Nurses in England have today rejected the government’s pay deal and have announced a fresh round of strike action. The next strikes will take place over 48 hours from 8.p.m on 30 April to 8.p.m. on 2 May, with no emergency cover. The Royal College of Nursing ballot showed that 61 per cent of eligible voters turned out. The vote was close: 54 per cent voted to reject the government’s offer – of a pay rise between 4.5 and 5 per cent – while 46 per cent voted to accept the deal.
The staffing crisis only exacerbates the pressures felt by junior doctors. Many tell me how consultants and hospital managers alike have resorted to intimidation in attempts to force juniors to cover rota gaps.
The timing is a killer blow for the government: it was expected that if the nurses were to accept this pay offer, it would set the tone for successful negotiations with other striking sectors. But this is not to be, and now there is speculation that future strikes could see doctors and nurses walk out together. Currently the government is refusing to compromise on pay disputes with junior doctors in England until they call off the strikes and decrease their starting request of a 35 per cent pay rise. Striking doctors have just over 12 hours left of their four-day strike, which is the longest the profession has undertaken in the history of the NHS. The BMA is asking for pay restoration to account for real terms pay cuts and inflation as the exodus of junior doctors from the UK is on the rise. Talks in March broke down when BMA representatives and health secretary Steve Barclay were unable to find common ground. Junior doctors say they will negotiate — but the government remains stubborn.
Today, the BMA Junior Doctor Committee wrote to Barclay saying that they would be open to have negotiations facilitated by Acas, a third-party organisation which aims to improve industrial relations. ‘We are available to meet immediately,’ the letter read. ‘We do not have any preconditions to negotiations with you. Given the barriers you have put in place to negotiations so far, we have confirmed to Acas our willingness to engage in a process facilitated by them.’
On Tuesday, a statement from Downing Street insisted that no talks would be held with the doctors’ union, the BMA, unless junior doctors ‘abandoned their starting position of a 35 per cent rise and called off the strikes’. It seems, however, that Mr Barclay doesn’t quite understand the meaning of negotiation. While almost all junior doctors are aware that they will not receive a 35 per cent pay rise, the union has said that they were after a ‘credible offer’ and that the figure is their preferred starting point from which compromises can then take place.
A recent Ipsos poll shows that both nurses and junior doctors have the public on their side: the poll found that 60 per cent of the public are in favour of nurses taking industrial action, while 54 per cent are in favour of junior doctor strike action. As I wrote recently, though it is difficult to predict if this support will last, having the public on side is a significant win for both the nursing and doctors’ unions.
The combination of long hours, physically demanding work and having to – literally – make life-or-death decisions against the backdrop of a bullying work culture has resulted in a growing frustration amongst junior doctors about how they are valued in the workplace. In England, junior doctors are paid a base salary, and may receive additional pay on top of this depending on how many night or weekend hours (antisocial hours) they work. For those starting out, the base pay can start at around £29,000 which, as the BMA has calculated, works out at approximately £14 per hour. Though campaign messaging that compares the pay of junior doctors to that of private sector workers in unskilled jobs has been controversial, their frustration is clear: medicine is a difficult, exhausting vocation and if doctors don’t feel valued for their work, both mentally and physically, then they will go wherever will treat them better.
And, unfortunately, that is what’s happening. The exodus of doctors from the NHS to countries like Australia has resulted in the worst workforce crisis the health service has seen. As I have written before, the UK provided Australia with 13 per cent of its GPs and 22 per cent of its specialists in 2011. There was a 17 per cent increase in the number of British doctors working in Australia and New Zealand between 2014 and 2016. The NHS is currently facing over 130,000 vacancies across the health service.
The staffing crisis only exacerbates the pressures felt by junior doctors. Many, from a number of different hospitals across the country, have told me how consultants and hospital managers alike have resorted to intimidation tactics in attempts to force their juniors to cover rota gaps. A significant proportion have no say in when they can take time off work, with some relaying horror stories about difficulties planning their own weddings – or missing funerals.
While the chairs of the BMA’s Junior Doctors Committee have been described as assuming a ‘political militant stance’, their strategy appears straightforward. The workforce crisis is crippling the NHS. To pull in more doctors, the working conditions need to become more attractive. To make working conditions more attractive, doctors need to feel better valued – and to be better paid. Paying doctors better will keep current medics in the UK, while hopefully encouraging more people to study medicine. Focusing solely on pay means that the government can’t dangle unquantifiable distractions in front of striking workers that may never come to fruition.
There continues to be furious debate about whether public sector pay rises drive inflation. Rishi Sunak is no stranger to this argument and Andrew Bailey, governor of the Bank of England, urged workers to stop asking for more money last year on this very point. Economists are split, and some have pointed out that there is ‘no evidence’ that public sector wage increases cause inflation to rise.
The vast majority of people agree that doctors deserve to be paid, and treated, better. Equally, a rise of 35 per cent is widely agreed, even by a number of striking doctors themselves, to be wholly unrealistic. But while the leadership of current BMA reps Rob Laurenson and Vivek Trivedi has been criticised, starting from a high bargaining position does make logical sense. While some have said that a rise of 20 per cent is closer to what they’d be happy with, some have gone even lower. ‘I’d hope for 15 per cent,’ one told me.
This may be a more palatable solution for the government, but it won’t be reached if Barclay refuses to engage. As Fraser Nelson said on Coffee House Shots, 'There are so many more intelligent ways of [the government] dealing with this than simply stonewalling and saying "no".' NHS bosses have today said that the strikes are making it 'almost impossible' to slash hospital wait lists. For the sake of the country, it is imperative that there is movement on the current position – from both sides.
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