Britain’s health workers stage biggest-ever walkout as pay negotiations hit stalemate

Nurses from the St. Thomas' Hospital in London take part in strikes on Monday, February 6, 2023.
Nurses from the St. Thomas' Hospital in London take part in strikes on Monday, February 6, 2023. ? Frank Augstein, AP

Tens of thousands of nurses and ambulance workers joined Britain’s?largest-ever health sector strike?on Monday – the latest?walkout?to cause disruption?at?the National Health Service. Public support for striking staff remains high, but negotiations with the government over pay increases have reached a stalemate.


This week is set to be the most disruptive in the 75-year history?of Britain’s?National Health Service (NHS),?according to National Medical Director Stephen Powis.

The start of the week was set to be especially?fraught as?nurses and ambulance staff staged strikes on the same day, leaving the health service tens of thousands of?workers short. Nurses will?continue striking?on Tuesday, followed by physiotherapists on Thursday and?another round of?strikes for ambulance staff on Friday.??

This week’s industrial action is the latest in a series of historic walkouts among Britain’s health workers that have grown in scale over the past three months – an extraordinary scenario in a country?that?views its universal healthcare system?almost?as more of?a national religion?than a public service.??

“Nurses are seen as the angels of the health system, and it's unprecedented for them to actually strike,”?said?Tony Hockley, senior visiting fellow in the Department of Social Policy at?the?London School of Economics. “They’ve threatened a few times over the years but it's never happened before.”??

Top of nurses’ demands is a pay increase to counter Britain’s soaring inflation rate, which as of December 2022?was at 9.2?percent?– the worst?it has?been in four decades.?

Working conditions are also in the spotlight. “NHS Staff do not reach the decision to vote to strike lightly,”?said NHS Workers Say No, a grassroots campaign group,?in?a statement.?“We have had enough of our patients receiving unsafe care in an understaffed and underfunded service.”??

‘Pay, recruitment and retention’?

Amid a cost-of-living crisis,?soaring prices have hit health workers especially hard. Nurses in the UK are among the?worst?paid?in Europe, according to OECD data. The?average salary?for a nurse of between ?33,000 - ?35,000 (€37,000 - €39,000) has lagged behind pay growth in the public and private sector, and failed to match inflation for the past?10?years.??

In early 2022, 14 percent of nurses were found to be?relying on food banks?run by charities that support the NHS.??

Low pay is exacerbating poor working conditions. “Pay, recruitment and retention are the biggest issues,”?said?Hockley. “The main driver of poor working conditions is staff vacancies but nurses are finding it hard financially to stay in the NHS. It’s losing experienced staff because they're going to?work in supermarkets.”?

Some 25,000 nurses have left the profession over just?the last?year,?according to the Royal College of?Nurses,?and the shortfall of nursing professionals could reach?almost 40,000?in 2023.

“They are saying that the NHS is in a serious crisis,”?said?Dr Jennifer Crane, lecturer in health geography at University of?Bristol. “And?that to strike is to show care because staff are flagging that their departments are too?short-staffed?to look after?patients.”?

‘A special case’?

When strikes began in December 2022, the?Royal College of Nurses?initially asked for a pay rise of 5 percent above inflation?and has since said it could meet the government "half way”. The trade union wrote to UK Prime Minister Rishi Sunak on Saturday asking him to bring the nursing strike?"to a swift close" by making "meaningful" pay offers.?

Meanwhile, Sunak said in a TalkTV interview last week that he would "love to?give the nurses a massive pay rise" but said the government faced tough choices and that it was funding the?NHS?in other?areas,?such as by providing medical equipment and ambulances.??

So far, weeks of pay negotiations between?workers’ unions?and the government have been fruitless.?The government?has argued that pay increases would be unaffordable and would cause prices to rise even further – and,?in turn, increase interest rates and mortgages.?

The health worker walkouts?are part of a wave of industrial action sweeping Britain. Since last?summer,?around 500,000 public and private sector workers have staged strikes disrupting schools, universities, transport networks and the civil service.?

This has contributed to the deadlock with health staff. “The government is very concerned that it will get an inflationary pay cycle in the public sector generally,”?said?Hockley. “Even though there might be a special case in the NHS, where there are huge vacancy problems, it’s worried about having a special case that then spills over to every other public sector.”?

Saving the NHS?

In April an annual public sector pay review is likely to?result in pay rises?across a variety of services, although there is no guarantee how much health workers may receive. Pay increases in 2022 were criticised by unions for being far below what was needed to “save the NHS”.??

For now, the government in England is “resolute” about putting off pay increases until spring, “and it seems adamant to stick to that if, politically, it can?weather it”,?Hockley?said.??

But pressure is mounting. NHS bosses on Monday urged the government to reopen talks with striking staff and stop the disruption caused by walkouts.?

Nurses, in particular, have strong public backing. A poll by the Observer newspaper in January found support for striking nurses was at?almost 60%?– the highest support for any group of striking workers, and a fall of just four points since December.??

“Even if people see their own healthcare disrupted in the strikes, many people have a deep love for the NHS as an ideal and are likely to believe NHS staff when they say that [they need] to fight for change,”?said?Crane. ?

Throughout Britain, ministers are also starting to take a divided approach. Health unions in Scotland paused strikes this week after the Scottish government agreed to start annual pay reviews?early, among?other measures.?

In Wales, many health worker strikes were averted on Monday after Health Minister Eluned Morgan offered eight health unions an extra 3 percent on top of the additional??1,400 (€1,570)?already promised.??

Nursing unions in England said on Monday they would stop?the?strikes if Sunak made them the same offer. Otherwise, they are determined to continue.?

“They are adamant that they can't go on providing unsafe care,” Hockley said.?

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