At the height of the Covid pandemic, Amy Fancourt felt things might change. Watching the public clap for the NHS in their millions, the 29-year-old A&E nurse felt her profession might finally be on the cusp of getting the recognition it deserved.
“And then it all fizzled out after a year, like a sad birthday candle,” she said.
The situation since the first Clap for Carers, some two and a half years ago, could scarcely be more different. There are reports of nurses using foodbanks and struggling to heat their homes; thousands are leaving the workforce every year for jobs in retail; the backlog in routine hospital treatment has ballooned to over 7 million. It culminated in the Royal College of Nurses issuing its 300,000 members with the first ever ballot for strike action in its 106-year history, with results set to be announced later this week.
Nurses across a variety of specialisms tell a similar story - of a workforce teetering on the brink of burnout, looking on in awe as the Government scraps bankers bonuses and prevaricates over public sector pay.
The Department of Health and Social Care (DHSC) says it has offered most NHS workers a £1,400 pay rise – though this remains well below the RCN’s demand of a rise 5 per cent above inflation, which is currently at 9.9 per cent. Nurses claim the pay rise doesn’t even come close to matching the soaring energy bills and rent hikes that have set the backdrop for Britain’s winter of discontent.
“The problem with nursing is that you could be doing it for 20 years and your prospects for earning more are still limited – there are finite opportunities. People are also coming out of college with huge debt,” says ICE nurse Linda Tovey.
“My situation isn’t comfortable, my house is falling apart and I haven’t been on holiday in five years.
“I love being a nurse and I wouldn’t want to do anything else, but it’s increasingly difficult to do because you go home feeling guilty every night… patients are being looked after by people being paid a pittance.”
Nurses’ real-terms pay has fallen 6 per cent
Analysis conducted by London Economics for the RCN found that nurses real-terms earnings had fallen by 6 per cent compared with 3.2 per cent for private sector employees. A newly qualified nurse starting in Band 5 will earn £27,000 a year in England, rising to a minimum of £33,000 in Band 6.
Niamh Bohnacker, a research nurse, was one of many to take her skills abroad in search of better pay.
“I went to work in the Middle East to boost my savings, but it’s a shame I had to do that because the Government weren’t willing to support me financially.
“I love the NHS but to come home at the end of the day and not feel recognised and valued financially just worsens the burnout you feel from a shift. Managing a patient requires knowledge, expertise and skill – there is a huge amount of responsibility.
“You give so much and if it’s not reflected in your pay, it does make a difference. Often you are with patients at the toughest time of their lives. I left frontline nursing as I just coudn’t manage the pressure and intensity anymore.”
For Rachael Nanikhan, a paediatric A&E nurse, there is not enough recognition that nursing is in fact a highly specialised, degree-based subject. The average student loan debt was £35,000 as of April 2022, according to the House of Commons library.
“Many of my colleagues have studied for years and are incredibly skilled. You can’t tell people they need to work harder when they are working flat out in the sixth biggest economy in the world and still can’t make ends meet.”
Insufficient pay rises and widespread staffing shortages have created a toxic cycle in which many younger nurses leave the profession just years after qualifying, Amy says. This in turn impacts patient care in the long-term.
“I work in one of the busiest A&Es in Europe and then come back to a house I can’t afford to heat, that’s when it becomes very real,” she says.
“London is ultimately unaffordable. Many people my age are leaving the profession to go to the Middle East or Australia because you make a lot more money over there. We have a leaving party every week at work now – it’s become a joke.”
Strikes ‘a last resort’
The nursing strikes, which would follow industrial action across the public sector, could prove a political headache for Prime Minister Rishi Sunak and Health Secretary Steve Barclay. The Government has previously taken a hard line on strikes but public opinion may force their hand: a recent YouGov poll found that two-thirds of the public support industrial action by nurses.
Upcoming spending cuts have sparked fears among nurses that they may be denied a further pay rise as Chancellor Jeremy Hunt seeks to plug a fiscal black hole caused by his predecessor Kwasi Kwarteng’s mini-Budget. Ministers have been forced to deny that austerity measures to balance the books will result in less spending on the NHS.
“People that earn millions obviously work hard, but so do we. Binmen work hard. Toilet cleaners work hard. These are important jobs that society couldn’t do without,” Linda says.
“Ultimately you need to know your whether your bins will be emptied or whether someone will be at the door of A&E to make sure you stay alive.”
Mark Farmer, the Interim Director for the RCN London region, told the Standard that the Government must up their pay offer from 5 per cent, saying it was “pitiful”.
“We’re in a situation where you have hospitals setting up food banks and uniform schemes. That’s great, but the NHS shouldn’t have to be funding this out of charitable reserves.
“Inflation has grown in the past year and that is stretching salaries even further. People are just unable to cope.”
The strikes face opposition from across the political spectrum. Tory party chairman Jake Berry has claimed that a significant pay rise for nurses would drive inflation, arguing instead that the Government’s plan for growth would eventually ensure public sector staff get a better wage. Labour leader Sir Keir Starmer said he “doesn’t want the strikes to go ahead” but that he could “understand why people are concerned”.
But for many nurses, industrial action is the last resort following years of real-terms pay cuts. The system, they say, is broken.
“Do I want to go on strike? No, but I don’t feel like I have a choice,” Niamh says. “We are doing this for the public, so they have the NHS that they need.”
