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The Guardian view on NHS strikes: a last resort
and a cry of despair
Editorial
Conservatives cannot deflect blame for a crisis that
has been building for the 12 years they have been in government
‘There is less capacity to make do with less in the
NHS because its staff have endured falling living standards for years.’
Wed 30 Nov
2022 18.44 GMT
Industrial
action can have many causes, but there are two responses available to
governments – negotiation or confrontation. Which path ministers take depends
on a calculation about public opinion. Sympathy with the strikers will
encourage compromise; suspicion that their demands are excessive permits
intransigence.
Frontline
health workers are generally held in high esteem, and the Covid pandemic
reinforced national affection for the NHS. That sentiment will extend to
support for striking nurses in England, Wales and Northern Ireland, but
compassion will compete with anxiety about patient care. Mindful of that
balance, the government has adopted a stance of calibrated intransigence,
signalling readiness to talk, but not about the main issue – pay.
The
government’s offer, a flat rate increase of £1,400 for most health workers,
amounts to a real terms cut, given double-digit inflation. The Royal College of
Nursing says that its members have suffered a 20% fall in incomes since 2010.
The union is asking for a 5% pay rise on top of inflation.
The
Department of Health and Social Care says public sector pay restraint is
unavoidable in times of straitened national finances, and that the health
service has been treated with relative largesse. Those arguments would carry
more authority if constraints on the Treasury weren’t a result of the
government’s own colossal mismanagement of the economy, and if the public
sector was not still suffering from the effects of the last dose of
Conservative austerity.
There is
little flex in budgets because Liz Truss’s wild fiscal experiments ruined
Britain’s credibility on financial markets. And there is less capacity to make
do with less in the NHS because its staff have endured stress and falling
living standards for years.
Those
grievances were set aside during the pandemic – a commitment recognised in
ritual clapping on the nation’s doorsteps. But applause doesn’t pay bills, as
the nurses’ banners say. Critics of the strike might try to cast industrial
action as an abdication of the duty to care, but the greater threat to safety
is corrosion of working conditions and staff stretched too thin. Patients
suffer most when nurses are forced out of the profession and none can be
recruited.
The same
applies to ambulance drivers, who have also voted to strike. These are workers
with a vocation. They know better than their critics what is at stake when they
withdraw their labour. That they feel compelled do it is a measure of
desperation. It expresses fear of penury and also anger at the state of a
health service where government reliance on the willingness of underpaid staff
to go the extra mile has turned to cynical exploitation.
Whether the
public sees it that way is hard to predict, not least because the mood around
strikes and the government reaction will be shaped by disputes in other
sectors. A winter of discontent will test the patience of people whose services
are withdrawn. It will also compound the growing sense of national stagnation
under a government that is weak and directionless.
Either way,
the prime minister should not imagine that he can ride out the coming storm or
deflect blame for disruptions and stoppages. There is room for debate over the
methods by which health workers express their grievances, but little question
over where the responsibility lies for a crisis that has been building for 12
years of Conservative government.
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