Exclusive: RCN leader makes the case for nurse strikes – Nursing Times


‘This is a situation that cannot go on indefinitely’
STEVE FORD, EDITOR
02 September, 2022 By
Source:&nbsp RCN and Justine Desmond
Nurses have been pushed to a point where they have “no choice” but to leave the profession or work every hour available to make ends meet because of poor pay, the chief executive and general secretary of the Royal College of Nursing has said in a frank warning.
Overseas nurses are considering returning to their countries of origin because they can no longer afford to live in the UK, while colleagues are living in rooms in other people’s houses, having to travel hours to work, and relying on uniform donations and food banks for their children.
“Nurses have been pushed to the brink and beyond, and the only way it appears we are going to get the government to listen is to take action”
Pat Cullen
Making the situation worse still are their concerns about crippling nurse vacancies and the subsequent impact on patient care.
This is what nurses have told Pat Cullen over recent weeks, as she tours NHS workplaces to speak with staff, patients and the public about the fight for “a decent wage”.
In her first interview with Nursing Times since taking the reins at the RCN last year, Ms Cullen said nurse morale was the “lowest” she had seen for more than four decades and that there was appetite for action like never before.
Members of health unions nationwide are preparing to cast their votes in upcoming ballots on industrial action, including strikes, following the latest pay awards from the four UK governments. The 2022-23 pay awards for NHS staff on Agenda for Change have fallen below the inflation-busting pay increases for which unions, including the RCN, have been campaigning.
In England and Wales, a pay increase of at least £1,400 was awarded, in line with the NHS Pay Review Body’s recommendations. In Northern Ireland, the lack of a fully functioning government means that, at the time of writing, nurses were still waiting for an official pay outcome. Northern Ireland’s health minister had announced his intention to accept the recommended £1,400 uplift but was unable to implement it immediately because of budget issues. In Scotland, which has broken away from the pay review body process, a 5% increase was put forward for nurses.
The RCN has been campaigning for a fully funded pay rise for nursing staff of 5% above inflation. It branded the below-inflation awards an insult to the profession and subsequently launched a set of official ballots in all four nations.
Opening on 15 September and closing on 13 October, they require a 50% turnout and must meet additional thresholds in England and Scotland. Votes for industrial action will mark the first ever strike by RCN members in England, Wales and Scotland. The college went on strike for the first time in its history in Northern Ireland in 2019 – led by Ms Cullen, who was then the country’s RCN director.
Other health unions, including Unison and the Royal College of Midwives, took strike action over pay in England in 2014, when the government sought to ignore the accepted pay review body process. However, the RCN’s leaders opted not to take part and did not formally consult college members.
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Ms Cullen highlighted that issues of inadequate pay, poor working conditions and worsening staffing levels have been raised year after year, but “the pleas of our nursing staff have fallen on deaf ears”. “Nurses have been pushed to the brink and beyond, and the only way that it appears that we are going to get the government to stand up and listen to the profession, on behalf of patients, is to take the action we are taking,” she told Nursing Times.
The RCN’s position on pay was “very clear”, she said. “Pay nurses a decent wage. Pay them a wage where they can comfortably pay their bills at the end of the month, pay nurses a decent wage so that we can retain them in our profession… and so we can continue to keep the health service going for those people in need.”
She added: “The pay offer is going to do nothing for the health service, it is going to do nothing for the profession, and it is certainly doing much less for patients and patient care.”
In recent weeks, Ms Cullen has been touring workplaces to see nurses and to try and convince members to vote in favour of striking in the upcoming ballots. In gauging the mood from her recent visits, she said she was confident it would be voted for. “I have never been so sure as I am now,” she said.
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Concerns about the cost of living coupled with the volume of staff leaving in the wake of the Covid-19 pandemic had seen a significant shift in feeling among nurses who were now ready to fight for change, noted the RCN leader. With an estimated 60,000 nurse vacancies in the UK, colleagues are saying “they can no longer continue to work” this way, she warned.
After speaking to nurses in England in August, Ms Cullen said they felt they had “no choice” but to leave the profession or work “every single solitary hour that is available in the day to make ends meet”. Nurses from overseas had also said they were now thinking “very seriously” about returning to their country of origin because they “can no longer afford to live here”.
She cited examples of nurses being denied rental properties as they did not earn enough, meaning some with young families were “being put up in a room in other people’s houses”. Some were having to live hours outside of the large London hospital areas, meaning their days were starting at 5am and finishing at around 11pm.
“Then they tell me that, when they have finished their shift, they have to ‘embarrassingly’ go along to the food bank and try and bring some food home to their children,” said Ms Cullen. One nurse had become tearful when they told her they had relied on a local church to knit school jumpers for their children because they could not afford to buy them.
The RCN leader said it was “shameful” that nurses were being made to live this way and urged ministers to “spend a day walking in the shoes of those nurses” to help them realise the importance of, and need for, a decent wage.
“This is a profession where morale is the lowest I have ever seen it in 42 years,” said Ms Cullen, whose background is in mental health nursing. “Morale is lower now than it even was at the time that we took strike action in Northern Ireland, and I didn’t think it could get much lower.”
Nurses in Northern Ireland successfully went on strike in 2019 to gain pay parity with the rest of the UK and a promise of safe staffing. In leading the campaign, Ms Cullen said she learned just how much the public trusted nurses and that “nurses will go to any length to do the right thing for patients”.
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While finer details would need to be arranged if action was voted for, Ms Cullen said the college would be “wishing to move very quickly” after the ballot closes. The RCN’s fund for supporting members taking industrial action has already been increased from £35m to £50m.
If strikes were not voted for, however, Ms Cullen accepted it would be “the voice of the nurse”. But she added: “It would be very clear to me that nurses are still concerned about the impact [strike action] will have on their patients, even though we will make sure it is safely, effectively and professionally delivered.”
The RCN’s industrial action handbook sets out the different types that can be taken, such as action short of strike, also known as working to rule. This means working strictly to the terms of a contract of employment, including by starting and finishing shifts on time and taking all contractual breaks. Meanwhile, strike action involves a complete withdrawal of labour from the workplace.
The key changes nurses needed to see included “a decent pay rise” and “decent career progression”, as well as increased recruitment and retention efforts, said Ms Cullen. As RCN leader, she said she wanted to see the profession “valued and respected by those in power” and that this should be the “top priority” for the next prime minster.
Governments across the four nations were contacted for comment. A spokesperson at the Department of Health and Social Care in England said the dedication and contribution of nurses was “hugely” valued and it was “working to boost recruitment, training and retention”. They reiterated that the department had accepted the pay review body’s recommendations in full.
A Welsh Government spokesperson said it wanted to ensure nurses “feel supported and valued”. “During an intense and unprecedented cost-of-living crisis, we understand the concerns of our workforce about how their standards of living may be eroded,” they added. The spokesperson said that “without additional funding” from the UK government, there were “limits to how far we can go to address these concerns in Wales” and that they had called for the additional funding necessary for “fair pay rises for public-sector workers”.
Meanwhile, Scotland’s health secretary Humza Yousaf said: “We have already made contact with trade unions to confirm that we will re-engage with them and hope to reach a satisfactory outcome.” He added that the Scottish Government was “immensely grateful for the incredible efforts” of all NHS and social care staff.
In Northern Ireland, health minister Robin Swann called for a UK-wide approach to dealing with nurses’ pay demands and said he was mindful of the impact of cost-of-living pressures on health and care staff. “I have made it very clear that the current financial package I have doesn’t even meet the independent body’s recommendations, never mind the additional asks we are seeing from our health service. But I have always been very clear in my support for our health workers in regards to what I have been able to do within the budgetary availability I have.”
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