The NHS is set for a winter of discontent. Health workers across disciplines are set for industrial action which could leave appointments cancelled as they fight for pay rises against the backdrop of a cost-of-living crisis which has left key staff reliant on food banks.
Services in North East are no different, and will likely be hit hard by strike action - unless there is a resolution to a number of pay disputes in the coming days. On December 15 and December 20, nurses at three of our hospital trusts will walk out - and the latter date could see co-ordinated action with others across the NHS. That would include the RVI. More strikes could follow.
Emergency and life-preserving care will be protected - but there is still likely to be huge disruption, with the Government continuing to urge workers set to strike to carefully consider their decisions. The army is said to be on standby to provide emergency support.
What will happen with nurses?
The Royal College of Nursing has now announced both where strikes will happen, when, and how services will be protected. In the North East, there will be strikes on December 15 and 20 at the Northumbria Healthcare, Newcastle Hospitals and Gateshead Health NHS trusts.
Between them, they are responsible for hospitals including the Freeman, NSECH, QE in Cramlington, and the Northumberland in Gateshead. Smaller sites in Northumberland and North Tyneside - such as Hexham, Wansbeck and North Tyneside hospital - will also see nurses walk out.
The RCN has now also highlighted services which will be protected. These are chemotherapy, dialysis, critical care units such as intensive care and high dependency, and neonatal and paediatric intensive care. Other services will be reduced to Christmas day or night duty levels, the union said. Details of where picket lines will be remain to be seen.
And the ambulance service?
On Tuesday, UNISON confirmed its North East Ambulance Service (NEAS) staff - including call handlers and paramedics - had voted to walk out. A day later, the GMB union followed suit. Dates are yet to be confirmed - as with any industrial action the union now has a six-month window for action. However, the warning has been clear: "Expect strikes before Christmas."
A number of other ambulance services around the country have also been affected by strike action - with it possible that the army could be called in to support services. It's been widely reported that the armed forces are on "standby" to step in. The Labour Party's shadow Defence Secretary has even warned that troops are being brought back from Ukraine in case they're needed.
However this week, Saffron Cordery, interim chief executive of NHS Providers, said it was likely any military support would be "at the margins" in an interview with BBC Radio 4's Today Programme. Confirmed strike dates and the nature of any action remain to be confirmed.
The extra pressure on services will come as ambulance handover delays - where ambulances are stuck outside of A&E units waiting to pass patients on to hospital staff - continue to be a nationwide problem. Though the North East's hospitals are not the hardest hit, work has been ongoing to mitigate the issue.
Will other NHS staff walk out?
Junior doctors voted overwhelmingly to ballot over strike action and this will take place in the New Year. Reps from the British Medical Association (BMA) have offered support to their NHS colleagues, too. Other allied NHS professions are also involved in either ballot proceedings. Health unions either with a live strike mandate include Unison, Royal College of Midwives, the Royal College of Nursing, the Chartered Society of Physiotherapy, GMB and Unite.
What have the unions said?
The RCN has been so far steadfast in its demand for an inflation-beating pay rise that also addresses what it has called two decades of eroding pay. Most recently its general secretary and chief executive Pat Cullen said: "Every nurse feels a heavy weight of responsibility to make this strike safe. Patients are already at great risk and we will not add to it.
"Nursing staff do not want to take this action but ministers have chosen strikes over negotiations. They can stop this at any point"
Earlier in November, Karl Norwood a RCN operational manager in the North, told ChronicleLive how "the RCN and nurses themselves have been warning that they have not been valued for the past ten years". He said some nursing pay had fallen 20% in real terms, and there were now 47,000 nursing vacancies in England.
He added: "Our nurses tell us there are not enough of them to deliver safe care. It's impacting on patient care and leading to worn down, burnt out nurses. That's essentially it and it's got to a point where enough is enough."
Unison's regional general secretary Clare Williams has also urged the Government to avert strike action before Christmas by boosting pay. She said: " The decision to take action and lose a day’s pay is always a tough call. It’s especially challenging for those whose jobs involve caring and saving lives.
“But thousands of ambulance staff and their NHS colleagues know delays won’t lessen, nor waiting times reduce, until the government acts on wages. That’s why they’ve taken the difficult decision to strike. Patients will always come first and emergency cover will be available during any strike. But unless NHS pay and staffing get fixed, services and care will continue to decline.
The NHS response
First and foremost, NHS leaders in the North East have said that strike action is a matter between trade unions and the Government. However some have touched on the impact of the strikes.
Dame Jackie Daniel, chief executive of the Newcastle Hospitals NHS Trust wrote in a board report last week: "Pay is a matter for Government and the trade unions but I want to reiterate how much we value our staff. Good pay and conditions are important for staff and their families, as well as for the NHS’ overall ability to retain and recruit the workforce we need.
"Preparations are underway by the Trust, in coordination with other partners across the Integrated Care System (ICS), to ensure that emergency care continues to be provided as normal in the event of any industrial action and that disruption to patients is minimised."
And after ambulance service strikes were announced this week, Karen O’Brien, director of people and development at North East Ambulance Service, said: “Although NHS pay is a matter for the Government and the trade unions, we recognise this is a very difficult time for everyone, including our colleagues. Whilst we have no role in negotiating the terms at the heart of the dispute, we need to ensure plans are in place to keep critical services running while respecting the right of staff to take industrial action.
"There may be an impact on non-urgent work because of industrial action. We are working closely with our trade union representatives and the Association of Ambulance Chief Executives (AACE) to ensure safe services remain. We recognise this can be a worrying time for our colleagues who work incredibly hard every day to keep our patients safe."
No backing down from the Government
Health Secretary Steve Barclay has repeatedly told those set to strike that - with economic turmoil and high inflation in the background - the Government simply cannot afford to meet the demands of NHS workers.
This week, Mr Barclay said: “I’m hugely grateful for the hard work and dedication of NHS staff and deeply regret some will be taking industrial action – which is in nobody’s best interests as we approach a challenging winter. Our economic circumstances mean unions’ demands are not affordable, each additional 1% pay rise for all staff on the Agenda for Change contract would cost around £700 million a year.
"We’ve prioritised the NHS with record funding and accepted the independent pay review body recommendations in full to give over one million NHS workers a pay rise of at least £1,400 this year, with those on the lowest salaries receiving an increase of up to 9.3%."
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