When Chukwudubem Ifeajuna received an email from his son’s teacher warmly praising his performance, his instinct as a proud father was to reward the youngster with a treat.
But Ifeajuna, who runs a community nursing team in Surrey, in the London commuter belt, was quick to reassess, realizing she couldn’t afford even this small act of generosity.
“He’ll have to get by with a ‘golden handshake’ and a pat on the back,” said a smiling Ifeajuna, who said his three children, aged nine to 12, understand the financial constraints the family lives under.
As nurses across England and Wales prepare for their union’s first strike in more than a century next week, as part of a winter of discontent involving paramedics, railway staff, postal workers and university professors, many, like Ifeajuna , face a constant struggle to make ends meet.
The Royal College of Nursing, the profession’s union, is calling for a pay increase of 5 percentage points above retail price inflation, which was 14.2 percent in October.
The current starting salary for a nurse is £27,055 in England and Wales and £26,104 in Scotland. An experienced registered nurse in England with around seven years experience is likely to earn £32,934 a year, according to the RCN.
As the nurses try to balance household budgets in the midst of a cost of living crisis, they are also dealing with the consequences of a decade of austerity in the NHS. Although they love their work, they sometimes feel caught between the needs of their families and those of their patients, and worry that they cannot fully meet them.
Nurses interviewed by the Financial Times said their financial situation had worsened significantly in recent years. Analysis by the Health Foundation, a research organisation, found that between 2011 and 2021, the average basic income of NHS nurses fell by around 5 per cent in real terms.
Austerity began the fall. In 2010, the ConservativeThe led coalition government imposed a seven-year salary cap on the public sector, causing a significant drop in nurses’ pay compared to overall average earnings in the wider economy.
Median earnings for nurses fell by 1.2% per year in real terms between 2010 and 2017, while for employees in the economy as a whole the decline was only 0.6% per year.
A report The OECD study published Monday, examining health in 38 countries, noted that in many, pay for nurses has risen in real terms since 2010, albeit at different rates.
In many Central and Eastern European countries, nurses gained substantial pay increases between 2010 and 2020 “allowing them to partly catch up with the EU average,” the report noted.
While not all of Western Europe experienced similar increases, in Spain the average pay level was about 7 percent higher in real terms in 2020 than it was in 2010. In Belgium and the Netherlands, wages in real terms were between 7 and 10 percent higher in 2020 compared to a decade earlier, the OECD said.
Ifeajuna, whose wife works for a local bank, cannot bear to think about how the family would manage if they had to survive on wages. Two days a week, the 44-year-old who works from home doesn’t turn on the heating, instead wrapping himself in a fleece until the children come home from school. “Getting to the end of the week is really tough these days,” he said.
She can barely remember the last time the family had a vacation together. Delight at his children’s achievements is tinged with sadness at his inability to support them as he would wish. “As a parent, you feel like you’re not doing what’s best for these kids,” he added.
Victoria Khafula, a mental health nurse in a London trust and mother of two, is engaged in the same daily struggle. She regularly has to stay up to an hour past her shift due to staff shortages; Nationwide, around 47,000 nursing positions are vacant in England’s NHS, according to official data.
Last year, 25,000 nursing staff across the UK left the Nursing and Midwifery Council register, many of whom were kicked out due to low pay, according to the RCN.
Khamphula said: “I think you have to love the job. Because you end up mostly without staff. Instead of having three nurses, you have one nurse. . . So you’re overworked and you’re doing the work of two or three different nurses.”
Exhausted when she returns home, she believes her family is losing. “Not only does it affect me, but it also affects my children because when mom is tired, they are not going to have 100 percent mom.”
While on maternity leave, she had to turn twice to a food bank for vital supplies. That someone as highly qualified as Khamfula (she has two titles) had to rely on her for charitable support left her “upset, angry and sad. . . because I have worked a lot in my life and I have done a lot in my life,” she added.
Jodie Elliott, an operating room nurse who shares a flat in west London with a friend, a nurse who left the NHS for the private sector, has also seen her earning power fall inexorably during her nine years in the profession.
He often uses part of his vacation allowance to work bank shifts. “It used to be that you would do those extra agency shifts and that would pay for Christmas, or if you wanted to go on vacation. . . It used to be like your pin money. But now it is the case that those shifts attract people from one month to the next,” added Elliott, 33.
She loves her job as a pediatric nurse, but dreads having to tell anxious families that a child’s operation was canceled at the last minute due to a lack of intensive care beds or professionals to care for them.
Their experiences point to the challenge of not only hiring but also retaining staff. The RCN has emphasized that the strike is not just about wages, but also about improving patient safety by increasing the number of nurses.
As the more experienced nurses leave, Elliott says the younger staff are becoming increasingly demoralized. “We are absolutely on fire [junior staff]. They arrive, newly graduated and very excited. . .[but] after two years they have been defeated by the whole process of being a nurse.”
In August, she made the difficult decision to opt out of her pension as the only way to avoid having an overdraft each month. She bemoans the government’s inability to understand that “investing in nurses is a no-brainer” if the goal is to drive growth.
A large proportion of the economically inactive (unemployed people who are not currently looking for work) cite illness as the reason. “If we had to. . . increase staffing, we would be overcoming that backlog. We would probably put people back into the economy,” she said.
For Khamphula, the job she loves may be demanding too high a price. She said: “You get to a point where you think ‘OK, is it really worth it? . . . Because how long am I going to do this? And how long are my children going to go through this?’”