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The Guardian - UK
The Guardian - UK
Comment
Polly Toynbee

Tin-eared Liz Truss is obsessed by tax cuts, so why shouldn’t NHS nurses strike?

Nurses protesting about pay march to Downing Street on 25 July 2022.
Nurses protesting about pay march to Downing Street on 25 July 2022. Photograph: Hesther Ng/Sopa Images/Rex/Shutterstock

Stop all the strikes, delay the nurses’ ballot, abandon this year’s pivotal TUC annual conference in mourning for the Queen. You might note this respect for the late monarch from workers facing gigantic pay cuts was not matched by the London Stock Exchange, which has missed not a nanosecond of trading in shares, including among those companies profiteering from high energy prices. Imagine the outrage at lese-majesty from the Mail and other papers had Mick Lynch done the same.

Before long, strikes will resume among ever more unlikely “militants”; Daily Express journalists, criminal barristers and postal workers will be striking. So will refuse collectors, firefighters, Felixstowe dockworkers and a gathering storm of other workers who cannot absorb huge pay cuts on top of the lowest wage growth in the G7.

So far, public opinion backs them, as pollster James Frayne of Public First recently told Politico. “There’s a lot of public sympathy for strikers. Most people think, well, if I was facing a 10 or 20 percent pay cut, and was in a job where I could strike … I would do it,” he said. The pay of public sector workers has been hit hard by freezes and cuts, so it has fallen well behind the private sector. People know that unions speak for them. If the minority who belong to unions are successful, it will pull up everyone’s pay – in an economy that currently has more than one million vacancies.

It’s impossible to know how far sympathy for strikes will stretch if they are seriously disruptive, but Liz Truss’s ill-judged threats of even tougher anti-strike laws, Jacob Rees-Mogg’s bonfire of working rights or the likes of MP Tobias Ellwood calling rail workers “Putin’s friend” will probably only stir up more support.

Next up are the nurses. The Royal College of Nursing in England, Wales and Scotland has never gone on strike, but any remnants of a sense of Florence Nightingale duty have been blown away by the current conditions within the NHS. Pat Cullen, the RCN’s general secretary, has been touring hospitals talking to her members ahead of the now-delayed ballot. It’s a sign of the times that none of the hospitals the RCN contacted allowed me to accompany Cullen and listen to nurses.

Barring the press from scrutinising frontline services is now the norm: the NHS is too intimidated by pressure from the government and the upheaval of four health secretaries in 18 months. This was never the case under Labour. I’ve been refused permission to visit a jobcentre numerous times. For a decade I have been requesting to observe HMRC’s minimum wage inspectors at work, yet every time I have been refused.

Cullen says nurses will vote to strike, not just for pay but against working conditions so intolerable and frightening that 8% fewer applicants are training to become nurses this year. “Many drop out with second thoughts when they see what’s ahead,” she told me. That is a growing disaster for the NHS when there are more than 46,000 vacancies, a number that is rising again and worst in community and mental health nursing. Nursing students are clocking up £50,000 debts after their bursaries were cut in 2017. Those nurses work all hours on unpaid placements, including evenings and weekends. They are increasingly relied on for washing, bathing and feeding patients by overworked registered nurses who don’t have enough time to give them proper instruction.

“What they see is 13-hour shifts from 7am to 8pm, often staying later unpaid because short-staffed wards have just three registered nurses and two healthcare assistants caring for 30 very sick elderly patients,” Cullen said. She talks to exhausted nurses, afraid of the dangers in their impossible workload. “The new secretary of state should take time to walk in their shoes for a week.”

In real terms, the RCN says, nurses have lost 10% in pay since 2010. About 60% are stuck in the lowest band 5 for registered nurses, earning between £25,000 and £28,000. Many more have remained there to save the government money, when they may have previously progressed up the pay scale more quickly. Many London nurses can’t afford to rent locally. “Some travel two hours each way, at a cost of £500 a month. I defy any politician to live like that, paying rent and childcare, never owning a car or home,” Cullen said. Vacancies from departed EU nurses are taken by nurses recruited from countries on the World Health Organization red list, such as Nepal, who can’t spare them. “But when they get here foreign nurses can’t survive on their pay, even living three to a room, let alone send money home to children. They beg me to help them get home again.”

Nurses worried about striking have asked Cullen how they can leave their patients. She tells them how the successful five-day strike she led in 2019 in Northern Ireland won nurses a rise: they staffed all emergency work in A&E and wards but stopped planned surgery, adding to already soaring waiting lists. A strike by nurses, and probably doctors and other health workers, would mean the NHS sliding yet further. The service is already overwhelmed, with 6.8 million people waiting for operations. Despite recent legislation allowing P&O-style strike-breaking by agency workers, in Northern Ireland nursing agencies refused. Cullen says that in England, Wales and Scotland, nursing agencies would refuse to supply strike-breakers this time too.

Last week she had a chance encounter with four nurses at a railway station. “They’d reluctantly just left the NHS as they couldn’t survive. They were on their way to work in private boarding schools crying out for nurses, paying twice as much, with free accommodation. They were amazed they’d get double time for work after 4.30pm.” There are plenty more such easier nursing jobs.

Truss needs to make a strategic decision before winter strikes build to a crisis. Will she relish a fight with workers who are resisting unprecedented cuts after the past decade of wage stagnation? She mistakenly thinks the blame will land on Labour and its support for union rights. She would be far wiser to make the same U-turn as she did on energy bills. If the government can afford to borrow £150bn, compensating even the well-off while wasting a fortune on tax cuts for the rich, it can afford to make fair pay settlements with public workers. If she wants a Thatcheresque showdown, Tin-Eared Lizzie will find herself on the wrong side of public sympathy. Two-thirds of voters support a nurses’ strike.

  • Polly Toynbee is a Guardian columnist

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