Britain is facing an era of strikes not seen for a generation. There are walkouts every day until Christmas and during it. Most worryingly, The Royal College of Nursing strikes begin on December 15 at half of all NHS Trusts. The Royal College of Midwives opened a ballot last month, so more strikes are likely next year.
Within nursing, this is a crisis that has been building for years. Nurses are asking for a 19 per cent pay rise, the Government is offering four, an insulting offer to the thin red line of men and women holding our nation’s health together. Nurses are in Band D of pay in the NHS, with a newly qualified nurse earning only £27,055, often rising to just £31,000, an amount that has fallen in real terms by eight per cent since 2010, fuelling shortages in this vital sector, with wages now hit by inflation.
Meanwhile, nursing agencies are being paid up to £2,500 to fill a shift. In the last financial year — in a pandemic — we spent £3 billion of the annual £12 billion bill for the NHS with agencies. Often, they are recruiting from hospital staff. Agency pay rates were capped at 55 per cent above normal pay — changed in March this year to 35 per cent — but often it is more as managers can go above in an emergency.
As those working in the NHS know, a huge amount of the pressure on nurses is because of this staffing crisis — 40,000 quit last year, as shortages mean longer hours for those that remain, often on the receiving end of abuse from patients.
At LBC Radio, where I often present a weekly show, doctors and nurses call in, tearful and emotional, upset that they cannot provide the care they want to, having worked extra hours, sometimes for free because they couldn’t leave vulnerable patients at risk.
NHS Trusts are recruiting like mad from abroad but with that comes extra costs and delays. How did we get here? Spending on NHS 2020/21 was £192.9 billion, or £3.7 billion per week (these are pandemic figures but the latest we have). Our spending on health as a proportion of GDP is among the highest in developed nations. We have more nurses employed than ever and there was a surge in those applying to UCAS after the pandemic to study nursing. But waiting times for urgent care keep growing. The NHS is arguably in a horrific spiral and increasing nurses’ pay is just the first unavoidable measure. Fears of large pay rises are not unfounded: matching those demands across the public sector is dangerous in an inflationary period. But with nurses, there is no option but to increase pay by more than four per cent.
Other measures need to happen too, or we will never break the cycle. The flow of new nurses into the NHS stalled in the last decade. Despite warnings that the strain on NHS staffing and midwives would only increase, the Government decided in 2015 to end student nurse bursaries. They were returned in 2020 but reduced from £16,400 to £5,000 (with top-ups for childcare costs). At the same time university degrees added loan debt to a career which was not exactly well paid.
Imagine the loss of nurses entering the NHS during that five-year period, as we led up to a pandemic? To make matters worse, available apprenticeships fell because of the apprenticeship levy introduced in 2017. Too many years of decline, with an ageing population, obesity on the rise and underfunded social care have all added to the downward pressures on nursing requirements. Recent applications have only taken numbers back to where they were eight years ago and is far from the scale needed. It doesn’t make sense, does it? Why lower funding for training and waste billions plugging the gaps recruiting abroad and on agency fees?
There has been a lot of talk about skills and higher wages from ministers. Take bursaries back to where they were. In the short term, offer larger grants to stop nurses quitting and give bonuses to those in trusts with the worst staffing problems so that they stay. Cancel the apprenticeship levy and support those taking the four-year nursing degree which includes paid work experience. Do it straight way so that they can switch courses.
Increase pay now and offer more later in the knowledge if you can plug gaps with an influx of trained nurses, trusts can lower the staggering agency bills. It is the only way out. Add better tax reductions for childcare for those on the front line. Don’t take this advice from me — this is what nurses and doctors are saying. It’s time the Government listened.
