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To my mind, nurses are not striking over pay but over workforce shortages


Marilyn Eveleigh


The vote to strike was an historic moment for all nurses, but low pay, poor working conditions and high vacancy rates leave them with little choice, argues Marilyn Eveleigh 

When the Royal College of Nursing (RCN) announced dates for strike action following failed dialogue with Government, it became clear that interesting times were ahead. Nurses are certainly not united in supporting a strike, but many of us concede it is a last resort.

Not all nurses can strike, as strict laws govern the process. Only those on Agenda for Change contracts  who work in the 130 NHS trusts and health boards (of 217) that secured a 50% ballot response from their RCN members have a mandate to strike. That’s not many nurses, but their vote is a voice and a historic gesture for all of us. Of the 705,000 on the NMC Register, the majority (55%) of nurses aren’t employed by the NHS, including practice nurses. Yet any NHS pay award achieved through strikes will set a new bar for pay scales, and will benefit all nurses wherever they work.   

To my mind, nurses are not striking over pay, but over the workforce shortages that are an inevitable consequence of low pay. Remuneration was once a secondary factor, but 12 years of below-inflation pay awards have magnified its importance, especially for younger nurses with families. The decline in nursing numbers has impacted negatively on healthcare services, alongside the increase in patient numbers and demand. Over 20 years, governments have responded by dabbling in training, bursaries, overseas recruitment and long-term strategies, to no avail.  

There are almost 48,000 NHS nursing vacancies: we are in short supply. Recruitment and retention is dire despite government rhetoric. In the past year, 40,000 nurses have left the NHS – one in nine of the workforce – leaving more posts unfilled. Many were highly experienced nurses with years left to give, and many left community services, with 43% citing retirement. At the same time, there were only 4,000 more nurse joiners than leavers in the past year; insufficient to make an impact.  

Scandalously, the 42% of nurses paid on AfC Band 5 could be paid a higher hourly rate if they were supermarket workers or cleaners. Improving remuneration is a means to an end: it leads to a committed and buoyant workforce. Higher salaries will retain the experienced and aid recruitment. The additional nurses will alleviate burnout, stress and poor job satisfaction. The ability to provide good patient care with a good work-life balance would also support retention, helping address the huge NHS waiting list. And research shows that healthy nurse-patient ratios improve safety and quality of care.

Nurses are highly skilled professionals, with years of training to degree level and further requirements for CPD and professional regulation to protect the public. That’s some status. According to a recent national annual survey, we are also considered the most trusted of all the professions.  The public has indicated it would support a pay increase. Ministers say there is no extra money, yet eye-watering fees are consistently paid for agency nurses, where shortages do determine remuneration.  

Strike action is not what nurses want: it’s almost sacrilege. We want to care for patients; we just need more of us. Improving recruitment and retention through better pay is what this strike is about. Because nursing is the cornerstone of the NHS.

Marilyn Eveleigh is a nurse adviser and independent trainer in East Sussex