Thousands of nurses across Wales have voted to strike over pay. Members of the Royal College of Nursing (RCN) have decided that a walkout, which was described as a "last resort", will take place after discussions with the Welsh Government failed to materialise.
However such a decision will undoubtedly cause distress for some people, particularly those who live with chronic conditions or are awaiting a planned operation or procedure. There are also fears the action could have an impact on the acute end of the system, such as accident and emergency or the Welsh Ambulance Service.
Here we look at the announcement in more detail to try and explain how this mass walkout might affect patients across Wales.
Read more: Nurses in Wales vote to go on strike for the first time in history
Why are nurses striking?
Nurses feel they have been getting a "raw deal" on pay for years. This all came to a head earlier this year when the Welsh Government accepted the recommendations of an independent pay review body to offer nurses a £1,400 pay rise - which equates to an average of 4.75%.
Health Minister Eluned Morgan said the pay award was structured so the lowest-paid staff in the NHS would see the biggest uplift in their pay, equivalent to a 10.8% pay rise, making the NHS in Wales the "highest-paying UK nation for staff in the lowest pay bands".
However the RCN described the award as "insulting" and "pitiful" and said it would leave an experienced nurse more than £1,000 worse off in real terms. The union asked for 5% above the RPI rate of inflation which stands at over 12%.
Who will be striking?
Following a ballot which ran between October 6 and November 2, 12 out of 13 NHS employers in Wales - which includes health boards and NHS trusts - reached the 50% turnout threshold.
Helen Whyley, director of RCN Wales, said the percentage of people voting for strike action was "in the high 80s and low 90s" in every employer. However Aneurin Bevan University Health Board, which had a 49.6% turnout, will not be involved in the walkout as they failed to reach the all-important 50% mark.
NHS employers who met the threshold to strike include:
- Betsi Cadwaladr University Health Board
- Cardiff and Vale University Health Board
- Cwm Taf Morgannwg University Health Board
- Digital Health and Care Wales
- Health Education and Improvement Wales
- Hywel Dda University Health Board
- NHS Wales Shared Services Partnership
- Powys Teaching Health Board
- Public Health Wales
- Swansea Bay University Health Board
- Velindre University NHS Trust
- Welsh Ambulance Services NHS Trust.
When will they be striking?
No dates have been announced yet, but RCN Wales has confirmed that the first period of industrial action will likely happen in December. Its mandate to organise strikes runs until early May 2023, six months after members finished voting.
It remains to be seen how long nurses will strike for, or whether it will run across consecutive days or be split up over different days. Either way it is designed to cause disruption to NHS services so the Welsh Government will sit up and take note.
The RCN has a statutory obligation to inform employers within 14 days of strike action, so it won't happen within the next fortnight.
What disruption will this cause?
Ms Whyley said the strike will undoubtedly cause disruption across the Welsh NHS and lead to routine appointments and procedures being cancelled. But she stressed that lifesaving services will be protected.
"Some nurses on strike will still go into work because they will be required to ensure that patients are safe, but there will be disruption, make no bones about that," she added. "We are doing this because things need to change, and if it takes disruption to do that, then we are prepared to do that.
"So yes, it may mean some routine operations are postponed. It may mean that outpatient appointments aren't undertaken, but what it will definitely never mean is any patient is put at risk."
Effectively, this means that urgent care in A&E, the Welsh Ambulance Service and intensive care will remain fully staffed, while other services, such as cancer care, are also likely to be protected.
But the action will affect routine services such as planned operations like knee and hip replacements, district nursing and mental healthcare. Non-urgent ambulance service provision could also be affected.
What's happening elsewhere in the UK?
Nurses in every service in Scotland and Northern Ireland voted to strike, but in England the turnout was too low in nearly half of NHS trusts for action to take place.
Scotland has offered a flat rate of just over £2,200, which means a newly qualified nurse would get around 8% more. In Northern Ireland, nurses are yet to receive a pay award because there is no working government. The pay award in England was the same as in Wales.
What do the politicians think?
Welsh Conservative Shadow Health Minister Russell George MS said: "It is highly regrettable that nurses have decided to go on strike, with all the implications for patients who depend on NHS services, but let there be no doubt that nursing pay and conditions are the responsibility of the Labour Government in Cardiff Bay.
"This will only compound the problems facing the UK’s worst-run NHS as, under Labour, Wales has the longest treatment waiting lists, A&E waiting times, and ambulance response times in the country.
"I would stress that we cannot make the NHS permanently dependent on agency nurses but, in Labour-run Wales, it is already the case, with nurse vacancies going up by a thousand in just the last year, with £134m spent on agency workers.
"I hope the minister finally engages with the Royal College of Nursing to bring this dispute to an end as swiftly as possible – it is disgraceful that she has avoided doing this so far to the detriment of patients and staff across Wales.”
Plaid Cymru’s spokesperson for health and care, Rhun ap Iorwerth MS said: "Plaid Cymru is on the side of all workers fighting for fair pay and safe working conditions. We can’t expect the kind of ongoing commitment that nurses give to their work and to patients, without ensuring they’re properly and fairly rewarded.
“No-one wants industrial action if there was any other option – and that includes the nurses themselves, more than anyone – but the fact the ballot took place in the first place indicates the strength of feeling. Plaid Cymru stands with the RCN and their members as they fight for the pay, working conditions and recognition they deserve.”
Welsh Liberal Democrat leader Jane Dodds MS said: "The Welsh Liberal Democrats support the RCN in their actions announced today. Our nurses are the backbone of our healthcare system. It is not acceptable they have been offered a below-inflation pay rise.
"This is the first statutory ballot in the RCN’s history, no one wants to see strikes in healthcare take place, but the economic situation, largely caused by the incompetence of the UK Conservative Government, has left our hardworking staff with little option.
“We rightly clapped for our nurses during Covid, but clapping isn’t enough. When we have nurses using food banks the system clearly isn't working and we must do better.
"Both Labour in Cardiff Bay and the Conservatives in Westminster need to get their heads together and ensure healthcare staff can be paid at a fair rate. I will continue to call on Labour to negotiate with the RCN."
What does the Welsh Government say?
A Welsh Government spokesperson said: "We recognise why so many nurses voted the way they did and we agree nurses should be fairly rewarded for their important work.
"We also recognise the anger and disappointment many public sector workers are feeling at the moment. There are however limits to how far we can go to address these concerns in Wales without additional funding from the UK Government.
"Following the ballot result, we will work with NHS organisations and health boards on their contingency plans. The public should be assured that arrangements will be made with RCN Wales to ensure there will always be a safe level of staffing, with life-saving and life-maintaining care being provided during any industrial action."
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