Karen Smith

Squeezing our public sector professionals

Public sector pay restraint since 2010 has left five million workers struggling. Many public sector staff now earn £2,000–3,000 less in real terms than in 2010. What does that mean for our frontline services?


Karen Smith, special care dental nurse for over 40 years. Currently at the Livewell Southwest Clinic in Plymouth. UNISON activist.


  • Special care dental nurse specialising in sedation, radiography and oral surgery
  • Works at dental school once a week
  • Supports evening assessments and out-of-hours emergency dental service


Karen has been a dental nurse since she left school. “Someone suggested I’d make a good dental nurse, so when I left school in 1976 I became one.”


Karen’s workplace has had a recruitment freeze to save clinical posts. But even when there isn’t a freeze, getting the right people into the right roles is difficult. “There are lots of vacancies. Lots of additional tasks are being included in job descriptions and jobs are being advertised at lower grades.”

Karen is also feeling the cutbacks personally. “I’ve had no pay rise for some time as I’m at the top of my band. Last year’s 1% cost of living increase just got swallowed up.”


The quality of service that Karen and her team can offer is suffering. “The oral surgery service has become figures focussed. It used to be about giving patients that extra bit of time and some TLC. Now the appointments are shorter, we don’t have time to talk to them about their fears. This is due to the constant push from commissioners to do more with less.”

Karen is also concerned about the impact these cutbacks are having on the wellbeing of her colleagues: “There aren’t enough staff to do all the jobs. We’re constantly juggling and there’s a lot of stress.” This relentless workload can be risky: “I do fear mistakes being made because it’s always more, more, more.”

The government’s pay cap and the rising cost of living makes home finances hard for Karen and her colleagues. “Everyone is struggling to make ends meet and budgeting to meet repairs, for example to their car or boiler. Morale is low and people don’t feel valued.”


“Sickness needs to be looked at – are staff stressed? Stress surveys should become mandatory. Now you have to work to live and it never seems enough. But happy staff offer a much better experience for patients.”

It all comes down to fairly valuing people for the work they do. “There should be some way for staff who give 100% to be adequately rewarded. It’s time the government stopped artificially holding down pay for hardworking public servants like me.”