing Street after being appointed home secretary. Pic: PA
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Shabana Mahmood arrives at Downing Street after being appointed home secretary. Pic: PA

With those roles rejigged, and Number 10 insisting from the start that Rachel Reeves was safe as chancellor, it was time to tinker with the rest of the cabinet.

It appears that while the reshuffle was carried out unexpectedly early, a lot of thought had gone into it.

Sir Keir began by creating a new ‘super ministry’, combining the skills remit of the Department for Education with the Department for Work and Pensions.

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Cooper appointed foreign secretary

Pat McFadden, on Friday morning the chancellor of the Duchy of Lancaster (the highest ranking Cabinet Office minister), has been given responsibility for this new ministerial empire. It also means that Bridget Phillipson, who was and remains the education secretary, has had her responsibilities slimmed down.

Officially, Mr McFadden has become the work and pensions secretary. This meant the current occupant of that role, Liz Kendall, also needed to be reshuffled.

She has now been appointed as the science, innovation and technology secretary. Her predecessor in that role, Peter Kyle, in turn received a promotion to lead the Department of Business and Trade.

Peter Kyle has been promoted to business secretary
Pic: PA
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Peter Kyle has been promoted to business secretary
Pic: PA

Mr Kyle made incorporating and using AI a key part of his first year in office, and had been seen to be doing well in the job. His promotion, though, has led to the current business secretary, Jonathan Reynolds, being left without a department.

While he remains in the cabinet, his appointment to the job of chief whip is unlikely to be viewed as a promotion.

The reshuffle brought better news for Darren Jones, who was only promoted on Monday to the newly created role of chief secretary to the prime minister.

He got to keep his role, but was gifted Mr McFadden’s old job – chancellor of the Duchy of Lancaster – to add to his growing political portfolio.

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Starmer’s effort to reset govt

Read more:
Cabinet reshuffle: Who’s in and who’s out
What a moment for Shabana Mahmood
Cooper picking up the reins at a challenging time

Steve Reed, another long-time Starmer ally, benefitted alongside Mr Lammy from Ms Rayner’s departure. He has been given her former role of housing secretary, leaving behind the Department for Environment, Food and Rural Affairs.

Also ending in a better position than they started off on Friday morning are Emma Reynolds, a Treasury minister who has now received Mr Reed’s old job, and trade minister Douglas Alexander, who has now become the Scotland secretary. Sir Alan Campbell, previously chief whip, has now become leader of the House of Commons.

On the other side of the spectrum, former leader of the Commons Lucy Powell, and ex-Scotland secretary Ian Murray, joined Ms Rayner in leaving the government. Both were sacked, and both made clear their desire not to lose their roles.

Sacked ministers Lucy Powell and Ian Murray.
Pic: PA
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Sacked ministers Lucy Powell and Ian Murray.
Pic: PA

Ms Powell said it had been “an honour” to serve but warned that “the future of our democracy looks uncertain”, citing rising levels of “abuse, misrepresentation…. and the call for easy answers”.

Mr Murray also echoed this sentiment, stating that politics in the UK “is at a dangerous crossroads”. He called on MPs to bring “prosperity, hope and our communities together, rather than furthering division and despair”, and said he would support Sir Keir’s government from the backbenches.

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Cabinet reshuffle: Who’s on Keir Starmer’s new team and who’s out?

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Cabinet reshuffle: Who's on Keir Starmer's new team and who's out?

Sir Keir Starmer has reshuffled his cabinet following Angela Rayner’s resignation after admitting she had not paid enough stamp duty on the purchase of a new home.

The prime minister’s former right-hand woman stepped down as deputy prime minister, housing secretary and deputy leader of the Labour Party after standards adviser Sir Laurie Magnus found she had breached the ministerial code.

Politics latest: Reshuffle after Rayner quits

She paid standard stamp duty on a flat she bought in Hove, East Sussex, in May after taking advice that it counted as her only home due to her disabled son’s trust owning the family home in Ashton-under-Lyne – but it was established she should have paid more.

Her resignation has left a hole around the cabinet table, which Sir Keir is now filling.

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The rise and fall of Angela Rayner

It was stressed early on Chancellor Rachel Reeves would remain as chancellor, in an attempt to stop the markets moving.

Read more: The working class mum who left school at 16 and became deputy PM

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This is who is moving and where to:

David Lammy – foreign secretary to justice secretary and deputy PM

After flexing his diplomatic muscles with Donald Trump and his deputy JD Vance over the past year, Mr Lammy will now move to the justice brief.

The move is likely to be a blow as the PM had promised, most recently in November, he would be foreign secretary for the whole parliament until 2029.

Although he is no longer holding one of the four great offices of state, he has also been made deputy prime minister, presumably to soften the blow.

Mr Lammy is close to Sir Keir, both as a friend and in his next door constituency, and was seen grinning as he went into Number 10 after being appointed.

Yvette Cooper – home secretary to foreign secretary

The Labour stalwart had made tackling illegal migration a priority, so the move could be seen as a disappointment for her.

However, she remains in one of the four great offices of state – PM, chancellor, foreign and home.

Shabana Mahmood – justice secretary to home secretary

A big promotion, the straight-talking Labour MP will be tasked with tackling the small boats crisis and asylum seeker hotel protests.

She is no stranger to making difficult decisions, deciding to free criminals early to reduce prison overcrowding as justice secretary.

Her move makes it the first time all three great offices of state, after the prime minister, are held by women.

Pat McFadden – chancellor of the Duchy of Lancaster and intergovernmental minister to work and pensions secretary and head of “super ministry”

Often seen as Sir Keir’s “number two”, Mr McFadden will take over a newly formed “super ministry”.

It will include the department for work and pensions and the skills remit of the department for education – taking a large part of Education Secretary Bridget Phillipson’s brief and taking over from Liz Kendall as work and pensions secretary.

While it is not a promotion at first glance, it is a much wider role than he has had as chancellor of the Duchy of Lancaster – the highest-ranking Cabinet Office minister after the PM.

Darren Jones – chancellor of the Duchy of Lancaster

It is the second new job in the space of one week for the new chancellor of the Duchy of Lancaster. The close ally of the prime minister was promoted from chief secretary to the Treasury on Monday to chief secretary to the prime minister. And now he gets another new job.

Steve Reed – environment secretary to housing secretary

A promotion for the man who has consistently defended the government lifting inheritance tax relief on farmers.

He takes over one of the two major vacancies left by Ms Rayner and will have the massive task of building 1.5 million new homes during this parliament, as promised by the government.

Jonathan Reynolds – business and trade secretary to chief whip

A slightly odd move for the MP seen as a steady pair of hands in his business secretary role.

He takes over from Sir Alan Campbell and will now have to hustle Labour MPs to vote with the government – something that has sometimes proved difficult with the current cohort.

Mr Reynolds will also attend cabinet, as is necessary so he can liaise between the party and No 10.

Peter Kyle – science secretary to business and trade secretary

A promotion for Mr Kyle, who is taking over from Jonathan Reynolds.

He is seen as a rising star and impressed Labour MPs when he refused to stand down after suggesting Nigel Farage was on the side of people like Jimmy Savile by opposing the government’s online safety law.

Mr Kyle will be in charge of getting trade deals with other countries over the line.

Emma Reynolds – economic secretary to the Treasury to environment secretary

Probably the biggest promotion of the reshuffle, Ms Reynolds is taking on Mr Reed’s role after serving as a junior minister in the Treasury.

She will have to take on farmers and deal with the water companies – a big undertaking.

Liz Kendall – work and pensions secretary to science, innovation and technology secretary

Pat McFadden has taken her role as work and pensions secretary, while Ms Kendall takes over Peter Kyle’s brief.

He has made AI a major facet of his role so we will wait to see which direction Ms Kendall takes the job in.

Douglas Alexander – trade policy minister to Scotland secretary

A promotion for the Blair/Brown minister who returned to politics last year after being ousted in 2015 by then 20-year-old SNP MP Mhairi Black.

He takes over from Ian Murray, who has been removed from the cabinet.

Sir Alan Campbell – Chief whip to Lord President of the Council and leader of the House of Commons

An MP since 1997 and part of Tony Blair and Gordon Brown’s frontbench, Sir Alan is taking over Lucy Powell’s role.

He will be in charge of organising government business in the Commons – a sizeable job.

Who is out?

Lucy Powell has been sacked as leader of the House of Commons.

Ian Murray has been sacked as Scotland secretary.

Not out – but

Bridget Phillipson remains as education secretary but her brief has narrowed as Mr McFadden has taken over the skills part of her job.

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From denial to resignation: How Rayner’s position fell apart – and why tax row risks damaging public trust

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From denial to resignation: How Rayner's position fell apart - and why tax row risks damaging public trust

The damage is immense. In retrospect, it seems incredible that Sir Keir Starmer and Angela Rayner thought they could tough it out before establishing the facts.

But they did, and not for the first time.

Politics latest: Starmer starts cabinet reshuffle

So, before we assess this particular case, it highlights a pre-existing nagging doubt. Is speaking without checking a defining pattern of this government?

Tax promises. Welfare cuts. Tulip Siddiq. Waspi Women. The initial winter fuel plan. The vow there would be no winter fuel U-turn. A pledge that David Lammy would be foreign secretary for five years.

Even a cast-iron guarantee in July that there would be no reshuffle this month – now there might be three, if you include junior ministers next week.

Each one: an action taken or promise made, combined with fighting talk – before reality dawns and the government retreats into reverse.

More on Angela Rayner

Is the word of ministers and their advisers in this government worth less than it should be?

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The rise and fall of Angela Rayner

Starmer and Rayner casually tossed untruths

So now this.

For days, two of the most senior politicians in the UK have clutched at factually inaccurate (Rayner) and emotionally charged (Starmer) smears against media reports that are today vindicated, and in doing so, casually tossed untruths into the public domain – even though behind the scenes they were still checking the facts.

The issue hinged on whether Ms Rayner should have paid a lower level of stamp duty on her new Hove flat, because it was her main home, or whether the rate £40,000 higher was due because of her interests in property elsewhere.

Read more:
Angela Rayner resigns after admitting she did not pay enough tax

The working class mum who left school at 16 to deputy PM

Angela Rayner has quit as housing secretary. Pic: PA
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Angela Rayner has quit as housing secretary. Pic: PA

After the Telegraph asked whether she had got it wrong last Friday, her spokesman said on the record she “paid the correct duty” and “any suggestion otherwise is entirely without basis”. Yet later the same day, on Friday night, they decided to check and get a second opinion from a tax barrister.

This led to a change of position from Ms Rayner on Wednesday, and the self-referral to the ministerial standards adviser.

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Angela Rayner: A tax row timeline

Starmer’s defence

But in the interim, on Monday, while the tax barrister was re-checking the facts, Sir Keir was picking a side.

He attacked critics – who were asking if the housing minister had paid the main housing tax at the right rate – for pursuing a class war.

“Angela has had people briefing against her and talking her down over and over again. It’s a mistake, by the way,” he said.

By this point, No 10 also knew that Ms Rayner was trying to lift a court order which she claims prevented her from going public with the truth. There was no attempt to nuance from the top, however.

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Rayner admits she didn’t pay enough tax

Only finally, on Wednesday, on Sky News, did Ms Rayner concede a mistake. The deputy prime minister’s defence was that lawyers had wrongly advised her to pay the lower stamp duty – it was all their fault and she should not be found culpable.

Even this has turned out to be a partial explanation, and that is why she’s gone.

Rayner took a chance

The conclusion by the Downing Street investigator was that she’d ignored clear warnings about her tax bill that she should have followed.

In his adjudication to the PM, Sir Laurie Magnus wrote: “In two instances, [the legal advice] was qualified that it did not constitute expert tax advice and was accompanied by a suggestion, and in one case a recommendation, that specific tax advice be found.”

So she took a chance on not following advice to get a proper tax lawyer, and took a chance a second time by claiming on telly that the advice to her was wrong – and has been caught out only because of media scrutiny.

Angela Rayner with Chancellor Rachel Reeves
Image:
Angela Rayner with Chancellor Rachel Reeves

Ministers take nuanced advice from professionals on a daily basis and have to use their political determination on whether they agree. Something very similar happened here in Ms Rayner’s private life, and she got it wrong.

And at no point did someone in No 10 or her team seek to challenge her explanations before multiple figures mounted a case for her defence in public, of things that proved later to be partial or untrue.

This is the sort of thing that damages public trust: making categorical statements that are untrue because the facts weren’t properly established in advance.

Will lessons be learned across the top of government?

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