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Striking NHS workers speak out… ‘only so much sacrifice you can take’

This article is over 1 years, 3 months old
The fight over NHS service pay has pushed tens of thousands of health workers to strike. Yuri Prasad spoke to two junior doctors preparing to strike for four days this week—and to a nurse furious at their union for pushing a poor deal to end the dispute
Issue 2850
Striking junior doctors at Homerton hospital in east London

Striking junior doctors at Homerton hospital in east London are joined by other health workers in solidarity. (Picture: Guy Smallman)

Paul, radiology doctor, east of England
  • How would you describe the mood at work in the run up to the four-day strike?

There is a definite mix of attitudes among junior doctors—a mix of optimism and frustration. The optimism comes from the way the BMA as a union has changed since the last junior doctors’ dispute back in 2016.

There was a lot of passion in that fight, but this time around everyone thinks it is being channelled more effectively. I’ve really noticed there is a different energy. The frustration is directed at the government and their delaying tactics.

Everyone knows that this dispute will end in negotiations, but the government is needlessly stringing this out. That is not helping anyone, least of all patients.

Health secretary Steve Barclay said he wouldn’t negotiate with the threat of strikes hanging over the NHS. So why did he not commit to negotiations months ago? Why is it only now, after we have voted to strike, that he uses this as an excuse not to come to the table with an offer?

  • Is it pay, or wider issues, that motivated junior doctors to strike?

I am glad that the BMA is upfront and clear that this is a dispute about our pay. I think it’s right to put that out there at the start of the dispute. Pay comes into everything.

It’s not just about us being able to pay our bills—it’s about staff retention, the rate of doctors’ burnout, and the need to feel valued.

A lot of health workers have made great sacrifices in recent years of austerity and the pandemic. But in return for that we’ve seen a cheapening of our contribution. It’s as though we’ve been taken advantage of because we care.

So the feeling among my colleagues is now, if not us, who? And if not now, when? Are we just going to let our pay—and the health service—just erode for another ten years, or are we going to fight?

This week’s four-day strike is going to be much more disruptive, and that is the point of it. We want to avoid a long, drawn out battle with slow and piecemeal action. Instead, our fight has to be sharp and clear—and that’s the message a 96-hour strike sends.

Having said that, I think a lot of junior doctors have underestimated just how disruptive this next strike is going to be.

  • The BMA is fighting for pay to be restored to 2008 levels. Can you really win that?

The government says it can’t offer us something that it’s not offering to everyone else. Our answer to that is, everyone deserves fair pay. Just because you are robbing nurses, porters and physiotherapists, that doesn’t give you the right to rob us doctors too.

Barclay says he can’t bring our pay back to 2008 levels. But what does that mean? Does he mean that we were overpaid 15 years ago? Should junior doctors have had a pay cut back then?

Of course, it’s hard to demand an increase of over 30 percent, but junior doctors are now asking how did we get into a situation where we lost money every year for more than a decade?

Full pay restoration is the only way the government can show it values the medical workforce. They say we should survive on less than we need because being a doctor is a calling, and a calling means sacrifice. But there’s only so much sacrifice you can take.

  • What do your patients think about the strike?

Every patient that I’ve spoken to about the strike—or, has made a point of talking to me about it—has enthusiastically backed us, just as they did for the nurses and ambulance workers.

  • What would it mean if other workers came to your picket lines?

I can’t stress this strongly enough. It would be immense if people came to our picket lines and would really make an impression on us.

It would break the idea that we’re out on our own and that no one backs us. And it would help win the idea that junior doctors are part of the trade union movement now and that we need to be involved in it.

Solidarity depends on the idea that every act of kindness gets repaid—but it has to start somewhere. That’s why when the nurses were on the picket lines we supported them. We’re stronger when we lean on each other, but that takes reaching out.

Sam, nurse and union activist, London

During the strike there was a feeling that we could change things, that we have power—and that by taking action we could change the future of the NHS. It was brilliant.

We were all together and in solidarity with one another. There was an overwhelming sense of unity. That feeling has gone—at least for the time being.

In my workplace people are now really polarised between a minority that support the deal being pushed by the leaders of our union, and the rest of us who feel betrayed. Some nurses are so angry they have even left the union.

But others, who began the strike as very unpolitical, are the ones now most enraged by the leadership. They are even more motivated to fight.

Most of them were expecting a decent deal, though some of us knew from the start it would never be that easy. It’s not just the low pay that angers people, and the impact it has on staffing and patient safety. 

The talk of a separate pay spine for nurses is seen as a way to divide us from other health workers we work with everyday—from porters to physiotherapists. It’s a very dangerous move because standing together is the only way to win. And, that’s why it was a mistake for the RCN not to strike alongside the ambulance workers when they were out earlier this year.

That was a wasted opportunity. We could have struck for longer and for more days to make more of an impact.

That said, it is really positive to see the junior doctors striking now. I hope in the future that we can learn from them, their willingness to take hard action, and make our union better.

James, year two foundation doctor, Midlands

For me, the NHS crisis is shown most by the declining number of doctors that choose to go on to specialist training in a particular area of medicine, such as surgery or general practice, for example.

As a year two foundation doctor, I get just one afternoon a week when I’m taught, and the rest of the time I spend learning on the job. And, while I’m learning how to manage complex patients and do everything from lumbar punctures and nerve blocks, to putting catheters in, I’m working on the wards.

At night, junior doctors like me will often work alone under the supervision of just one or two medical registrars who have at least five years training but are themselves junior doctors. And we sometimes cover hundreds of patients, some of whom are very unwell. When you’re working in a hospital with five floors and dozens of wards, that means if you run into trouble, help is not going to get to you quickly.

So, you can be with a very sick patient that needs your help urgently, say someone having a cardiac arrest, and all the while your pager is beeping because another patient also needs you urgently. While you’re trying to remember all the things you have to do in a cardiac arrest situation, there’s the knowledge that the other patient isn’t getting the care they need. That weighs on you a lot.

Junior doctors are often put in situations they are not ready for, and then worry about something they might have missed, and the harm that might result. I’ve found it hard to switch off from that level of stress. The problem is that the stress never goes down—never. The pressure is just non-stop.

Sometimes, when I start my shift in the emergency department at 8am, I’m treating patients that arrived here at 10pm the night before but haven’t yet been seen. It feels like all of that is getting worse. Patient numbers are going up, and the patients are generally sicker, on more medication and have more complex needs. In part, that’s because of the social situation.

People find it increasingly hard to look after themselves because they can’t afford to eat properly, or they don’t have decent housing, or they don’t have the right support. Sometimes, they put off coming to hospital until they are really unwell because they can’t afford to get here, or they can’t afford to take time off work. Then there are the impacts of the health service crisis itself.

We often see elderly patients who have fallen at home and broken their hips. They then wait hours for an ambulance, and by the time they get to us, they’re having kidney trouble because they haven’t had any fluids for a day.

That makes you feel that just about everything is broken. But the junior doctors’ strike at least gives you a chance to see things collectively. The picket lines earlier this year were the first time I’ve met most of my colleagues.

The best part about the strike was how united it felt, like we were all together rather than facing things individually.

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