Nurses Strikes and Class War in the UK, Part 1

Mia talks with Nick, a resident nurse from the UK, about the events that led to the unprecedented nurses strikes sweeping through the UK.

 

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Episode Transcript

Speaker 1 (00:04):
Welcome to Dick it happened here, a podcast for the
Thing is Not Well, We're here has temporarily been relocated
to the UK once again. Oh what am awful place
to be? Lookay, Yeah, I'm your host Mia Wong, and
today with me to talk about things in the Kingdom
that is united for some reason is Nick, who is
a resident nurse there? Nick. How are you doing? I'm

(00:26):
doing all right? Um, a lot better for being a
holiday right now. Yeah, yeah, getting getting, getting to escape
the sort of dismal swamp of rainy, rainy Island. Yeah.
So on the other hand, there are things that are

(00:48):
in motion on Turf Island which are interesting and cool,
and that is on the Okay, So I have no
idea once again when this is going to come out,
Like this could be coming out like four weeks from now,
like there could be six more prime ministers, like who
knows what's going to happen. Um yeah, I six could
be rich. He's outlasted the Lettus unlike our last one.

(01:10):
But you know, sorry to anyone who's up to British
political memes, that's going to be arcane and inscrutable And
I'm not collecting we we we we we ran them
through a like two hour British Politics boot camp a
couple of weeks ago, so hopefully they still remember. Yeah.
But so the reason thing is so on on on
the day we are recording, there are a bunch of

(01:32):
strikes going on in the UK. There have been a
bunch of strikes going on in the UK for a while.
They keep doing this weird okay, this is my this
is my, my, my, my, my, I'm gonna I'm gonna
do my one bit of what what are you guys
doing strategically thing, which is okay. So they keep having
these strikes and then they'll like go off strike for
like three weeks as like a quote side of good

(01:54):
faith for their negotiations, and then nothing happens and they
go back on strike and it's like, well, okay, like
you could not do this. Yeah, so straight strikes have
been continuing, and yeah, I wanted to talk to you
about some of the nurses strikes that's been happening and
about the sort of organizing that's been going on, because
that's what's been really cool and not reported on enough.
I guess the place that I want to start with

(02:16):
this is with the last art of deck, Well, I mean,
I guess there's been a lot of usteria the UK,
but I want to kind of start with the last
sort of decade of austerity and the damage that's been
doing to the healthcare system and what what what that's
looked like on your end. So there's a couple of

(02:37):
ways it's manifests. One is like there's been a centralization
of healthcare services, are closing down of hospitals and making
larger hospitals and contain more and more specialties. So, for instance,
my hospital that I work in as a result, came
about the closing downs about I think three smaller hospitals.
She is, I mean eas hospital that was lost. We

(02:59):
lost about at least a hundred beds for each one
that was created that centralized into our one. There's been
massive cut back in like lack of funding and preventive
healthcare and community healthcare. One interesting example of how that
manifests is like they shifted the provision of community healthcare

(03:19):
and social care for new mothers to being run by
the local council that's like local either county or city
even larger cities level government, and then they would put
out the process where rather than just it goes automatically
to the NHS. It needs to be put out to
tender and give like charities or nonprofits or even private

(03:43):
healthcare providers an opportunity to bid on providing the service.
That's and that's a terrible winner on the system. Oh no,
it's absolutely insane. It's absolutely insane. And what and then
the end result of this is the NHS service gets
it because they're the only one that can actually credit
credibly provide the service. But they have to essentially massively

(04:05):
underestimate how much it will cost to run in order
to run to run the service, Oh, because they have
to they have to underbid the other services that are
not going to Yeah. Wow, that is a terribly designed system. Yeah.
And then there's also like introduction of like trying to

(04:27):
in order to cut back on the backlogs that like
the cutting down and services have created via like outsourcing
some healthcare, some surgeries and stuff to private healthcare, private hospitals.
But then they're able to just pick and choose the easiest,
least risky, and most profitable ones. And of course, any
any complications that result of the problems with surgery, issues

(04:52):
with treatment, adverse reactions, the surgeons fucking it up because
they were working overnight in order to get extra in
order to get some extra money after doing a shift
in the NHS hospital, which is often the case, then
falls back on the NHS proper and then in terms
of workforce the average on average, this isn't just nurses.

(05:15):
There's an universal pay scale using the NHS for everyone
called the Gender for Change. There's a pastory prime that
confusing name, but the reason for that is it was
a very much it was a less unified system before,
like the early two thousands, everyone knew it was messed up.
There was a big pushed by unions and also by

(05:36):
government who wants to rationalize the whole thing to make
it make more sense in theory, tie people's wage to
what they were actually doing more directly in a more
consistent way. Hence Agenda for Change because there was an
agenda for changing of what's happening, but it's been in
place for over twenty years. Not so the name doesn't
make sense, but basically everyone on Agenda for Change has
on average in the last ten years, had a twenty

(05:57):
percent pay cut in real terms. Then doctors and dentists,
because they're special boys love them, but you know, have
on a different pay scale, and junior doctors on average
have had an even worse paycut of about twenty eight percent.
Then there are strikes. There are on strike like right now. Yeah,
they're on strike right now. And unlike my union, they

(06:20):
haven't pissed about the government. They've gone straight to a
full three days no derogations, the term for agreeing to
not provide services for life or in order to protect
patient safety, which the RCN went in for in a
big way. In some ways they've got it a bit
easier and that they can just say, oh, the consultants
will do all of this, like that is to you

(06:42):
to translate into a mouth to make and healthcare that
would be attending. And so this strike of junior doctors
includes everyone from like their first two years post medical
school what we call foundation years. Possibly that'd be equivalent
to internship in America, and they and our registrars, so
people who rested in specialty training equivalent of a like

(07:04):
a resident. I believe the government tried to persuade them
to call off in order to go into talks, but
they hadn't made a big show in promise of like
we will in good faith, we will call off strikes
and go into negotiations if the government agrees to have
serious formal talks. So they were able to just say

(07:24):
to the government, no, you're putting too many preconditions on
these talks. We're not doing it until you make until
you stop messing us about, whereas unfortunately my union, the RCM,
is addicted to protecting the image of nursing and like
acting in good faith even when they're dealing with someone
who have no intention of dealing in good faith. Yeah, which, yeah,

(07:45):
that that that I don't know as a strategy. It's
really frustrating because you just didn't get like you can
just get locked in endless negotiations, which is nothing is happening,
And yeah, it's really frustrating to pricing the SOCLE compact. This.

(08:11):
The RCM in England, Wales and Scotland Northern ireland's a
slightly different story. I've never had a strike until last year.
Historically the RCN was an anti strike union. Wait white, yeah, yes,
that's the thing in the UK. Yeah, like I know,
I know, like the US has a lot of weird,
not very good unions, but like, I don't know, I'm

(08:31):
notch ever heard of me? Really, that's yes. Wow, So
that changed either in the nineties or the early two thousands.
I honestly can't remember when I tried to look it up.
But whenever you trying to search this stuff, just your
search results are like flooded by stuff around the latest round.
What you're gonna understand is the RCN. It's one hundred
and six years old. It only became a union though

(08:53):
about fifty years ago then. So the RCN is both
the union and a professional body in that okay. It
also does stuff around developing, developing nursing best practice, research
and that kind of thing, and that's what it existed
as originally. So yeah, like a like a professional association. Yeah, okay, exactly,

(09:18):
And so it still has a dual structure of its
union side, it's professional body side that like develops nursing
practice and stuff like that. Yeah. Well, I guess, I guess.
I guess that that raises the sort of question of like,
like what was so like unbelievably like what what what
what happened like such that for the first time in

(09:40):
like one hundred and whatever years, they finally went on strike.
So it's partially amount of breaking points. The nursing turnover
in the UK's absolute dog shit um. Thousands of people
leave the profession every year. There's this massive pay cut
that's happened over the last ten years. Nurse and nursing
was always underpaid in the UK. To be frank, there's

(10:03):
also then there was the cut in the nursing bursary
about five years ago. So it used to be the
government would pay for you to train as a nurse.
It would also give you not not like enough to
be equivalent of the ways of the work you were doing.
Nursing in the UK has a far higher amount of
practice hours than it does in the US. I believe

(10:26):
it's part of the degree and like a lot of
that time you're sensedly working as a as a hate
c A or CNA as you'd say in America. Can
you explain what that is for people who don't know
like medical stuff, so hate a healthcare assistant or what
was it CNA certified nursing assistant. I think what stands

(10:48):
for is essentially a healthcare worker who does a range
of like what you describe as nursing tasks button but
not the role of a registered nurse. So they would
assist with mobilizing patients, monitoring observations hygiene, potentially taking bloods,

(11:11):
and some investigations such as setting up an ECG, but
they wouldn't do more advanced investigations ristanizement, care planning, medication management,
assessing of patients and that kind of stuff. So yeah,
like about five years ago, the nursing bursary was cut,
so then it's became as with every other degree having
to take out a student loan in order to pursue it.

(11:34):
And then in twenty eighteen there was a particularly disastrous
pay deal where the RCM in a number of ways
just absolutely fun. Not just the RCM, the other healthcare
unions representing unions representing healthcare workers also messed up hutely,
but like they really fumbled the ball. It resulted arguably

(11:55):
some people describe it as the leadership setting out the membership.
And then after that there was a general, an emergency
general meeting called the RCM wh's resulted in the entire
executive being booted. Wow um around this type leading up
to that, they're being like increasing like grassroots militancy around nurses.

(12:20):
Recognizing that this was an awful situation, we were in there.
This also then resulted in like there were various grassroots
campaigns started, such as like a Nurses United UK. We
started employing organizing the UK to like act to take nurses.
There was a concerted effort to put presses on the
RCM by like I would say, a radical minority, but

(12:43):
one that represented like a general general feeling among nurses
on the on the front line to push for the
RCN to take a more radical stance. Then at the
same time, I don't know if this was covered in
your talk in about English politics you're to our deep dive,
But Northern Ireland didn't have a government at this point

(13:08):
because as they are now, the DUP and chin Fain
had fallen out and legally it has to be both
of them together as the largest republican and largest unionist
party Unionists in pro the United Kingdom Party after former government,
which meant it was impossible legally for any for any

(13:29):
pay rise in the NHS in Northern Ireland at that time,
so there was not a government that could legally enact
one great and this was and this resulted in the
twenty nineteen the first strikes by the RCM. Ever, and
also like the first nursing strikes in the NHS in

(13:50):
a very long time. I might be wrong about this.
I think the last ones were like in the eighties
or the seventies. I might I might be wrong about
this though. And this was both called by the r
and one of the other biggest trade unions in the
probably the biggest trade union as it's a generalist trade
union in the NHS Unison. They both called strikes at
this time and they were significant factor in getting the

(14:15):
Northern Ireland government back meeting alongside other things. I'm not
going to give ourselves all the credit, but it was
a significant factor. It off it gets overlooked and actually
having any pay eyes and acted the tool on the
in Northern Ireland just to clear for every second this
strike was a specifically like a strike that was happening
for nurses norther in Ireland. Yeah, in twenty nineteen. I
think it's very important. I think that triggered something that

(14:37):
she see changed in the RCNA. That was kind of
the culminating point of like trying to push for a
more militant attitude on the RCN. And it really like
broke the thug gates open and made what's happening now
possible even though a lot of nurses in England particularly,
I can't come on on the situation in Wales on
Northern Ireland, like how much people know about you by

(15:00):
what was going on, But like a lot of use
in England didn't even know about it. And when I
was going around the wards pushing for people to vote
in favor of the strike action, a lot of people
didn't weren't aware that that had been a thing that
had happened until I told them about it. Because people
in England, as Moss, as England is determined to keep

(15:20):
Northern Ireland, don't know what's going on, and not into
any degree to a terrifying degree. Sometimes I would say, yeah,
that that sounds like it sounds like a thing that
happens when you're a colonial power, et cetera, et cetera. Well,
like I mean like like there was I feel like, well,
our equivalent isn't the right term. But like around the

(15:41):
same time, like people in Puerto Rico like ran out
their government and almost no one in the US, like
like in the commental US has like ever heard of it.
So yeah, yeah, I would say if yeah, if there's
not bombs going off in Northern Ireland, people in England

(16:01):
not paying attention. I would say, yeah, that makes sense,
and it's also really depressing. Yeah, I would like I
would say Norman Islands in the sub maybe in some ways,
and the bets in Puerto Rico in that it actually
has a degree of political representation in the main in
the Westminster and starts, even though obviously should have its

(16:21):
independence and might, but yeah, doesn't even have that as
my understanding. Yeah, And I mean there's a whole there's
a there's a whole thing there, Like the Puerto Rican
statehood people are like weird reactionaries. The independence people are cooler.
But also there's this whole sort of I don't know,
there's there's a kind of like there's a kind of

(16:45):
paralysis anywhere. It's like that, And it's like DC is
kind of similar, where there's a whole sort of there's
this kind of paralysis where like nothing's ever going to
be done about it other than the US just like
basically imposing whatever random colonial governor that they've just I
did to bring in as an emergency manager or whatever. Yes, sorrkay,
but we are getting we are getting far afield from

(17:05):
it as before I put yet yeah, something about Nomanala
that will piss off everyone. Yeah, it's like I didn't
even know even less about Bulscott about Puerto Rico. Yeah yeah,
I would also say okay, like so so so people

(17:26):
don't get mad at me, Like all of the US
is a quality. It's like the substitute of difference between
New York and Hawaii and Puerto Rico was when like
when when we took it over. But yeah, yeah, okay,
so we're we're turning to we're turning actually well you know, okay,
all right, I will I will take this complete interruption

(17:47):
of the flows as a point to do an ad break.
So do you know what else is an extensive colonial
power that who's might cannot be checked. It's it's the
products and services that support this podcast. Yea, all right,

(18:13):
and we are back. Yeah. So I wanted to move
from the Northern Ireland strikes to talk about the sort
of broader strikes that I've been happening in the last
like my understanding about a year or so, yes, okay, yeah, yeah,
is it going longer than that? Yeah, we talk about
like you it's like what happens to move from the
Northern Ireland strikes to the current situation. So do you

(18:37):
mean with specifically NHS strikes or like in the UK,
specifically with the NHS strikes. But I guess we can
talk about the broader wave if you want to too.
So obviously all the ship with COVID happened, Yeah, and
then we came to the payoffer of last year, and

(18:58):
at this point they've been general building of an attitude
that we don't just need a decent pay rise that
keeps up inflation, we need one that goes towards restoring
lost pay. And the RCM leadership after the kicking out
of the entire executive in twenty eighteen kind of on

(19:20):
the back foot, kind of like wanting to a piece
the membership go along with it a bit more. Also,
we had knew General Secretary Pat Colin, who was the
secretary of the Northern Ireland section of the RCM during
this Northern Island strikes, took a more militant position in
the pain negotion in the joint union pain negotiations with

(19:42):
the government towards the end towards the beginning of last year,
where the RCN took a position of we need inflation
plus five percent. Now this is a bit of an
inside baseball which like I don't think I've ever seen
like officially, but what I know from various people involved

(20:04):
in these things and like statements by different unions, what
my understanding it is the biggest of the trade unions
in the NHS in general. The Unison put forward line
it was only willing to go for a generic significantly
better than inflation pay ballot of like pay demand from
the government, which the RCM was due to like changing

(20:27):
attitude of its membership of what happened when it accepted
ship a bad deal last time, was not willing to
go for and a result of the RCM splitting from
the Joint Union Like Pay Council like the Joint Union
Council over this issue, which then the offer the government's
pay thing came in. It said we will do a

(20:49):
flat one thousand, four hundred for everyone, like on all bands,
so not a percentage like it normally does. And you know,
to be honest, if it was a significantly higher amount
that was bigger than inflation for the lower bands, like
the lower paid works in the NHS, wouldn't be the
worst thing in the world. But this one thousand, four

(21:09):
hundred isn't good enough for anyone. And while I'm talking
about this, I'm talking about specifically in England. It was
slightly different in Wales and Scotland. I think generally slightly better,
but still far lower than it should have been, than
it needs to be. And so the RCM was the
first of the unions in the NHS to say it

(21:30):
was balloting, it was doing a paid ballot, and this
kind of sprung on the other unions, like a week,
two weeks, three weeks later all said that they were
doing it as well. The RCM also at the same
time hired a load of organized like paid organizers to
support the paid ballot effort. And what I'll say is

(21:54):
obviously paid organizers. There no substitute for rank and files militancy.
But it was very helpful, to be honest, because I
think there was a lot of like milited, a lot
of milited sentiment of the RCM. But although there were
some like rank and file initiatives which had had a
massive impact on like pushing the RCM to a stronger position,

(22:18):
I don't I don't think that could have materialized, and
there wasn't enough people like actually who had an idea
about organizing, about what it meant to go out and
push through this kind of thing to get what we
needed in that time frame. Sadly I wish that wasn't
the case, but I do think these paid organizers much
is not what I think the correct model for workplace
organizing is did help a lot, and this then resulted

(22:42):
in the RCM strike ballot passing in one hundred and
seventy six NHS trusts across the UK. Let me just yeah,
check that I've got that right, yeah, which is huge.
It's not all, but it is. It's over fifty percent.

(23:03):
It's pretty much all trusts in Scotland, all trust in Scotland,
all trusts in Northern Ireland, I think all bar one
or two in Wales, and the majority in England. It's
also worth pointing out the ones that didn't pass it.
They didn't pass by less than a percentage. Wow, they

(23:25):
felt they didn't pass by like pen votes in all cases.
I think the one in Wales that didn't pass it
was literally by three votes. And it's also worked with
I think in two thousand and sixteen or two fifteen,
anti union legislation was passed by the Conservative government, which
raised the bar you need in order to have to

(23:47):
have legal strike industrial action, and under the law as
it existed a decade ago, every NHS trust that the
RCM ballot didn't would have passed the ballot. Also unfortunate timing.
It was happening at the same time as the posts,

(24:07):
as postal strikes were happening, and in the UK industrial
ballots for industrial actions to be legal have to happen
by post A little bit sad. Yeah, it's like timing, guys. Yeah,
full power to you. Oh god, I wish the timing

(24:32):
it slightly different. Yeah. Yeah. And of all the of
all the trust, of all the unions in the art,
in the NHS that were passing ballots, the RCM was
the most successful. We passed it in significantly more places
than other unions did. Um to my shock, to be honest,
because like when I was going around balloting or like

(24:54):
um talking to people, like on my days off, like
going on the wards talking talk to people while I
was at work, Everyone's like, yes it was in other unions,
like yes, I'm voting for it. I'm waiting on tender
Hicks to have my ballot. When's my ballot arriving. Why
is my union not opened their ballot yet, and so
like when particularly like other unions didn't pass in my trust,

(25:16):
I was really shocked. I was really confused, And it
seems like a lot of them didn't actually want to
fight to a degree in that like they were opening
it because the RCN had opened it. I'm certain people
in those unions might discrib me, but that's really I
find it really hard to understand how these unions that
have historically they're all none of them are that that militant,

(25:39):
you know, but they all have a history of strikes
and other sectors or organizing for this, they'd never had
been anti strike unions unis in particular, it was there
came about like several unions being collamorated, like joining together,
including unions that had been founded by nurses in the
seventies in reaction to like the RCN being anti strike

(26:05):
and going on like that was the last big wave
of nursing strikes at that time. So that really shocked me.
This has been it can happen here Join us tomorrow
for a part two of the interview, and in the
meantime you can find us on Twitter and Instagram at
happen Here pod, and you can find us on Twitter
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(26:27):
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