At the height of the Covid pandemic, Amy Fancourt felt things could change. Watching the public applaud the NHS by the millions, the 29-year-old A&E nurse felt her profession might finally be on the verge of getting the recognition it deserved.
“And then it all went out after a year, like a sad birthday candle,” she said.
The situation since the first Clap for Carers, around two and a half years ago, could hardly be more different. There are reports of nurses using food banks and struggling to heat their homes; thousands of people leave the workforce each year for retail jobs; the backlog of routine hospital treatment climbed to 6.7 million. It culminated when the Royal College of Nurses delivered its 300,000 members the first-ever strike ballot in its 106-year history.
Nurses in various specialties tell a similar story – of a workforce on the brink of burnout, watching in awe as the government cut bankers’ bonuses and dither on public sector wages.
The Department of Health and Social Care (DHSC) says it has offered most NHS workers a pay rise of £1,400 – although this remains well below the RCN’s demand for a 5% raise above inflation, which is currently 9.9%. Nurses say the pay rise falls far short of the soaring energy bills and rent hikes that have served as the backdrop to Britain’s winter of discontent.
“The problem with nursing is that you could do it for 20 years and your prospects of earning more are still limited – the opportunities are limited. People are also coming out of college in huge debt,” says ICE nurse Linda Tovey.
“My situation is not comfortable, my house is collapsing and I haven’t taken a vacation for five years.
“I love being a nurse and wouldn’t want to do anything else, but it’s getting harder and harder to do because you go home feeling guilty every night…patients are cared for by people paid a pittance.”
The real salary of nurses has fallen by 6%
An analysis by London Economics for the RCN found real earnings for nurses fell by 6%, compared to 3.2% for private sector employees. A newly qualified nurse starting in Group 5 will earn £27,000 a year in England, reaching a minimum of £33,000 in Group 6.
Niamh Bohnacker, a research nurse, was one of many to take her skills overseas in search of better pay.
“I went to work in the Middle East to increase my savings, but it’s a shame I had to because the government was unwilling to support me financially.
“I love the NHS, but coming home at the end of the day and not feeling recognized and financially valued only adds to the burnout you feel after a shift. Caring for a patient requires knowledge, expertise and skill – there is a huge responsibility.
“You give so much and if it’s not reflected in your salary, it makes a difference. You are often with patients at the most difficult time in their lives. I left frontline nursing because I couldn’t handle the pressure and intensity anymore.
For Rachael Nanikhan, an A&E pediatric nurse, there isn’t enough recognition that nursing is actually a highly specialized, degree-based subject. Average student debt was £35,000 in April 2022, according to the House of Commons Library.
“Many of my colleagues have studied for years and are incredibly competent. You can’t tell people they have to work harder when they’re working hard in the world’s sixth largest economy and they still can’t make ends meet.
Insufficient salary increases and widespread staffing shortages have created a toxic cycle in which many young nurses leave the profession just a few years after graduating, Amy says. This in turn has an impact on long-term patient care.
“I work in one of the busiest A&E’s in Europe and then come back to a house that I can’t afford to heat, that’s when it gets very real,” she says.
“London is ultimately unaffordable. A lot of people my age leave the profession to go to the Middle East or Australia because there you make a lot more money. We have a going away party every week at work now – it’s become a joke.
Strike “as a last resort”
The nurses’ strikes, which would follow industrial action in the public sector, could prove a political headache for Prime Minister Liz Truss and Health Secretary Therese Coffey. Ms Truss has previously taken a hard line on strikes, but public opinion can force her hand: a recent YouGov poll found that two-thirds of the public support industrial action by nurses.
The mini budget, in which Chancellor Kwasi Kwarteng unveiled a (now scrapped) cut in the tax rate of 45p, has drawn fury from nurses. Ministers have been forced to deny that austerity measures to balance the books will lead to lower NHS spending.
“People who make millions obviously work hard, but so do we. Binmen work hard. Toilet cleaners work hard. These are important jobs that society could not live without,” says Linda.
“At the end of the day, you need to know if your trash cans will be emptied or if someone will be at A&E’s door to make sure you stay alive.”
Mark Farmer, acting director of the London RCN region, told The Standard the government needed to raise its wage offer by 5%, saying it was “pitiful”.
“We are in a situation where you have hospitals setting up food banks and uniform programs. That’s fine, but the NHS shouldn’t have to fund this from charitable reserves.
“Inflation has increased over the past year, which is stretching wages even further. People are simply unable to cope.
The strikes are met with opposition from across the political spectrum. Conservative party chairman Jake Berry claimed on Thursday that a significant rise in nurses’ salaries would lead to inflation, saying instead that the government’s growth plan would ultimately ensure that public sector staff get better pay . Labor leader Sir Keir Starmer said he ‘doesn’t want the strikes to continue’ but can ‘understand why people are worried’.
But for many nurses, industrial action is the last resort after years of real pay cuts. The system, they say, is broken.
“Do I want to strike? No, but I don’t feel like I have a choice,” says Niamh. “We are doing this for the public, so they have the NHS they need.”