Nurses’ strike: what’s at stake and how will it affect patients?

Health unions have rejected government’s pay offer while RCN seeks above-inflation pay rise

What pay offer has the government made to NHS staff?

Ministers have offered about 1 million NHS staff in England – everyone bar doctors and dentists – a pay rise of at least £1,400 for 2022-23. That represents a rise of between 4% and 5% for staff covered by the longstanding Agenda for Change negotiating framework.

Ministers say that’s as much as they can afford, that the £1,400 is honouring in full the recommendations of the NHS Pay Review Body and that it comes a year after NHS staff got a 3% uplift in 2021-22 when the rest of the public sector workforce had their pay frozen.

Health unions have rejected the £1,400. They want a rise that would at least match inflation – which is currently 10.1% – while the Royal College of Nursing (RCN) is seeking inflation plus 5%. Without inflation-proof rises, staff will suffer a real-terms cut in their take-home pay, unions say.

“Our members will no longer tolerate a financial knife-edge at home and a raw deal at work”, said the RCN general secretary, Pat Cullen. Sara Gorton, head of health at Unison, added: “Inflation has already wiped out this year’s 72p-an-hour increase. The government must put pay right to spare the NHS, its staff and all those relying on its care from a dispute no one wants to see.”

What have nurses said?

The RCN has balloted its members across the UK. The results, published on Wednesday, show that a majority of nurses in most but not all hospitals and other NHS services across the four home nations have rejected the government’s offer and decided to strike in pursuit of better pay.

The union did not release aggregated figures showing how many members voted and how many of those who did take part endorsed or rejected strike action. However, a large majority of NHS services across the UK will see strikes by nurses in the next few weeks. That is because in most but not all places the RCN did clear the two main legal hurdles to striking – that at least 50% of union members in a particular workplace have to vote and that at least 50% of those voting must back withdrawal of labour.

The RCN has urged Jeremy Hunt, the chancellor, to use his budget next Thursday to unveil the “serious investment” needed to fund a much better pay deal and thus avert strikes. That looks unlikely to happen, partly because the sums of money involved would be huge.

What did the government say about the RCN’s decision?

Steve Barclay, the health secretary, has praised NHS staff’s dedication and hard work. But, he added: “we deeply regret that some union members have voted for industrial action”.

Privately sources at the Department of Health and Social Care claim that the RCN is seeking a 17.6% rise, which if applied to all NHS staff covered by Agenda for Change – paramedics, physiotherapists, cleaners and porters, for example – would cost £9bn. That £9bn would be 6% of NHS England’s £152.6bn budget this year, sources point out.

How will the NHS keep services running on strike days?

The priority will be to maintain urgent and emergency services, such as A&E and emergency surgery. Strikes by nurses will inevitably limit what care the NHS can provide. Non-urgent operations will be postponed, as will outpatient visits and sessions of chemotherapy and kidney dialysis. Hospitals will offer a weekend or bank holiday level of care.

What are Labour saying about nurses striking?

Wes Streeting, the shadow health secretary, has condemned as “unacceptable” the fact that strikes will disrupt services and affect patients’ care. While he has not criticised nurses or any health union, he has blamed ministers for not negotiating with the RCN to try to avert strike action.

“I’m concerned, I think lots of people are concerned about the impact of disruption”, he told LBC’s Tonight with Andrew Marr on Monday. “That’s still a disruption to patients, which I think is unacceptable.”

If he were the health secretary he would see patients as his “first and foremost” responsibility, he said. “That’s why I think the government have to get a grip on this and get the unions around the table because there is a deal there to be done.”


Denis Campbell

The GuardianTramp

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