Striking NHS workers demonstrating in Dulwich, south London, in 1982 (Pic: John Sturrock)
The early 1970s were a tremendous time to be a trade unionist. The Tory government and the employers were on the ropes as strikes landed blows for better pay. And rather than national trade union leaders being in charge of action, rank and file activists often held the reins of power.
But NHS workers must have felt as if the era of militancy was passing them by. Most clinical staff regarded themselves as “professionals” and dared not strike. And it was widely thought that ancillary workers—such as porters, cooks, cleaners—were too weak to fight.
There had never been a strike in the NHS before, and union organisation was patchy at best. As a result pay was terrible, especially for the workers at the bottom of the scale.
“The trade union leaders weren’t really interested in us,” remembers Bill Geddes. He was a senior shop steward in the Nupe union at Hammersmith Hospital in west London.
“Most ancillary workers were women,” said Bill. “At my work, many had come from Spain or Portugal on temporary visas, or were part of the Windrush Generation. These people were angry and determined to fight.
“If ever I had to go to a ‘tricky’ meeting with management I’d take about 20 of them with me. The Jamaican women in particular had no hesitation in tearing a strip off the bosses. They’d leave them shaking in their chairs.”
In 1972 a mood of militancy finally started to spread through the NHS when the government pay deal offered £1.80 to women and £2 to men.
Bill joined other rank and file union activists to plan unofficial strikes. They knew it would take more than the half-day strike the union was offering to win.
Unofficial action spread and pushed the union to catch up
They also knew that rank and file members were far stronger than the leadership bargained for.
These stewards demanded an £8 a week pay rise, shorter hours, longer holidays and equal pay for women, while union officials sought just £4 a week.
Unofficial action spread and pushed the union to catch up. Nupe’s half‑day strike in December involved 55,000 workers, and in many areas was unofficially extended to last the whole day.
On the picket line at Charing Cross hospital in London in 1988 (Pic: John Sturrock)
There was now massive pressure on the union to call an indefinite strike. In meeting after meeting Nupe members voted for one, but the leadership wouldn’t allow it. Instead, it offered week-long selective strikes.
Pressure on the government grew as nurses in the Cohse union voted four to one for industrial action and ancillaries at over 240 hospitals struck.
But by failing to call the all-out strikes needed to win, the union handed the Tories a lifeline.
The press went into overdrive against the strike, insisting that it put patients’ lives at risk. Ministers said they were determined to stand firm lest the NHS strike spread to other workers.
Socialist Worker at the time saw the risk the strike would be isolated.
“The key question for the trade union movement, especially the powerful sections, is: will you stand by and see the hospital workers driven to defeat?” it asked.
“The hospital workers must appeal over the heads of the vacillating union bosses to such powerful sections as miners and car workers.”
Both these groups had recently won substantial victories by taking militant action, and some were open to the idea of solidarity action.
In the weeks that followed Nupe members continued to show heroic commitment to the strike. But all the while their leaders sought a backroom deal with the government.
By April the union settled for a terrible pay offer that was no better than the original proposal—and didn’t mention equal pay for women.
Yet defeat was not the word on the lips of the thousands who had taken part. Instead they talked of “sellout” by the Nupe leadership.
The strike didn’t win. But union organisation grew—as did workers’ confidence. Ancillaries who were once thought to be powerless had shown they could be militant.
“Lots of people who are still around today had their lives shaped by that strike,” says Bill. “Certainly for me, it was one of the best periods of my life. The way we united people from so many backgrounds on the picket lines was brilliant. It was a time when we felt like we had real power.
“The main lesson people drew was that we need to stick together.”
How union leaders squandered anger of ‘Winter of Discontent’
Workers fought another round in the NHS pay fight during the dying days of Jim Callaghan’s Labour government. Between October 1978 and February 1979 Britain experienced a wave of strikes that became known as the “Winter of Discontent”.
Labour faced a huge economic crisis. It decided workers would have to sacrifice their pay—and that union leaders should help them push this through.
The result for millions of people was a huge drop in pay. Real wages for NHS staff fell by 19 percent. When ministers offered yet another below-inflation pay rise for 1979, thousands resolved to fight.
Following a massive demonstration in London, cleaners at Westminster Hospital decided they would not clean the rooms of private patients. Six women were suspended and workers walked out across central London hospitals.
The Nupe union voted against the government’s 9 percent offer— inflation was over 13 percent—and organised selective strikes. But their timid action, combined with the failure of other health unions to join, led the strike into a dead end.
One key difference between this strike and the one six years earlier was that the union leadership had tight control from start to finish.
Nurses demonstrate on budget day in 1988 (Pic: John Sturrock)
This reduction of rank and file power featured again in a confrontation between health workers and Margaret Thatcher’s Tory government in 1982.
But it didn’t diminish the anger people felt.
Hatred of Thatcher ran deep. So when health workers rejected the government’s 4 percent pay offer, thousands rallied to their cause.
Health workers struck and by July some 70 hospitals were operating on an emergency cover only basis.
There was an outpouring of solidarity as miners, dockers, steelworkers and Fleet Street printers defied the Tories’ new anti-union laws to stage solidarity strikes. Jim Fagan was a nurse in a small unit in east London at the time.
There was an outpouring of solidarity as miners, dockers, steelworkers and Fleet Street printers defied the Tories' new anti-union laws to stage solidarity strikes
“What I remember most was that the mass support gave us the confidence to act,” he said. “Myself and the cook at my work went to Hackney council’s direct works unit, and just the two of us picketed out the whole workforce.
“But I also remember that at the end of the strike, we didn’t feel defeated. We could have fought on.”
A day of action in September was a clear indicator of how to win. Some 2.25 million people joined it, many striking to do so. There was a groundswell of support for a general strike.
But union leaders accepted the Labour right’s idea that unions’ use of collective power had led the Tories into office in 1979.
This allowed the nurses’ RCN union, which then had a no-strike clause in its constitution, to step in and negotiate a shoddy settlement.
It won a 10 percent pay deal over two years for nurses, but abandoned lower paid health workers to the original offer.
‘Our strike won for both nurses and patients’
The Tories didn’t hesitate when they offered health workers a pitiful 3 percent pay rise in 1987. They had seen off the Miners’ Strike two years earlier. Surely nothing could touch them now?
But the darkness of the Thatcher years was broken in December by a wave of unofficial health strikes. Workers with no experience of previous defeats often initiated them.
Action began in February 1988 when 38 nurses from North Manchester General Hospital struck.
Within days nurses in Glasgow and Edinburgh were out for 24 hours over threatened privatisation. Pressure grew on the Cohse and Nupe health unions to call a national strike.
In a bid to manage the anger, the TUC organised a 100,000-strong national demonstration in March. But it refused to allow striking nurses to address the rally, fearing the action was spiralling out of the union’s control.
Eventually union leaders called a national strike—then quickly grasped an opportunity to end it after the Tories promised to up their offer. It was a double cross.
The government wanted to split workers by downgrading some and rewarding others using a “regrading exercise”.
Soon nurses were picketing again.
In Burnley, Lancashire, nurses burned their regrading forms. Karen Reissmann, a Cohse member and psychiatric nurse, was one of them.
She said, “Some of us had done well out of the regrading. I’d been awarded a 36 percent rise, for instance, which reflected how scared of our strikes the Tories were.
“But they were trying to play divide and rule by paying some of us far less. We weren’t going to stand for that.
“At a mass meeting in November we voted to strike. We didn’t know that you were supposed to have a formal ballot—we simply put our hands up and walked out.
“There were 300 of us, and we stayed out unofficially for a month.”
The national strike wave subsided at the end of the year as the Tories were forced to climb down.
“Most of us got big rises—but that wasn’t the main gain,” said Karen.
“For years afterwards management were careful not to piss us off. In our hospital, that meant better services for patients, more staff, more resources—and a much stronger union.”
A timeline of national strikes in the NHS
- 1972-3 Ancillary workers launch the first national strike in the NHS
- 1974 Nurses in the Cohse union strike over pay and win pay rises averaging 30 percent
- 1975-6 Junior doctors strike over working hours, eventually winning overtime payments
- 1979 Health workers strike over derisory pay offer. Nurses make marginal gains but most workers are left out
- 1982 Health workers strike over pay and win mass support but are unsuccessful
- 1988 Nurses’ strike wins large pay rises
- 1989-90 Ambulance workers’ strike wins some pay improvements
- 2011 Huge strike of public sector workers, including health workers, is settled badly by union leaders
- 2014 Half a million NHS workers strike for four hours over pay, including midwives taking action for the first time
- 2016 Junior doctors strike over new contracts which include more weekend and night work