by
London
Cnn
—
Nurses in the UK have reached their breaking point.
As many as 100,000 members of the Royal College of Nursing will cross England, Wales and Northern Ireland on Thursday in the first of a two-day strike this month to protest against low pay and working conditions. They plan to come out again on December 20th. (Nurses in Scotland are negotiating a separate payment offer).
Is the first time in its 106-year history that the RCN, the largest nurses union in the UK, has gone on strike in England. The action was triggered by a cost-of-living crisis that sharply reduced the spending power of nurses nearly three years into the start of a pandemic that has pushed many to their limits.
“It’s pretty unprecedented,” Billy Palmer, a senior fellow at the Nuffield Trust, a health research firm, told CNN. While small pockets of nursing staff have already exited, the country’s NHS has seen “nothing of this magnitude so far,” he added.
This is partly because, for most of its history, the RCN has had a ‘no strike’ policy. In 1995, the union changed its rules, allowing strikes as long as they did not jeopardize patient care.
“Patient safety is always paramount,” the RCN says on its website, adding that some nursing staff will continue to work during the strike. The RCN has pledged to maintain critical services, including chemotherapy and dialysis treatments, during disruptions this month.
The nurses join hundreds of thousands of other British workers who are on strike this December, including railway staff, postal workers and ambulance drivers. At the heart of these controversies is pay, which is failing to keep pace with inflation which hit a 41-year high of 11.1% in October.
It is the largest wave of industrial unrest since the country’s infamous “Winter of Discontents” in the late 1970s, when large numbers of workers, from truckers to gravediggers, went on strike.
The chaos has prompted Prime Minister Rishi Sunak to warn that “tough” new laws are on the way that limit the strike.
Earlier this year, the RCN rejected a government offer to raise nurses’ pay by a minimum of £1,400 ($1,707) a year. The offer amounted to an average hike of 4.3%, well below the inflation rate.
Pat Cullen, RCN’s general secretary and chief executive, said last month that “enough [was] enough” and that nurses “would no longer tolerate a financial knife at home and a rough deal at work”.
The union says it wants a 19% pay rise. – a 5% rise on 14% inflation, as measured by October’s retail price index – and for the government to fill a record number of jobs which it claims is jeopardizing patient safety.
The RCN knows he is optimistic, Palmer said. Nurses are not “genuinely resisting” such an increase, she said, but are simply using it as a starting point for negotiations.
But that question “isn’t accessible,” UK health secretary Steve Barclay told CNN. Every additional 1% salary increase for nursing staff would be costly the government about £700 million ($854 million), he added.
Barclay said Chirping last month that industrial action would ‘inevitably’ impact services, but that the NHS had ‘tried and tested plans in place to minimize disruption and ensure emergency services continue to operate’.
The dispute has its roots in previous grievances. The 360,000 nurses who work for the NHS — the largest professional group in the service — have suffered from underinvestment for years, argues the RCN.
In 2010, the Conservative-led coalition government embarked on a decade of austerity to stabilize the country’s finances after the global financial crisis.
Nurses’ pay fell by 1.2% each year between 2010 and 2017 when inflation is taken into account, according to The Health Foundation, a British charity that campaigns for better health and healthcare. For the first three of those years, their pay was frozen.
Despite pay increases in subsequent years, the Nuffield Trust estimates that the typical nurse salary – around £40,000 ($49,000) for experienced nurses working full-time – has fallen by nearly 6 per cent after inflation compared to a decade ago. This compares with a 0.6% increase in private sector pay over the same period.
Internationally, it’s difficult to compare UK nurse pay, given that healthcare systems differ significantly between countries, but it sits somewhere in the middle of the range in comparable economies, Palmer said.
“Almost any way you slice it, we’re pretty much in the middle, generally [we] we look a little worse than Germany, but a little better than France, and we certainly look worse than the Anglosphere, like Australia and the United States,” he said.
This also applies to the overall expenditure for the NHS. Although the government has increased funding over the past decade, the gains have been “marginal,” according to Palmer. When inflation and demographic changes are factored in, spending in England has risen by just 0.4% a year since 2010, data from the Nuffield Trust show.
Pay isn’t the only problem. Nurses are also sold out, partly because there are 47,000 vacancies in England.
Nuffield Trust data shows that 40,000 nurses in England, or around 11 per cent of the total nursing workforce, left their jobs in the year to June. A similar number joined – nearly 45,000 – but it wasn’t enough to fill the gaps.
Most nurses have retired, but the number citing work-life balance, the second most common reason for leaving, is almost four times higher than a decade ago.
And others may quit if conditions don’t improve. An RCN survey of its members last December showed that 57% of those questioned were considering leaving. Feeling undervalued and working under too much pressure were the main reasons given.
Sally Warren, director of policy at The King’s Fund, a think tank, told CNN that the past decade has been “challenging” as staff numbers had lagged behind demand. The pandemic has only intensified those problems.
“[Nurses were] having to handle ipad call between someone who [couldn’t] being visited by relatives in their last hours,” Warren said. “[It was] really emotionally draining.
— Zahid Mahmood contributed to the reporting.
