RCN UCLH picket line, 6 February RCN UCLH picket line, 6 February. Photo: Lewis Baker

The strikes in the NHS are part of a fightback across the working class and in defence of public services, argue Counterfire health workers

On Monday, we witnessed the biggest walkout in NHS history. After the historic strikes that began in December, nurses and paramedics striking together marks an escalation of the struggle and cross-union collaboration to save the NHS. 

Public support has remained strong, with strikers reporting huge public solidarity on their picket lines. A YouGov poll commissioned by the TUC in January showed that even 61% of patients with a health condition support the NHS strikes.

The ongoing crisis in the NHS – which is resulting in at least 500 unnecessary deaths per week – has demonstrated how frighteningly deteriorated the health service is, in terms of resources and staff. It has been absolutely clear on the picket lines, from chants and homemade placards, that health workers, other trade unionists and the public are all acutely aware that this isn’t just about pay – it is about the survival of the NHS itself. 

Wage suppression of frontline workers goes hand in hand with the chronic underfunding and privatisation of the health service. The strikes have empowered workers who, while lauded as heroes during the pandemic, have been forced to make enormous and unsustainable sacrifices to keep a crumbling NHS afloat. As one striking nurse told Counterfire,

“The experience of being on the picket lines is transforming people. I’ve seen so many colleagues who previously didn’t feel they had a voice at all now completely changed and have a sense of the power we hold.”

However, alongside this historic action, we must remain aware of our goals and the strategy needed to achieve them.

Missed opportunities

The 6 February strike saw nurses from the RCN and ambulance workers from Unite and GMB strike together. Physiotherapists from the CSP are striking separately on Thursday 9 February and ambulance workers from Unison are striking on Friday 10 February.

Unison and the CSP not coordinating with other unions is a mistake. As Unjum Mirza explains

“Joint strike dates and joint picket lines demonstrate a class logic. They hold both the industrial power needed to win while generating a gravitational force that pulls wider layers of workers into its orbit and action at the same time.”

The scale of the crisis means we simply cannot afford to be sectional or sectarian. The battle ahead requires maximum unity if we want to win. Junior doctors with the BMA are balloting to strike and midwives, outsourced workers and other sections of the NHS workforce could soon join the fray. All unions representing health workers should be working together at every opportunity.

Calling off strikes is not a good idea

Less than three days before the planned strikes on Monday, the RCN and GMB called off their strikes in Wales following a new offer from the Welsh government. As NHS Workers Say No! explained, unions are under no legal obligation to present slightly improved offers to their members, nor are they obligated to cancel strike action.

It is not only disheartening to members prepared to strike to be told last minute that they won’t be able to, but it also breaks the momentum going forward and leaves other strikers out in the cold – in this case Unite ambulance workers. It is especially ridiculous that this decision was taken when the RCN is rightly demanding a 19% pay rise (inflation + 5%) and the Welsh government only offered a 1.5% increase to the already mandated 4% with a one-off 1.5% payment. This is less than a third of what the union is asking for and massively below current inflation. It certainly doesn’t begin to address a decade of real-terms pay cuts. 

The goal of the strikes cannot simply be to force the government to negotiate a slightly increased pay offer. If the health unions are serious about pay justice and improved conditions for their members – which would involve solving the recruitment and retention crisis as well as the inefficient and wasteful involvement of the private sector – then its strategy must reflect that.

That means it cannot demoralise its members or break the momentum of the strike whenever presented with a new pathetic offer. It also means it should not be looking at industrial action as a long-term slow burn. The tactic of one-day strikes once a month – this time 48 hours for the first time for the RCN – is not good enough. The plan of incremental escalation does little to put the kind of pressure needed on the government to back down, and risks burning out health workers who are losing pay for striking.

Criminal barristers on a national level and bin workers, bus drivers, manufacturing workers and others locally took or threatened all-out strike action and won their disputes with speed. They have shown that bold and decisive action works, and facing a government on the back foot, that is what is needed to break them now.

Generalise the struggle

On 1 February, an estimated 500,000 workers from the NEU, PCS, UCU, Aslef and RMT went on strike nationally. The result was a huge day of strikes and protests across the country that mobilised hundreds of thousands of people, built cross-union collective action and demonstrated the scale of support and solidarity with the strikes.

The fight to save the NHS can only be won if it is widened as much as possible, and the health unions should have joined in with striking on 1 February instead of separately the following week.

The NHS is a central part of our society, which also means the struggle of NHS workers is inherently linked to the struggle of all workers. All public sector workers taking strike action are fighting the same employer – the government. It is only logical that linking up the fights increases the strikes’ effectiveness and amplifies the power of every section of the movement.

That’s why the Tories are passing new legislation to outlaw strikes and that’s why we need to see united, coordinated action by all public sector workers to defeat them. The NEU has called 15 March, Budget Day, as the next day of coordinated strike action. We hope the health unions along with other unions will get involved and strike together.

We also need to be part of mobilising the broadest layer of people on the streets and in communities through solidarity. On the last RCN strike day, several thousand people assembled at the UCLH picket line in London and marched to Downing Street. It was an impressive show of unity and solidarity and demonstrated how the trade union and social movements can work together to maximise the resistance. The 11 March SOS NHS national demonstration is going to be an opportunity to do that on a much bigger scale.

Organising from below

The strikes have been hugely inspirational and transformational for many NHS workers. They demonstrate the power of collective action and the possibility of radical change. The Tories are divided and weak, they don’t have solutions to the crisis and they are terrified of the renewal of industrial militancy. This is a moment we cannot afford to squander.

For all the reasons above, it is up to us as health workers and trade unionists to organise together and to put pressure on our union leaderships to strengthen our strategy and to not settle for anything less than we deserve. Get involved in organisations like NHS Staff Voices and NHS Workers Say No, get this motion to support the 11 March national demo passed at your trade union branch, and get to picket lines of strikers in other unions to make it clear that we are united in this fight. Together we can win. 

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