Rishi Sunak has been warned he faces the prospect of more strike action in the new year unless the government “corrects” a decision to give nurses one of the lowest pay rises in the public sector.
Nurse leaders said it was an “absolute shame” that their members had not been prioritized over the past year, adding that they would consider putting members to another vote on strike action if necessary once they had led the NHS through the winter . The warning follows a pay deal for NHS consultants that came on top of the rise, which was already larger than that for nurses.
Professor Nicola Ranger, the chief nurse at the Royal College of Nursing (RCN), said Observer it was “naive of the government to think this dispute is over,” after a year in which nurses staged a series of strikes in protest over pay and conditions. She said nurses had rejected the 5% pay offer and lump sum that was eventually forced on them. Further strikes were only avoided after the union narrowly missed the legal threshold for strike action, which requires 50% of members to cast a vote.
“We work incredibly closely with our consulting colleagues, so our problem is not with them,” she said. “It lies with the government. When we negotiated nurse pay, we absolutely knew the offer wasn't enough. But we were categorically told that, due to the cost of living crisis, this was the best we could get. Understandably, many of our nurses were disappointed by this and therefore declined the offer.
“They will be very frustrated. We have a huge recruitment and retention problem. This needs to be resolved if we want to fix healthcare in this country. Wages and employment conditions are an important part of this. If I were the government, I would take this opportunity to correct that appropriately. The government doesn't listen to nurses, at your peril.”
Last week, ministers announced the fact that more than 50,000 extra nurses were working in the NHS in England compared to 2019, fulfilling a manifesto pledge. However, official figures also show that there are more than 42,000 vacancies for registered nurses.
Ranger warned that talk of a crackdown on foreign workers and their rights would also impact recruitment. She said the RCN was already preparing for next year's pay talks. “We are hopeful that the government will take this seriously because it has intervened directly with the medical staff. So is this over? No.
“There is real frustration now. Nobody wants to make things more difficult for patients. But we have a government that simply does not value our profession. So of course we always have the option to vote again. We would like to find a way to solve this. And that's what I would do if I were the government.”
The return of industrial unrest in the NHS would be a huge blow to Sunak in an election year. Hospitals have already been told to shift their efforts away from tackling the treatment backlog that Sunak has pledged to prioritise, after being told to ensure they do not overshoot their budgets and focus on emergency departments this winter. NHS experts warn finances are under constant threat. “In 2018, Theresa May promised an average annual increase for the NHS of 3.4% per year,” says Sally Gainsbury, senior fellow at the Nuffield Trust. “That deal expires this financial year, and the Autumn Statement imposed a budget on the NHS from April that is at least £9 billion less than if it had continued. That is a figure that is frankly impossible without proposing large-scale cuts to healthcare.
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“I fear we are entering a period where politicians on all sides are simply unwilling to be honest about the level of funding that modern health care requires. They don't want to admit the tax or other budget implications if the NHS were fully funded for all the demands we put on it.”
A spokesperson for the Department of Health and Social Care said: “We really appreciate the hard work of NHS nurses and that is why we have provided a 5% pay increase. We also provided two significant non-consolidated awards, which for nurses in the top band five were over £2,000, equivalent to an additional 6.1% of their basic salary. This deal was accepted by the NHS Staff Council and we continue to work, including with the RCN, to deliver a range of agreed reforms, but we will not reopen negotiations on pay. The offer for consultants includes significant reforms on a pay scale that has not changed since 2003.”