Nurses vote to strike over pay, as other health workers are balloted

Dear Editor

I read with sadness and trepidation news item on nurses’ strike (1). Sad because our hard-working dedicated colleagues had to be on the picket lines instead of with patients to have their voices heard. Although nursing leaders have reassured that they will adopt a ‘life-preserving care model’ during industrial action (2) many patients will be potentially affected. In the USA in-hospital mortality increased by 19.4 percent and hospital readmissions increased by 6.5 percent for patients admitted during nurses’ strike (3, 4). This report states (4) “Nurses are a crucial part of the hospital production function and are, as one hospital CEO said, “the heart and soul of the hospital”.

This festive season is full of worrying news from all directions; cost of living crisis with inflation over 10%, strike by railway staff, postal workers, ambulance staff, border force, energy crisis, hike in mortgage payments (5), migrant crisis, austerity 2.0 on the horizon (6) , increased deaths in children due to invasive Group A Streptococcus (7) just to name a few and this doom list appears to be growing. One is left to wonder whether this Christmas be a “Christmas of doom and gloom” or a “Christmas of hope and joy”. Last Christmas we were rolling out the first booster vaccine with the objective of protecting lives (8). This is the first Christmas where we are free of COVID worries and enjoy the festivities. According to the latest available figures there were 57 deaths due to COVID on 8th December in England compared to 1255 on 19th of January 2021. (9) In the latest Office of National Statistics survey which measured the important issues facing the country today COVID was ranked 12th by the adults lower than EU exit, employment, and education. We as a country managed to conquer the virus working together and deploying a very effective population level intervention – the vaccine and nurses played a key role in the pandemic (10).

The same NHS and the system which helped us to defeat COVID appears to be in deep crisis now. The cases of flu admissions rising (11) and hospitals are being asked to free up beds (12) to be ready for the strike by ambulance staff, one of our three blue light services. General practices are pushed to their limits with a surgery telling their patients “The practice will be priortising medically urgent cases only this week. Limited routine appointments will be made available for booking 1-2 weeks in advance” (13). Due to the restricted private market a 15-minute private GP consultation costs £65-110 (14) unaffordable by most already struggling with their finances. Access to health care by the wealthy will only lead to further exacerbation of existing health inequalities as documented in “The State of Health and Care 2020” report. (15) Unfortunately, NHS primary care is forced to turn into urgent treatment centres with patients waiting for routine appointments for weeks and no doubt the founding fathers of the NHS will be turning in their graves at this ominous development.

For the impartial observer all the strike actions appear like a pincer movement on a young government and Prime Minister with the public caught in the crossfire. I have pointed out before it is not fair only to blame the government (16). My humble appeal to all parties this festive season is please sit down and resolve the disputes by talking and not grand standing. With COVID variants lurking around the corner (17) and US offering free tests again (18) help to turn this Christmas one of hope and joy as we do not know what comes next.

Dr Padmanabhan Badrinath, Retired Consultant in Public Health Medicine
badrishanthi@hotmail.com

Disclaimer: The views expressed here are the personal views of the author and in no way represent the views of any organisation the author has been associated with in the present or past.

Conflict of interest: The author is a member of the British Medical association and supports industrial action which does not harm patient care.

References:

1 Mahase E. Nurses vote to strike over pay, as other health workers are balloted. BMJ 2022;379:o2740. Available from: https://www.bmj.com/content/379/bmj.o2740

2 Royal College of Nursing. Royal College of Nursing sets out protected areas during strikes. RCN [Internet]. [cited 2022 Dec 2]. Available from: https://www.rcn.org.uk/news-and-events/Press-Releases/royal-college-of-n...

3 The Digest. Evidence on the Effects of Nurses' Strikes. The Digest [Internet] [cited 2020 July]. Available from: https://www.nber.org/digest/jul10/evidence-effects-nurses-strikes

4 Gruber J and Kleiner SA. Do Strikes Kill? Evidence from New York State, NBER Working Paper No. 15855, March 2010. Available from https://www.nber.org/system/files/working_papers/w15855/w15855.pdf

5 The Times. Interest rates rise to 3.5% – what it means for you. [Internet] [Cited 2022 Dec 15]. Available from https://www.thetimes.co.uk/money-mentor/article/interest-rates-rise/

6 The King’s Fund. Austerity 2.0: why it’s critical for our health that the government learns the lessons of Austerity 1.0. [Internet] [Cited 2022 Nov 1] Available from https://www.kingsfund.org.uk/blog/2022/11/critical-for-health-government...

7 Independent. Child deaths from Strep A in UK rises to 19 as outbreak spreads. [internet] [cited 2022 Dec 16]. Available from https://www.independent.co.uk/news/health/strep-a-deaths-children-update...

8 Badrinath P. War on COVI19 - State authority, social responsibility and saving lives this Christmas. BMJ [Internet]. [cited 2021 Nov 13] available from https://www.bmj.com/content/375/bmj.n2773/rr-0

9 Gov.UK. Coronavirus (COVID-19) in the UK. Deaths within 28 days of positive test by date of death. Gov.UK. [Internet][cited 2022 Dec 15]. Available from https://coronavirus.data.gov.uk/details/deaths?areaType=nation&areaName=...

10 Fawaz M, Anshasi H, Samaha A. Nurses at the Front Line of COVID-19: Roles, Responsibilities, Risks, and Rights. Am J Trop Med Hyg. 2020 Oct;103(4):1341-1342. doi: 10.4269/ajtmh.20-0650. PMID: 32783796; PMCID: PMC7543802.

11 Lacobucci G. NHS facing “perfect storm” as flu admissions rise 40% in a week. BMJ 2022;379:o2920. Available from https://www.bmj.com/content/379/bmj.o2920

12 BBC. Hospitals told to free up bed. BBC. [Internet] [cited 2022 Dec 17] Available from https://www.bbc.co.uk/news/uk-64005274

13 Ashfield Surgery. Latest Update. [Internet] [cited 2022 Dec 17]. Available from https://www.ashfieldsurgery.co.uk/

14 PRIVATEGP.COM. Private GP costs. [Internet] [cited 2022 Dec 17]. Available from https://privategp.com/fees/

15 Thomas C, Poku-Amanfo E, Patel P. Institute for Public Policy Research. THE STATE OF HEALTH AND CARE 2022. March 2022. Available from https://www.ippr.org/files/2022-08/state-of-health-and-care-march-22.pdf

16 Badrinath P. Turning up the hear on the NHS - it is not fair to blame only our government. BMJ [Internet] [cited 2022 2021 Nov 22] available from https://www.bmj.com/content/375/bmj.n2618/rr-1

17 UK Health Security Agency. Risk assessment for SARS-CoV-2 variants V-22OCT-01 (BQ.1) and sublineages, and V-22OCT-02 (XBB) December 7, 2022. Available from https://assets.publishing.service.gov.uk/government/uploads/system/uploa...

18 BBC news. US brings back free at-home Covid tests as part of winter plan. BBC [Internet] [cited 2022 Dec 16] Available from https://www.bbc.co.uk/news/world-us-canada-63990173