Pay the Nurses

Emma Baines

Yesterday was the second day of the nurses’ strike in the UK. Up to 100,000 nurses at almost eighty hospital trusts, health boards and other NHS centres in England, Wales and Northern Ireland were on strike over inadequate pay and appalling working conditions. Many nurses on the picket lines have spoken to reporters about relying on food banks and not being able to pay their energy bills. Some newly qualified nurses are choosing to look for work elsewhere rather than take up the job they’ve trained for because it simply doesn’t pay enough.

Further strikes are planned for the new year if the government doesn’t come forward with an improved pay offer by the end of the day tomorrow, which is looking extremely unlikely. And nurses in Scotland announced today that they, too, will be going on strike in the new year, having rejected a pay offer from the Scottish government that doesn’t come near to meeting their demands.

The largest nurses’ union, the Royal College of Nursing (RCN), is asking for a pay increase of 5 per cent above RPI inflation for all UK nurses on the standard NHS contract. Given the current rate of inflation, this comes to 19 per cent. That may seem a lot, but it’s the amount needed to make up for twelve years of below-inflation pay growth. According to analysis commissioned by the RCN, an experienced nurse’s pay has dropped 20 per cent in real terms since 2010: in other words, they are working one day in five for nothing.

The average nurse’s pay is currently £33,000. A newly qualified nurse is on £27,055, while a clinical specialist nurse, who will usually have completed a masters degree, may earn up to £47,672. These rates are fixed by the NHS contract, and apply across the UK. The RCN and other unions decided to ballot nurses on strike action after all NHS staff in England and Wales were given a measly £1400 raise across the board (between 3 and 5 per cent, depending on experience). Scottish nurses got a marginally better 5 per cent overall uplift, while nurses in Northern Ireland got no increase at all, because there isn’t a functioning government at Stormont to make the decision. The Scottish government responded to the ballot with a slightly improved offer of 7.5 per cent, which nursing unions in Scotland have now rejected as still not enough.

But successive Tory governments in London have insisted the RCN’s demands are ‘unaffordable’ and refuse to discuss pay at all. In a statement released before the strikes, the health and social care secretary, Steve Barclay, said he was ‘hugely grateful’ for the hard work and dedication of nurses but ‘the RCN’s demands, which on current figures are a 19.2 per cent pay rise, costing £10 billion a year, are not affordable.’

So far, industrial action has taken place at only half the NHS hospitals and health centres in England where the RCN got a mandate to strike. But the union’s general secretary and chief executive, Pat Cullen, has warned of further strikes at more NHS hospitals next year if the government doesn’t come to the negotiating table. ‘With the end of today’s strike, a clock is running for the prime minister,’ she said yesterday.

There are two days for us to meet and begin to turn this around by Christmas. By Friday, we will be announcing the dates and hospitals for a strike next month. Westminster may be shutting for Christmas tonight but nursing staff are readying for their shifts over the next two weeks and looking at the new year with trepidation. We are not looking for a miracle, just the fair pay and recognition that is in the prime minister’s gift.

Despite the serious threat of disruption to the NHS at the season when hospitals are most likely to be overrun with flu and Covid patients, government ministers don’t seem to be taking the nurses seriously.

The cabinet office minister, Oliver Dowden, told the BBC’s Laura Kuenssberg on 18 December that the government ‘valued nurses’. He and the prime minister, he said, ‘would love to give nurses an enormous pay rise’ but it just wasn’t possible. Claiming that the government was being ‘reasonable’ and ‘sensible’, he urged the nurses to accept the additional £1400 they’d been given, promising that when the economy is stronger the government would be able to ‘give the kind of pay rises we’d dearly love to give them’.

You can hardly fault nurses for doubting they’ll get a proper pay rise as soon as the economy is sufficiently ‘strong’, considering their pay has been cut in real terms every year since the Tories came into government in 2010. It’s clearly a scandal that many nurses can’t afford their food or heating bills. But even if ministers don’t care about that, paying enough to make nursing a reasonable choice of profession is the only way for the government to ensure the NHS has enough nurses to keep functioning at all.

Nurses are not optional. You can’t run a health service without a huge number of them, and modern health systems require more nurses than ever before. This is in part because new roles for nurses are constantly being developed, and in part a matter of demographics: more nurses are needed every year to deal with an ageing population.

NHS nurses risked their lives to work through the first months of the pandemic, and were then asked to get through the backlog of appointments and operations that the pandemic created, all while a large percentage of them were out sick at any one time.

The pressure of working long hours, for inadequate pay, without enough staff to provide adequate care, has taken its toll on morale. The most recent NHS staff survey found that 52 per cent of nurses had felt unwell as a result of work-related stress and 40 per cent felt burnt out. It’s hardly surprising that nurses are choosing to leave the NHS in ever larger numbers. And as they leave, the situation gets worse for those who stay, increasing the pressure on them to leave too.

According to analysis by the King’s Fund, between June 2021 and June 2022 more than 34,000 nurses left their role in the NHS, an increase of 25 per cent on the previous year. As of September, there were a record 47,496 nurse vacancies in the NHS in England, which means that nearly 12 per cent of nursing posts were vacant.

Nurses want the health service to work, and they want to be able to care for patients properly, and that means paying nurses enough so that people can reasonably choose to pursue a career in nursing without extreme personal sacrifice. As Jacqueline Brandon, a paediatric community nurse on the picket line in Cardiff yesterday, told the Nursing Times: ‘I’m not doing it for me, I’m doing it for our future nurses.’


  • 25 December 2022 at 11:13am
    Paul Beardsell says:
    Most nurses did not strike. This pleases me. However I too share the headline notion "pay the nurses!". Yes, of course. But how much? Because by the reasoning advanced nothing would ever be enough. This is true! There is no monetary compensation adequate to compensate nurses for the humanity and care they show others daily. So that's settled then, it's not about the money, we all know that! But the strikes are about money. That is the principle demand. More money. OK. But how much? Would you agree with me that nurses should be paid much better than the average wage? Yes, of course! And they are, especially when you consider the retirement benefits. Would you also agree with me that nurses should be paid about the same as teachers and police officers. Yes! And they are! All of these are paid much better than the average median wage. For everybody paid above the median wage there must be someone paid under it. My questions are these: Who should be paid under the average median wage? If nurses are already better paid than average (and they are!) and this dispute is about money (it is the only real issue raised) then HOW MUCH WOULD EVER BE ENOUGH?

    • 25 December 2022 at 4:31pm
      Thomas Jones (blog editor) says: @ Paul Beardsell
      As the piece says, they're asking for a 19 per cent raise to bring their real-terms pay back in line with what it was in 2010. That would be enough.

    • 26 December 2022 at 5:22pm
      nlowhim says: @ Thomas Jones (blog editor)
      Good article. I wouldnt worry about the commentator who seems to think a small raise might as well Be infinite. Seems similar to an argument made by conservatives in the states against minimum wage. If you raise it a little you can raise it to 100$/hr etc.

    • 3 January 2023 at 7:29pm
      Rachael Padman says: @ Paul Beardsell
      @Paul Beardsall assumes that all jobs are equal, and asks who should be paid less than the median wage. Well, perhaps those who don't invest several years of their life at low or zero pay to join a profession, and who commit themselves to an effective tax uplift of 9% for the rest of their working lives, via student loan repayments. Perhaps those who don't spend their days dealing with the dead and dying, and those close to them. Perhaps those whom we did not recognise during the pandemic as being "essential workers"? And perhaps those for whom the withdrawal of their labour is not almost unthinkable - both to them and to us - because of the effects on other people. Maybe those who put their lives on the line so that the rest of us don't have to. This definitely includes the police, and largely (with reference to the pandemic) the teaching profession.

    • 3 January 2023 at 7:31pm
      Rachael Padman says: @ Rachael Padman
      Bother: got the last line wrong. I meant to include the police and teachers with the nurses; not to exclude them.