NHS nurses took a historic step this month, voting to strike in their first vote on industrial action since the Royal College of Nursing was founded more than 100 years ago. When my girlfriend, who works for a central London trust, received her ballot paper in October, she filled it out in no time.
Never mind that many accident and emergency nurses like her still have to work during any strike. Or that some hospital departments are already operating with staffing levels below the minimum legal requirements for strike days. Returning her vote felt like a rare victory in her fight with an institution she fears is slowly consuming itself and her with it.
The discussion of the ballots has focused mainly on salary. With annual inflation above 10 percent, the government offer of a £1,400 raise for the average nurse it means a devastating cut in real terms. But it’s likely that the nurses’ frustrations had more to do with their general well-being than just money. A drop in wages in real terms means less disposable income to do things that improve well-being and make difficult work seem worthwhile.
An increasingly important factor in nurses’ decisions may be how their work affects their health. front line National Health Service The work is almost perfectly designed to create illness: it’s physically and mentally exhausting, the shifts are long, and the hours are unsociable, putting strain on relationships and making it difficult to maintain healthy routines. Last year’s survey of NHS staff found almost half felt unwell and a third suffered musculoskeletal injuries due to work.
My partner is on a list of over 1 million people across the country, NHS staff and others, waiting for mental health support. The causes are complex but have been exacerbated by work, while the irregular nature of her work adds to the challenge of fighting through NHS bureaucracy to get care. She knows better than most that services are stretched. But private care is prohibitively expensive; she is still paying off debts from studying for her nursing license.
Anxiety, stress, depression and other psychiatric illnesses are the leading cause of absence among NHS staff, far more than covid. In June 2022 alone, they lost the NHS the equivalent of 476,000 days.. Most trusts do not have dedicated staff psychiatrists or prioritize staff to see specialists; however, reducing absences and improving well-being would boost NHS productivity and results, according to think tank King’s Fund. That would help address waiting lists and reduce the drag of poor health on the broader economy.
Since the start of the pandemic, some other sectors have moved towards greater labor flexibility, but NHS arrangements remain archaic. With little or no say in when to work, many staff are finding that they would rather switch to an agency or work in an NHS bank to gain some autonomy. My girlfriend has had to cut back on her contracted hours and take banking shifts that she can more easily control.
This is a win-win situation: less job security for nurses and more staffing uncertainty for the trust, which has to use more expensive temporary workers. The Commons health and social care committee recently called on NHS employers to give all staff access to flexible working patterns, although this will mean increasing overall numbers.
Meanwhile, it is not surprising that nurses they are leaving to the highest level in a decade, fueled by young people who are not prepared to sacrifice their own well-being for their work. Retail and hospitality offer better wages and conditions. Chancellor Jeremy Hunt, a former health secretary, is well aware of the NHS staff shortage: he admitted in the summer to helping to create it. He increased NHS funding in his Autumn Statement, but needs to go further to ensure there are the resources to introduce good working practices for the 21st century.
The risk now is that the NHS begins to devour itself into a spiral of sick and overburdened staff needing treatment from a sick and overburdened service. My girlfriend loves the NHS and doesn’t want to leave it. After dropping her receipt in the mailbox, we discussed whether acknowledging the pressures in the health service would help her feel better about her job. “I guess,” she replied hesitantly. “I just want to feel good again.”