strike of nurses and ambulances, symptom of a failed health system

After a first day of strike in mid-December, the nurses took to the streets of the United Kingdom again on Tuesday. And this Wednesday, December 21, a historic mobilization of British ambulance drivers took place, the first in 106 years.

In a country suffering from inflation above 10%, workers in many sectors, including railways, logistics and border police, have decided to go on strike at the end of this year to denounce the deterioration of their working conditions and demand wage increases.

But in the case of health, the economic crisis and record inflation add to a series of problems that the National Health Service (NHS) has been facing for years, an institution created in 1948 that guarantees free access to the British to health care. Shortage of staff, insufficient funding, repeated scandals… France 24 analyzes the causes of discontent.

• Years of insufficient economic investment

While the conservative government of Rishi Sunak has announced an increase of 3,300 million pounds (3,800 million euros) in the NHS budget for next year and the following, the British health system, which costs a total of 190,000 million pounds a year (221,000 million euros), is paying the price for years of austerity under successive conservative governments.

In an interview with the newspaper ‘Le Monde’, Tim Gardner, an analyst at the Health Foundation and a former British Ministry of Health official, recalls a turning point in 2015, when the Conservative government of David Cameron decided to stop investment in the public hospital.

For Richard Sullivan, a professor specializing in cancer at King’s College London, the NHS crisis has been brewing “for years”. “Once you start to overheat the engine, you wear it out,” he told the AFP news agency.

• A Chronic Staff Shortage

At the same time, the working conditions of hospital staff have not stopped deteriorating, reaching their peak during the Covid-19 crisis. One reason is chronic staff shortages. According to the Royal College of Nursing (RCN), the main nursing union, there are currently up to 50,000 nurses and 12,000 doctors missing in England alone. According to Ameera, a nurse interviewed by AFP, all the nurses are on call non-stop and are under immense pressure, which causes them stress and psychological problems.

Furthermore, even before the pandemic, Brexit had already dealt a heavy blow to the workforce. According to a study commissioned by the British newspaper ‘The Guardian’, the departure of the United Kingdom from the European Union has caused an estimated deficit of 4,000 doctors from the EU in four major specialties: anesthesia, paediatrics, cardiothoracic surgery and psychiatry. Disciplines in which European doctors were previously particularly well represented.

The main reasons for this shortage are the uncertainty of doctors in the face of the new rules on the movement of people, the tightening of the rules for granting visas and, finally, the “deterioration of working conditions” in the health system in general. , details the study.

On the other hand, outside hospitals, access to doctors is also increasingly complicated, forcing patients who cannot find an appointment to go to the emergency room for treatment. The same goes for ambulance drivers, who suffer the same deterioration in working conditions, according to the GMB, their main union.

• Salaries are inadequate

Frustration over worsening working conditions is exacerbated by the UK cost of living crisis. According to union estimates, real wages for nurses have fallen 20% since 2010, with inflation above 11%. Specifically, the annual salary of a junior nurse is 27,000 gross pounds (31,400 euros).

“Before, with a nurse’s salary, if you wanted to afford it, you could work in shifts and do overtime. Now you have to do overtime to make ends meet, and it’s very difficult,” Pauline explained to France 24.

“When you take away the pension contribution, the student loan, the price of parking your car… there’s not much left to live on. Especially since you still have to add taxes and insurance. We can’t get ahead,” he adds Emily. One in four hospitals have set up food banks to help staff, according to NHS Providers, which represents UK hospital groups.

Given these conditions, in 2021, 25,000 nurses working in the public sector resigned. “Low wages contribute to staff shortages across the UK, which affects patient safety,” says the RCN union. More than 7 million people are currently waiting for treatment in English hospitals, a record number.

The NHS has come under pressure and its image tarnished in recent years by a series of scandals. In October 2022, a report revealed a series of “glitches” in British maternity units. “The care in almost two out of five maternity units is not good enough”, with 6% of the services qualified as “inadequate” and 32% that “need improvement”.

But it is the ambulance services that are the most visible part of the crisis. Stories of increasingly long wait times for help to arrive, and even cases where help never arrives, abound in the British media. The case of 18-year-old Jamie Rees, who suffered a cardiac arrest on January 1, caused a flurry of emotion across the country. The ambulance took more than 17 minutes to arrive at the scene, too late to revive the young man.

• A political response considered insufficient

For the moment, the Government is inflexible in the face of these demands. During a trip to Latvia on Monday, Prime Minister Rishi Sunak defended his government’s “responsible and fair” approach, saying acceding to the unions’ demands would be “unsustainable” for Britain’s public finances. “I recognize that it is difficult. It is difficult for everyone, because inflation is where it is,” he acknowledged Tuesday before the heads of parliamentary committees in Westminster. “The best way (…) to help everyone in the country is to get our batteries together and reduce inflation as soon as possible,” he insisted.

For his part, Health Minister Steve Barclay met with the unions on Tuesday, but without advancing on a solution, denouncing what he described as “unaffordable” demands. Onay Kasab, head of the Unite ambulance union, called the meeting “useless” because of the minister’s “refusal” to talk about wages. “How do you expect to get things going and resolve the conflict without debating the key issue?

But faced with the risk of the movement spreading, unity within the Conservatives has been eroded in recent days. Some deputies from the prime minister’s party have urged the government to relent or, at least, engage in a more constructive dialogue with nurses and ambulance drivers.

According to a YouGov poll published on Sunday in the ‘Sunday Times’, almost two-thirds of Britons support the nurses’ strike and half that of ambulances, compared to 37% who support the railway strikes.

This article was adapted from its original in French