National nursing strike: should the patient ‘always come first’?

“In the 106-year history of the Royal College of Nursing (RCN) there has never been a national strike,” said Andrew Fisher in the i news site. That looks set to change this winter: in a ballot earlier this month, nurses working for hospitals and other NHS services across most of the UK voted to strike (although around half of hospitals in England will be unaffected, because turnout did not meet the 50% threshold).

Their demand is simple: “fair pay for nursing”, after years of real-terms pay cuts (of about 20% since 2010). And it is in the interests of both nurses and patients that their demands are met. Nursing is in crisis. One in nine nurses left the profession last year alone: more than 40,000 in total.

This exodus “reflects terrible morale and low pay”. Nursing is “tough”; work-life balance is now the most common reason for leaving, except for retirement. And the exodus makes the job still harder. There are more than 46,000 vacancies in NHS England. Nurses can count on public support, said Polly Toynbee in The Guardian. A recent YouGov poll found that 65% were in favour of the strike, and only 27% were against.

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‘Justified admiration’

“There is plenty of justified admiration for nurses,” said Ross Clark in The Daily Telegraph. We haven’t forgotten the pandemic. And unlike, say, train drivers, they are not overpaid: pay starts at £27,000 for newly qualified nurses.

But the RCN – “and that’s a trade union, lest anyone be confused, not a real college” – seems to have calculated that this means they can ask for whatever they like: in this case, a pay rise of 17.6%, more than five percentage points above inflation, though other public sector workers are reportedly having pay capped at 2%. This would cost the Treasury some £9bn.

‘Goes against nursing’

Striking also goes against a fundamental tenet of what it means to be a nurse, said Carmelah Jacobs in the Daily Mail: “that the patient always comes first”. The RCN has insisted that emergency care will be unaffected. But even so, thousands of operations, and chemotherapy and dialysis appointments, will be cancelled, at a time when the NHS is already under great strain.

“It is not too late for both sides to compromise,” said The Times. Steve Barclay, the Health Secretary, should reflect seriously on this “unprecedented action”. He won’t be able to meet their demand, but he should make a “fair pay offer” – above the current one, of around 4%.

Equally important, though, is a proper strategy “to solve the staff shortages that leave so many nurses overworked and hospitals overstretched”. Failing to reach a deal would be disastrous, “for nurses as well as patients”.