The government’s case against strikes by nurses is truly weak

Nurses shouldn’t need to push their action too hard – particurly as public goodwill may not be infinite, says Sean O’Grady

The RCN has called for a wage increase based on the RPI inflation rate plus 5 per cent (PA Wire)

A national strike by nurses is due to happen on 15 and 20 December (albeit not in Scotland, where strike action has been paused as talks continue). It’s about pay but the Royal College of Nurses (RCN) insists it’s also about patient safety, as “staffing levels are so low that patient care is being compromised. Only by paying nursing staff fairly will we recruit and retain people in our profession.”

The nature of the action is not yet clear. It might be relatively few areas, or for only a few hours, and levels of cover may vary. Or it could be more national, last a full 24 hours, and cover everything bar emergency care. The RCN is calling for a wage increase based on the RPI inflation rate (which was 14.2 per cent in October) plus 5 per cent. The government in Scotland is talking about 7.5 per cent, and in England, the UK government wants to implement the recommendations of the independent pay review body: a pay rise of at least £1,400 with the lowest earners receiving up to 9.3 per cent

The Department of Health states that “the average basic pay for nurses will increase from around £35,600 as of March 2022 to around £37,000 and the basic pay for newly qualified nurses will increase by 5.5 per cent from £25,655 last year to £27,055.”

The nurses join many thousands of other workers in taking industrial action, in what is shaping up to be – media catchphrase alert! – a winter of discontent.

It’s set to be the biggest industrial action in the history of the NHS but not the only one. Various groups of workers in the NHS have taken industrial action before, notably in the original Winter of Discontent in 1978-79, with disruptive consequences. The net result of those waves of strikes across many sectors was a loss of faith in the old ways of industrial relations and union power, and 18 years of Conservative governments passing progressively more draconian laws on industrial action and trade union governance. But at a time of high inflation and labour shortages, such laws are not going to stop workers from defending their positions.

So who will win?

Much does depend on public opinion. The case against the nurses is most succinctly made in a tweet from Kelvin McKenzie, a former editor of The Sun and a fan of plain language: “By using the sick and dying as a battering ram to win a rise, nurses will hit an unforgivable low by striking on Dec 15 and 20. Their average pay is £40K. Supposing it’s your mum or dad left suffering.”

The RCN should be very clear that journalists on the rightist papers will feature distressed patients in pain and relatives in despair, in order to report on the realities of strike action/exploit the suffering of others for a political agenda (take your pick). Local and national RCN officials will be accused of “playing God” insofar as they try to implement inevitably broad guidelines for the strikes. Urgent cancer services, urgent tests and scans and ongoing care for vulnerable patients will be protected alongside A&E and intensive care – but it will be up to local health bosses and union leaders to negotiate exact staffing levels on strike days.

The nightmare for the RCN is a death attributed as a direct consequence of industrial action (or plausible accusations to that effect), and public sympathy rapidly evaporates. All memories of those who risked and sometimes lost their lives on the front line during the Covid-19 pandemic will be wiped. The strike will then fail.

So the best course of action for the RCN in its first mass action is to proceed very cautiously and use the strike mandate (which lasts until next May) as more of a deterrent, even a token, rather than unleashing an unpredictable chain of events across hospitals and clinics.

The RCN’s timing is also unfortunate. It understands better than most just how busy the NHS gets around winter, and how long waiting lists are. That is of course precisely why it’s going on strike; but the risks of things going wrong, causing harm and forfeiting public backing are much worse at this time of year.

So the nurses enter this struggle with much goodwill, but it’s not universal; they still need to win the argument against those who will seek to distort what they want and what they are doing. After all, even in the most unpressured routine situation, some medical detriment may be caused for a postponed test or minor treatment. Nurses should look to make their industrial action as painless as a vaccine injection for the flu, and concentrate on the facts and figures that will win their case.

In the end, the government’s logic would have them working for virtually nothing, as if volunteering for a charity; and ban them from ever taking industrial action about anything. It’s absurd, and the weakness of the government case is the nurses’ greatest strength. They shouldn’t need to push their action too hard.