A nurses’ strike before Christmas is on the cards, with the Royal College of Nursing about to announce a positive result in its strike ballot – the first ever strike by RCN members. NHS worker Rachel Iboraii writes that the service is on the brink of collapse. We need coordinated action by health staff, unions, patients, communities and campaign groups to defend the health service.
In its annual assessment of health and social care in England, the Care Quality Commission has described the NHS as “gridlocked” and “unable to operate”. A record of over 7 million people are waiting for NHS treatment, and this figure is rising every month. 2.75 million have been waiting for over 18 weeks and nearly 400,000 people for over a year. Cancer targets continue to be missed. The numbers attending Accident and Emergency departments have stayed stable, however waiting times have soared and the number of patients waiting over 12 hours is now 88 times higher than it was 3 years ago.
Growing waiting lists pre-date the pandemic and are the direct result of insufficient funding from the Tories. At best, longer waits mean inconvenience, anxiety and discomfort for patients – however for some it means deteriorating health, waiting in pain and premature death. Those who live in the most deprived areas are waiting longer. Within this context, it is no surprise that dissatisfaction with the NHS is at 25 year low. Public satisfaction has fallen across all NHS services – including inpatients and outpatients, accident and emergency services, as well as general practice and dentistry. In addition, the costs of tackling the backlog of maintenance problems has risen to £9.2 billion – and a substantial amount of the maintenance needed is described as urgent to avoid harm to patients or staff.
The government argues that the crisis in the NHS is due to the Covid pandemic, but this is a lie. The pandemic accelerated the trajectory that the NHS was already on. The crisis in the NHS has been caused by years of chronic underfunding for both health and social care. As inflation rises the NHS will be facing massive real-term cuts. The newly formed Integrated Care Boards (ICBs) will be looking for £5.5 billion in targeted savings. In September the government announced £500 million emergency funding to prepare for winter, but no NHS trusts have yet received any of this money.
In addition to chronic underfunding there is a massive staffing crisis – there simply aren’t enough nurses, midwives, occupational therapists, support workers and so forth to provide the treatment and care that people need. The latest statistics show that there are 132,139 vacancies across the NHS including 46,828 nurses. In addition to this, the NHS staff survey found that 19% were actively planning to leave their jobs and a further 38% were thinking about leaving.
Pay is obviously a key issue as staff are forced to choose between rent and childcare and struggle to buy the basics as inflation soars. Workers across the NHS are being balloted by their unions to take strike action after the government imposed another below-inflation pay rise. It is vital that these ballots are successful, not just to ensure that NHS workers are paid a decent wage but we have to be clear that poor pay leads to worse care. As staff leave to find better-paid jobs there simply aren’t enough people to treat and care for patients – or else staff take on extra shifts, leading to tiredness and stress which may cause patients harm.
However, it will take more than decent pay to ensure the NHS can provide the care and treatment that people need. The NHS needs to recruit layers of workers to deal with the waiting lists and the crisis in social care. As a start, we need to demand that those who are training to become medical professionals are paid a living wage whilst they are training.
Working conditions need to improve as medical professionals face stress, workplace trauma, bullying, long hours, workplace violence and abuse, in fact, female nurses are twice as likely to die by suicide than the general population.
When Jeremy Hunt talks about making difficult decisions he is ushering in another round of austerity which will mean cuts to NHS services, pay cuts for health workers and more privatisation. The strikes are key to defending the NHS, but to ensure that we have a decent health service we will have to go further. Patients, workers, trade unions, communities and campaign groups will have to coordinate a movement opposing all cuts and privatisation as well as acting in solidarity with NHS workers. This coalition needs to be prepared to employ a variety of tactics including demonstrations, direct action and industrial action.