Support the Nurses or Lose the NHS
This month, the Royal College of Nursing voted for its first national strike in over 100 years. Its members aren’t just fighting for themselves – they’re fighting for the future of the NHS.
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It’s the end of another busy night shift, and my partner is describing what happened. I can see the exhaustion in her eyes. Put in charge of a critically understaffed and busy ward having graduated not two years ago, it’s not been easy. She describes it to me as akin to spinning plates, constantly on her feet managing multiple different patients with different ailments who need major amounts of care and treatment in different ways, a situation far from the desired optimum setting to give care. And that’s the danger: if one patient deteriorates and needs all hands on deck, and then another needs it too, the slack simply isn’t there, and the plates come quickly crashing down.
When the RCN started to brief the press last Tuesday about the expected unprecedented ballot results, I felt a mixture of regret and determination for my partner. Regret for a government that will allow nurses to bear the brunt of unjust scrutiny and determination because we both know the RCN must win for the future of nurses and the NHS writ large.
The full results were released on Wednesday, as it was revealed that a total of 176 NHS trusts had voted to strike, including every trust in Scotland and Northern Ireland, all bar one in Wales, and a large majority in England. The dispute started back in July after the government ended its consultation with independent pay review bodies over pay increases for NHS staff.
With inflation at 11.1 percent, the pay offers made to NHS staff equate to real-terms pay cuts. The highest pay rises of 9.4 percent were offered to the lowest-paid staff like porters and healthcare assistants, and measly rises of 4.5 percent for doctors and dentists, and crucially just a 4 percent uplift for many nurses. The RCN then quickly mobilised, holding an emergency meeting of its council before voting to hold a full ballot of its members over strike action, demanding a pay rise of 5 percent above inflation.
Political support
Regrettably, the forces of reaction are already in full force to discredit the nurses’ brave moves before the proverbial dust has settled. When news started to come in that the ballots had been successful—bear in mind that this is before the results in full had even been announced—there were already two headlines in The Telegraph condemning the strikes as ‘testing the public’s patience’ and compromising essential cancer care. The Telegraph continued when the results were announced in full, with headlines touting a ‘growing mutiny’ from patients and the need for an insurance the model being the worst offenders. Even by the standards of the billionaire press, one fails to comprehend how such wild accusations about strike dates that haven’t been announced yet can really constitute good-faith journalism.
Politicians from both sides of the aisle have similarly failed to rise to the challenge of protecting and honouring the skilled workers who make the NHS tick. Prime Minister Rishi Sunak has said the RCN’s pay demands are ‘not affordable’, and Northern Ireland Secretary Chris Heaton-Harris, who is responsible for a country where every branch voted to strike, called the pay demands ‘remarkably high’ and unjustified due to the work done by nurses as ‘a vocation’. Similarly, the Labour Party leadership is assuming its default position in falling over itself to justify its lack of solidarity with workers. In an interview with ITV, Keir Starmer separated the ‘pay question’ from staff shortages, outlining that a future Labour government is going to ‘inherit a pretty awful economic situation’ from the Tories and therefore may be unable to afford nurses’ pay rises in the immediate future.
While Starmer separated the issues of pay and staffing, to invest in nurses’ pay is to invest massively in the country’s essential and skilled workforce, making an underpaid, overworked and highly-skilled job more attractive to prospective nurses. In supporting what is a modest pay rise following nurses’ pay suffering a 20 percent cut in real terms over the past decade, progressive political forces can show what solidarity looks like beyond banging some pots and pans on your driveway.
Enough is Enough
The RCN’s successful ballot isn’t isolated in its courage and determination to win just pay and conditions for its workers. From the initial announcement of the ballot back in July, the RCN has framed its fight through the verbiage of Britain’s most popular social movement today; Enough is Enough, uniting their demands with the wider fight being wrought by unions and their members for pay, conditions and dignity at work. Take the CWU, who fresh off of historic levels of strike action in Summer is balloting its members again on industrial action, also the highly publicised disputes in rail are ongoing, with train drivers at 12 different rail companies represented by Aslef set to go on strike at the end of the month.
The RCN is also joined by unions across health, with ballots for strike action for paramedics, junior doctors, and midwives also incoming over Winter. Put short, the RCN and their ‘radical’ demands don’t exist in a vacuum, representing a crucial front in a movement that continues to blossom in the face of apathy and cowardice from both sides of the political aisle.
All on the line
Ultimately, if the government is serious about bucking the low wage, low growth and low productivity model in the British economy and ‘levelling up’ the country, you can’t do it without access to a well-staffed, safely run and most importantly universal National Health Service, ensuring that work is worthwhile and prosperous. And this is the critical point at the nub of this dispute: universalism.
Without a well-paid, well-staffed sector of nurses in the NHS, the crises become self-fulfilling. The long backlog in the NHS will be exacerbated further so long as pay and conditions remain dismal, causing nurses to leave the profession. And as services worsen because of staff shortages, patients who can afford to use private providers will do so, further diminishing the perceived feasibility of the NHS as an efficient and totalising health service, and ultimately creating health divides stratified by class akin to the oft-cited example of America.
This is an existential problem happening right now, as over the past 12 months an additional 7,000 nurses left the NHS compared to last year, with the majority under 45. It’s only when you see the dispute in this context that its importance is clearest, the RCN’s member’s brave fight as a proxy referendum for the existence of the NHS itself.