An NHS nurse speaks out
A myth was perpetrated in the late 19th century that continues to this day. A new political party, the Labour Party (LP) was born to represent the interests and needs of the urban working class, but on analysis, when has the Labour Party ever truly fulfilled that role?
Reaching power in 1945, at the end of WW2, it was Clement Attlee’s government that gave rise to the National Health Service (NHS) along with the welfare state but what was the real motive? The NHS was designed to appease the working classes and crush any ideas of socialist rebellion at a time when the socialist USSR was standing tall in the world following its victory over fascism. The same government, under the direction of Ernest Bevin, assisted in the formation of the North Atlantic Treaty Organisation (NATO) created to fight against communism. It encouraged the British workforce to ignore the nefarious acts committed by the same ‘party of the people’ against the working classes, their comrades, outside of Great Britain. It goes some way to explain, but not excuse, unacceptable behaviours of some sections of the working class who blame “the other” for their ills rather than laying blame at the true culprits, the ruling classes and their acolytes.
This year marks the 75th anniversary of the NHS but there is not much to celebrate. Privatisation of this organisation continues apace ensuring that pay remains lower than rates a decade ago. Staff shortages and low staff morale are accepted as the norm. This impacts hugely on patient safety and staff wellbeing. Many seem unaware that the NHS has and continues to be privatised by stealth. This year also marks both the 75th anniversary of the Windrush generation as well as, unfortunately, the 10th anniversary of the Francis report. The passengers from SS Empire Windrush made a valuable contribution to rebuilding Great Britain after World War II. Many of these passengers were the mainstay workforce of our NHS. In addition to their practical help, they brought a wealth of cultural enrichment to our society whilst experiencing appalling racism and discrimination. Their descendants have been subject to further cruelty and prejudice by the British government in recent times, as discussed by comrades previously, see ‘The Windrush scandal’, in Lalkar of May/June 2018. Additionally, the recent and brutal Illegal Immigration Bill will prevent refugees seeking asylum here and enhancing our culture and workforce.
Conversely, the NHS has actively recruited overseas nurses, mainly from India. Many of these excellent recruits struggle to integrate within the existing workforce owing to both unconscious bias as well as episodes of discrimination; despite all Hospital Trusts waving BAME friendly banners alongside rainbow ones. In recent Trade Union ballots, many have declined to vote owing to fears of losing their visas. Some were bewildered by the ballot and were not sure that they were eligible to vote; possibly to an undercurrent of feeling ‘less than’. The government is keen to employ overseas nurses as they have been ‘grown’ and paid for elsewhere.
The Francis Report (Report of the Mid-Staffordshire NHS Foundation Trust public inquiry) and the G
government’s response – House of Commons Library (parliament.uk), were published and it appears that lessons learned have long been forgotten. Bullying, cliques and harassment were endemic within the Mid Staffordshire hospital and this was a factor which led to its failings. There is still a culture of cliques, bullying (including racism and undermining of those with invisible disabilities) as well as anecdotal evidence of nepotism within the NHS. Many Trusts have installed full-time ‘Freedom To Speak Up Champions’. It is unclear whether these measures have afforded any respite to victims of bullying. In one Trust, a respected obstetrician and gynaecologist was sacked after voicing his concerns regarding ‘normal birth’ ideology. He indicated that other staff in lower grades would be unlikely to speak out as a result. As reported previously, the numbers of beds has decreased over the decades to such an extent that it leads to artificial pressures on the NHS. The cuts to social care budgets result in medically fit patients remaining in hospital whilst interim beds or carers are frantically sought. This stops the flow of patients from A & E to the wards most appropriate for their care. It was recently reported that there are no beds available to mental health patients on a regular basis. This, in addition to lack of care in the community leads to increased numbers of patients in A&E and repeating the downward cycle. A&E patients are routinely given treatments in waiting rooms and other non-clinical areas. The RCN has announced that it does not endorse nursing care provided in non-designated clinical areas, such as corridors due to lack of patient flow. This statement is to be applauded. However, the RCN have not proffered a solution to this degrading and unsafe practice as yet.
The ruling class device of divide and rule is fully evidenced within the NHS. The added pressures, low pay and bullying results in sickness and haemorrhaging of NHS staff. This is a clear approach to completely privatise the NHS by keeping morale and the wage bill low.
The Thatcher administration got the ball rolling in earnest and subsequent Labour governments maintained its momentum, despite rousing speeches to the contrary. The Labour Party under Tony Blair continued John Major’s Private Funded Initiatives (PFIs) and created Foundation hospitals that leave the NHS with overwhelming debt and bills that mean buildings cannot be maintained to acceptable levels.
While ‘Partygate’ stories dominate mainstream media news cycle most have forgotten the horrors endured by all NHS workers, their patients and their families during the peak of the Covid 19 pandemic. Many colleagues died horribly from this virus or complications caused by it. Those remaining were expected to carry on working with suboptimal PPE. Many lived in fear and ensured they completely decontaminated themselves after long shifts before greeting their children and family to prevent infection.
The government has recently offered a below inflation pay award to NHS workers that includes a one-off ‘Covid bonus’ payment; aka a Covid bribe for workers. The offer is seen as attractive by many, especially those being paid less than workers in private companies but the ‘Covid bonus’ in no way compensates for the trauma experienced.
Despite this, recent pay rises afforded to NHS workers were made by raiding existing NHS budgets, thereby impoverishing other sections of the system. Health workers are considered greedy for simply asking for a restorative, above inflation pay rise made all the more urgent during this cost of living crisis. Headlines scream that pay rises increase inflation, but it has become clear to most of us that inflation is not caused by pay rises.
Problems within the NHS are manifold. There is a culture of fear perpetuated to prevent workers in the industry from speaking out about problems. Student nurses are being used as cheap labour, inappropriately, in an attempt to plug staff shortages. Workers on zero hours contracts (bank shift workers) pick up additional shifts, in addition to their already onerous jobs just to earn enough to survive. Despite them proving to be a crucial part of the workforce they will not receive the one-off payment. Another blow that will likely cause many to seek employment elsewhere.
The RCN strike ballot closed on 23 June 2023. It is an aggregate ballot of all members in England who work in the NHS and who are on the Agenda for Change pay scale. The rank-and-file support for the strike was strong. Unfortunately, union leadership capitulated and recommended no to strike action. However, their response created a furore amongst members resulting in the RCN having to run an about face polished ‘Vote to strike’ campaign. There are already rumours in the media that the result will be a disappointing ‘No’ to strike action. All NHS workers should defy this, though it is unlikely that they will, sadly.
Many healthcare workers are not members of unions; some because they are unsure what a trade union does but most because they do not believe the unions can offer them anything worthwhile and therefore the union subs do not reflect good value – especially when every penny counts toward their survival.
Each union has a unique selling point to attract the subs necessary to run slick campaigns that appear to support their membership. Nevertheless, meaningful work such as fighting in solidarity for the genuine restoration of pay that improves patient safety, and retains and attracts staff, is not forthcoming. As a result, workers do what is necessary for their survival. Many nurses have left their principal roles to join private agencies who contract their resource back to the NHS (another example of stealth privatisation) and return to their former workplaces with improved salaries, increasing the wage bill to boot! And remember, some of that increased cost to the NHS has been syphoned off privately!
Healthcare support workers feel undermined, overworked and underpaid and are actively seeking employment both outside the NHS and away from their vocation and the jobs they love and perform excellently.
PS At the RCN Congress that took place from 14 to 18 May in Brighton, guess whose question wasn’t read out by Pat Cullen! It was fun listening to her stumble for a few seconds before reading out a question about what to do if members have not received their ballots! my question Model motion: Defy the anti-trade union laws This [conference] notes that, since the defeat of the heroic 1984/5 miners’ strike, several rounds of anti-trade union legislation have been enacted in Britain, whose cumulative effect and specific aim has been to erode workers’ ability to defend their pay, pensions and conditions of work to the point of non-existence. Conference further notes that the right to withdraw their labour is the only real right that working-class people possess within the conditions of the capitalist economic system. Britain’s anti-union laws, while officially leaving the ‘right’ to strike intact, have in reality created a situation in which it is impossible for workers’ collective action to be successful. Conference notes that while campaigns officially exist whose stated aim is to overturn these laws, these have to date been entirely ineffective. History shows that the only way to have unjust anti-worker laws overturned is via mass non-cooperation. If workers make the laws unworkable (as they did with the poll tax in 1990), the government will be left with no choice but to rescind them. This conference believes that it was a serious mistake for trade unionists ever to accept the situation in which the capitalist class granted itself the right to oversee the running of working-class organisations. Our accounts, our rule books and our elections are our own business and no one else’s. Conference concludes that in order to exercise our right to take action in defence of pay and conditions, our only option is to defy en masse the laws that stop us from being successful, whether these are laws prohibiting mass walkouts and secondary actions or laws stipulating state supervision of ballots and notice to employers. Every one of these laws is an attack on the rights of working-class people, and must be abolished by means of workers’ collective action. Conference resolves that from now on our reps and officials will run disputes.