Britain is facing an era of strike action not seen in a generation. There are strikes every day up to and during Christmas. Most worryingly, the Royal College of Nursing strikes begin on 15 December in the middle of all NHS Trusts. The Royal College of Midwives opened a ballot last month, so more strikes are likely next year.
Within nursing, this is a crisis that has been building up for years. Nurses are asking for a 19% pay rise, the government is offering four, an offer offensive to the thin red line of men and women holding our nation’s health together. Nurses are in bracket D of pay in the NHS, with a newly qualified nurse earning just £27,055, often rising to just £31,000, an amount which has fallen in real terms by 8% since 2010, fueling shortfalls in this vital sector, with wages now hit by inflation.
Meanwhile, nursing agencies are being paid up to £2,500 to cover a shift. In the last financial year – in a pandemic – we spent £3bn of the annual £12bn NHS bill with agencies. They often recruit from hospital staff. Agencies’ rates of pay have been capped at 55% of normal pay – changed in March this year to 35% – but it’s often more since managers can go further in an emergency.
As those working in the NHS know, much of the pressure on nurses is due to this staffing crisis: 40,000 quit last year, as shortages mean longer hours for those who stay on, often facing abuse from patients.
On LBC Radio, where I often present a weekly show, doctors and nurses call, tearful and excited, distraught that they cannot provide the care they want, having worked extra hours, sometimes for free because they could not leave vulnerable patients at risk .
NHS Trusts are recruiting like crazy from overseas but with that comes extra costs and delays. How did we get here? NHS spending 2020/21 was £192.9bn, or £3.7bn a week (these are pandemic figures, but the last we have). Our spending on health as a proportion of GDP is among the highest in developed nations. We have more employed nurses than ever before and there has been an increase in those applying to UCAS since the pandemic to study nursing. But waiting times for urgent care continue to grow. The NHS is probably in a horrible spiral and raising nurses’ pay is only the first inevitable measure. Fears of large wage increases are not unfounded: meeting such demands across the public sector is dangerous in an inflationary period. But with nurses, there’s no choice but to raise pay by more than four percent.
Other measures must be taken as well, or we will never break the cycle. The flow of new nurses into the NHS has stalled over the last decade. Despite warnings that the pressure on NHS staff and midwives would only increase, the government decided in 2015 to end grants for nurses. They were returned in 2020 but reduced from £16,400 to £5,000 (with top-ups for childcare costs). At the same time, college degrees have added loan debt to a not exactly well-paying career.
Imagine the loss of nurses entering the NHS during that five year period, as we led to a pandemic? To make matters worse, the available apprenticeships have fallen due to the apprenticeship levy introduced in 2017. Too many years of decline, as the population ages, obesity on the rise and underfunded welfare have added to pressures on the discount on nursing requirements. Recent applications have only brought the numbers back to where they were eight years ago and that’s far from the scale needed. It doesn’t make sense, does it? Why underfund training and waste billions filling gaps in overseas recruitment and agency fees?
There has been a lot of talk about higher skills and salaries for ministers. Return the scholarships to where they were. In the short term, offer bigger grants to stop nurses from quitting and give bonuses to those in trusts with the worst staffing problems so they stay on. Cancel the apprenticeship levy and support those taking the four-year nursing degree that includes paid work experience. Do it straight so they can change course.
Increase pay now and offer more later knowing that if you can fill the gaps with an influx of skilled nurses, trusts can lower staggering agency bills. It’s the only way out. Add in better child care tax breaks for those on the front lines. Don’t take this advice from me – this is what nurses and doctors say. It’s time for the government to listen.