Tens of thousands of nurses will strike across England, Wales and Northern Ireland on Thursday, sparking major disruption to services in the first such action in NHS history.
Nurses will refuse to work at hospitals and other places of care across the three countries from 8am until 8pm, in the first of two days of scheduled walkouts over their pay claim.
Their action has led to large numbers of outpatient appointments and operations being cancelled. Urgent and life-saving services will be fully staffed, but many non-urgent services will operate with only the much smaller numbers of nurses usually on duty on Christmas Day or overnight.
Less unwell patients attending A&E have been told to expect to wait even longer than usual.
Members of the Royal College of Nursing (RCN) are staging the strikes in an effort to win a pay rise for this year of 5% above inflation, and in protest at the government’s decision to award them an increase of at least £1,400, which is the equivalent of about a 4% uplift.
The RCN’s general secretary, Pat Cullen, has stressed that nurses do not want to strike but feel obliged to do so because, with soaring inflation, the government’s pay offer amounts to a real-terms cut in their salaries after a decade in which the value of experienced nurses’ pay has already fallen by 20%.
“Nurses are not relishing this,” she said. “We are acting with a very heavy heart. It has been a difficult decision taken by hundreds of thousands who begin to remove their labour from tomorrow in a bid to be heard, recognised and valued.
“It is a tragic first for nursing, the RCN and the NHS. Nursing staff on picket lines is a sign of failure on the part of governments.”
Cullen has been engaged in a heated war of words with the health secretary, Steve Barclay, over his refusal to engage in discussions with the RCN over pay, despite the union’s willingness to compromise on what ministers have called an “unreasonable and unaffordable” demand.
The RCN undertook action short of a strike and three days of walkouts in Northern Ireland in late 2019, in a dispute over pay and safe staffing levels. This is the first time, however, that they have taken coordinated action across the NHS. They will strike again on 20 December.
Nurses will not withdraw their labour in Scotland. RCN members there are voting until next Monday on whether to accept a “best and final” offer from Nicola Sturgeon’s government, which is worth £2,205 or a rise of about 7.5%.
The RCN has bowed to pressure from NHS leaders in recent days and agreed to protect patient safety by exempting extra areas of care in England, Wales and Northern Ireland from the strikes, including children’s A&E units, emergency cancer services and some forms of mental health care.
“The RCN has agreed that all emergency departments and urgent care units affected by industrial action should be staffed to at least Christmas Day levels,” said Matthew Taylor, the chief executive of the NHS Confederation, which represents NHS bodies in England and Wales.
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“But with such high demand from patients, people arriving at A&E with more minor ailments should unfortunately expect to have to wait longer.
“The NHS will make every effort for this not to happen but patient safety and maintaining safe staffing levels in the most critical services has to be the number one priority.”
The Welsh government said NHS care would be “significantly impacted” and that services were likely to resemble those usually provided on public holidays. Non-urgent or routine appointments are likely to be postponed, it said, though health boards hope to offer patients new dates as soon as they can.
Voicing his support for striking nurses, the Welsh health minister, Eluned Morgan, stressed the Labour government’s belief that “all public sector workers should be fairly rewarded for the important work they do”.
She said: “The strikes which begin today will inevitably have a significant impact on NHS services. But we recognise the strength of feeling among staff, which the difficult decision to vote for industrial action reflects.”
Barclay said: “Our nurses are incredibly dedicated to their job and it is deeply regrettable some union members are going ahead with strike action.”
Keeping patients safe was his top priority and arrangements had been made to ensure that, he said, but “I do remain concerned about the risk that strikes pose to patients.”