Pat Cullen, general secretary of the Royal College of Nursing (RCN), recalled a conversation with frontline staff at a major hospital: “They said to me, ‘We’re not important to the government. We were seen as important during the pandemic, but we’re not important now. We don’t think the government will do anything for us’.
“When I talked to them about being a demoralised workforce, they said: ‘we’re not just a demoralised workforce. We have given up. No one seems to care any longer.’
There is anger that they have been pushed to this position.
"The health service is not just staring over the precipice. It has gone over. And the very people who are trying to bring it back up are being paid the lowest wage we can possibly pay them. If we deplete it any further, there will not be a health service there.”
The RCN decided to ballot for industrial action after the government unilaterally gave NHS nurses a £1,400 pay rise, leaving them £1,000 a year worse off in real terms, according to the union. It wants a rise of 5% above inflation to avoid a flood of nurses leaving the profession.
“It is probably the most difficult it has ever been for every single nurse – even more challenging and difficult now than it was through the pandemic,” Cullen said. “And I think it’s quite a frightening place for our nursing staff because of the absolutely depleted workforces.”
Cullen became general secretary in July last year, having been director of RCN Northern Ireland. She has been a nurse for 42 years: for much of that time she worked as a nurse psychotherapist in Northern Ireland’s prisons, and principally with victims of the Troubles. She is confident she can lead a successful strike. The union has a £50m hardship fund for striking staff whose pay is docked – members of the public have already offered donations as well – and she speaks strongly of nurses’ resolve. She also has some practice in industrial disputes, having successfully led a strike in Northern Ireland in 2019.
If the government believes it can out-wait the RCN, or take them on, Cullen has a warning. “If the government thinks of trying to set the public against nursing, I’d tell them not to bother,” she said. “The public are smarter than that.”
Starmer has told Labour MPs not to join picket lines, and Cullen is not expecting particular support from the party for the strike.
“It’s entirely up to them. What I would suggest is that no politician should turn their back on any nurse. If they turn their back on nurses during what will be a very, very challenging time for nurses – if we move to strike – those 500,000 nurses will not forget that, and I think patients will have something to say.”
Nurses are caring for patients with highly complex needs, she said, particularly older patients who have been waiting for surgery for years. At the same time, many nurses find themselves having to use food banks, and can’t afford to cook hot meals or buy school uniforms for their children.
NHS England said 6.8 million people were now waiting for treatment, a record high, with 377,689 waiting for more than a year.
Ambulance waiting times have shot up, with only 58% of patients seen within four hours, far below the 95% target.