Health care workers are walking out in record numbers this week, crippling the National Health Service and piling pressure on Prime Minister Rishi Sunak to resolve multiple disputes over pay for public-sector workers.
Some 100,000 nurses are striking alongside about 10,000 ambulance workers on Monday, with 4,200 physiotherapists walking out on Thursday. Nurses will take action again on Tuesday, and ambulance workers will do so on Friday.
At least 55,000 appointments are likely to be delayed as a result of this week’s strikes, according to Bloomberg calculations based on NHS England data on previous industrial action.
Maria Caulfield, the health minister who’s also a nurse, blamed unions for refusing to abide by a pay review process that the government insists is independent. Labor groups say it’s not truly independent and argue that governments have previously ignored pay recommendations.
“We’re stuck in a kind of circle here,” Caulfield told Times Radio on Monday morning, because unions won’t discuss next year’s salaries and ministers are refusing to renegotiate pay for the 2022-23 fiscal period.
Pat Cullen, general secretary of the Royal College of Nursing, said again Monday that Sunak could stop the strikes by agreeing to consider higher pay for the current year.
The combined walkouts “could see the worst disruption yet,” said Saffron Cordery, deputy chief executive of NHS Providers, which represents hospital trusts across the UK. “We can’t go on like this.”
The upheaval threatens to plunge the state-run NHS into further chaos at a time when the latest British Medical Association estimate shows a record 7.2 million patients are waiting for treatment, exacerbated by the Covid-19 pandemic. Meanwhile, ambulance response times have hit their longest on record this winter and weekly deaths in England and Wales have been above the long-term average since September.
“I’ve been a nurse now for eight years,” said Jack Potter, 30, speaking from a picket line in London. “I actually have recently been thinking about leaving the profession. There are more attractive opportunities outside of the NHS.”
The industrial action also represents a dilemma for Sunak, who’s made getting NHS waiting lists down and halving inflation two of his government’s five key priorities. He and Chancellor of the Exchequer Jeremy Hunt have repeatedly pushed back against revising pay decisions for the current tax year, saying the government has accepted remuneration levels recommended by independent panels, and that increasing pay risks stoking inflation.
University staff are also striking again this week, while firefighters and rail workers are in crunch talks. Around 70,000 employees will be walking out demanding better pay and working conditions for two days later this week, according to the University and College Union.
The industrial action mirrors protests elsewhere in Europe. In Germany, postal workers are walking out at the start of this week, while French President Emmanuel Macron is trying to defuse mass strikes over plans for increase the retirement age.
‘Not Always Popular’
“I would love to give nurses a massive pay rise. Who wouldn’t? It certainly would make my life easier,” Sunak told TalkTV last week. “It’s not always easy in this job because I’m focused on doing what I believe is right for the country, and in the long term and often that means doing things that may be not always popular and this is a good example of that.”
Unions representing NHS workers say the government has imposed years of real-term pay cuts, with many leaving the sector for higher-paying jobs, resulting in staff shortages that put patient care at risk.
The RCN has backed away from its opening demand for a pay rise of about 19% and indicated a willingness to compromise, but the government has stuck firm behind the current deal of about 4%. The union argues an uptick is needed not only to help existing staff cope with a record squeeze on living standards, but also to attract new workers and retain existing ones amid mass unfilled vacancies.
Cullen said Monday that there were 47,000 unfilled posts for nurses.
EXPLAINER: Why Strike-Averse Britain Is Gripped by Labor Unrest
Ministers have pointed to extra money earmarked for health services and signaled a willingness to be more generous in the next tax year, which begins in April, but talks with unions have stalled. The RCN appealed directly to Sunak this weekend, offering to call off the strikes if his government would enter into “genuine negotiations.”
For now, the strikes are set to continue, and that’s affecting patient care: almost 90,000 appointments including elective procedures were rescheduled due to the strikes that have already taken place, according to NHS data.
Bloomberg’s estimate of 55,000 potential delays this week is conservative, with February’s strikes set to be more widespread. Nearly 25,000 appointments needed to be rescheduled on each of the days that nurses walked out in January, when 55 trusts were affected. This week’s action targets 73 trusts.
Chris Hopson, chief strategy officer at NHS England, has called Monday’s planned walkout the biggest in NHS history.
The timing on a Monday of the action “effectively makes it difficult to deploy the discharge of patients,” Hopson told the House of Commons Health and Social Care Committee last month. “We are now entering a new and more difficult phase in the dispute.”
There’s also risk of contagion into other parts of the health service. Junior doctors are balloting for strikes, with the vote due to close Feb. 20. The BMA says they’ll strike for 72 hours in March if the vote is successful. The union is also taking early soundings over potential action by senior medics.
The timing couldn’t be worse for the UK health system amid a winter surge in Covid cases as well as other illnesses whose spread was suppressed during successive pandemic lockdowns. Mary Ramsay, head of immunization at the UK Health Security Agency, sees more hospitalizations in future weeks.
“The real risk was always that rather than being a one-off, the strikes would drag on, cause regular disruptions, and derail efforts to increase overall treatment volumes and tackle waiting lists,” said Ben Zaranko, senior research economist at the Institute for Fiscal Studies. “There’s also a wider risk that an ongoing ill-tempered industrial dispute hits staff morale.”
--With assistance from Kitty Donaldson.
©2023 Bloomberg L.P.
