Nurses in the UK have reached breaking point.
Up to 100,000 members of the Royal College of Nursing will march across England, Wales and Northern Ireland on Thursday in the first of two strike days this month to protest poor wages and working conditions. she planning to go again on December 20th. (Nurses in Scotland are negotiating a separate salary offer.)
It’s the first time in its 106-year history that the RCN – the UK’s largest nurses’ union – has gone on strike in England. The action was prompted by a cost-of-living crisis that has severely reduced the purchasing power of nurses nearly three years after the start of a pandemic that has left many stretched to the limit.
“It’s pretty unprecedented,” Billy Palmer, a senior fellow at Nuffield Trust, a health research firm, told CNN. While small groups of caregivers have previously left, the country’s National Health Service “has not seen anything of this magnitude until now,” he added.
This is partly because the RCN has had a ‘no strike’ policy for most of its history. In 1995, the union changed its rules, allowing strikes as long as they didn’t affect patient care.
“Patient safety is always paramount,” the RCN says on its website, adding that some nurses would continue to work during the strike. The RCN has promised to maintain essential services, including chemotherapy and dialysis treatments, during this month’s disruptions.
The nurses join hundreds of thousands of other British workers who are striking this December, including rail workers, postal workers and ambulance drivers. At the heart of these disputes is pay, which is failing to keep up with inflation, which hit a 41-year high of 11.1% in October.
It’s the widest Wave of industrial unrest since the infamous “Winter of Discontent” in the late 1970s, when large numbers of workers, from truck drivers to gravediggers, went on strike.
The chaos has prompted Prime Minister Rishi Sunak to warn that “tough” new legislation curbing strike action is on the way.
Earlier this year, the RCN turned down a government offer to increase nurses’ salaries by at least £1,400 ($1,707) a year. Supply averaged a 4.3% increase, well below inflation.
Pat Cullen, RCN’s general secretary and chief executive, said last month: “Enough [was] enough” and that nurses “would no longer tolerate a financial knife edge at home or a bad deal at work”.
The union wants a 19% pay rise – a 5% rise amid inflation of 14% as measured by the October Retail Price Index – and for the government to fill a record number of vacancies which it argues are jeopardizing patient safety.
The RCN knows that’s optimistic, Palmer said. Nurses would not “really put up with” such an increase, he said, merely using it as a starting point for negotiations.
But that demand is “unaffordable,” UK Health Secretary Steve Barclay told CNN in a statement. Every additional 1% salary increase for nursing staff would incur costs the government around £700m ($854m), he added.
continued Barclay Twitter last month that industrial action would “inevitably” have an impact on services, but that the NHS had “tested plans to minimize disruption and ensure emergency services continued to operate”.
The dispute has its roots in previous complaints. The 360,000 nurses who work for the NHS — the service’s largest professional group – have suffered from years of underinvestment, the RCN argues.
In 2010, the Conservative-led coalition government began a decade of austerity to stabilize the country’s finances in the wake of the global financial crisis.
According to The Health Foundation, a UK charity working to improve health and healthcare, between 2010 and 2017 nurses’ salaries fell by 1.2% each year when inflation is factored in. Her salary was frozen for the first three years.
Despite wage increases in the years since, the Nuffield Trust estimates that a nurse’s typical salary – around £40,000 ($49,000) for experienced nurses working full-time – has fallen by almost 6%. after inflation compared to a decade ago. This compares to a 0.6% increase in private sector wages over the same period.
Internationally, it’s difficult to compare UK nurses’ pay because healthcare systems differ significantly between countries, but they fall somewhere in the middle of the range of comparable economies, Palmer said.
“Usually we’re in the middle in almost every way [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 total expenditure of the NHS. While the government has increased funding over the past decade, Palmer said gains have been “marginal.” After accounting for inflation and demographic changes, spending in England has grown by just 0.4% a year since 2010, data from the Nuffield Trust shows.
Pay isn’t the only problem. Nurses are also burned out, partly because there are a record 47,000 vacancies in England.
Data from the Nuffield Trust shows that 40,000 nurses in England, or around 11% of all nursing staff, have left their jobs in the year to June. A similar number followed – nearly 45,000 – but it wasn’t enough to fill in the gaps.
Most nurses retired, but the number of reasons for work-life balance, the second most common reason for termination, is nearly four times higher than it was a decade ago.
And more could quit if conditions don’t improve. An RCN poll of its members last December found that 57% of respondents are considering leaving the company. 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 workforce numbers have lagged behind demand. The pandemic has only exacerbated these problems.
“[Nurses were] having to manage the iPad call between someone [couldn’t] being visited by relatives in their final hours,” Warren said. “[It was] really emotionally draining.”
— Zahid Mahmood contributed to the coverage.