OPINION

'A Californian jet ski will create more waves than a nurses’ strike'

16 August, 2011 | By Mark Radcliffe

I was in California recently - yes, lovely, thank you.

I took my daughter on a jet ski and made friends with a sea lion. And I saw some dolphins swimming past the beach, showing off and taking the mickey out of the kite surfers. Anyway, driving from the airport we were passed by a van advertising its wares: “Relationship counselling for you and your pet,” it said.

“How do you train it to do that?” I asked our hosts. “There’s a college in the hills,” they drawled proving that, actually, Americans can be sarcastic if they want. As if George W Bush wasn’t proof enough.

But as if the training issue wasn’t curious enough, the fact that it passed us at speed intrigued me. It was in a hurry. Someone and their pet were experiencing a crisis; maybe a cat was having commitment issues and the pet counsellor was rushing to the rescue. And to collect whatever someone who manages relationships

with pets earns…I’m thinking at least £50 an hour. I thought momentarily about a career change.

I wondered what would happen if these counsellors withdrew their labour? What if they’d had enough of coaxing bunny rabbits to talk through their problems? Or what if someone decided to cut their pay? Or mess with their pensions? And they went on strike. Who would care?

Well presumably someone would - overly committed pet owners, some neurotic dogs maybe. One or two may even be angry but it wouldn’t have quite the impact of a nursing strike would it?

It’s different for nursing obviously. A nursing strike would matter. The paradox of a nursing strike is the fact that by freezing pay, increasing pension contributions and re-framing nursing from public service to economic blight, it is being told it has no value. Yet at the merest mention of industrial action nurses are told that what they do is too important for them to strike. Indeed people are affronted at the very thought. “How could they even consider doing such a thing? Don’t they even care anymore?” And let’s face it, lots of nurses would agree with them because many still find the very idea of striking an anathema.

I wonder if the problem is that discussing a nurses’ strike divides nurses in such a way as to make the action untenable. Without a unity of purpose, striking would simply be an expression of outrage rather than a political tactic designed to protect services. Let’s face it, if this government cared enough about patients to respond to a strike, nurses wouldn’t need to strike in the first place. The profession is caught between a rock and a hard place.

As always when it comes to politics, nursing will be hamstrung by its own diversity. In my view a strike is justifiable if there is a strong chance it will be effective. Personally I don’t have a problem with nurses striking; I went on strike myself in 1989 and we won that particular dispute. But I don’t believe the principle of striking is the issue; I think all that matters is the effectiveness. And I don’t believe a strike would be effective, mostly because a large number of nurses wouldn’t join it.

So what are we left with? A work-to-rule? A withdrawal of goodwill? Or just silent pockets of unfocused unhappiness that has no political manifestation?

This must be one of the hardest times to be a nursing leader because nurses are such a sprawling, disparate mass of difference. How can we make a collective and powerful defence of nursing and its purpose? Perhaps that is the most difficult - and the most important - question of our nursing times?

Readers' comments (24)

mike | 17-Aug-2011 3:12 pm
I agree and disagree with you here Mark.

I do agree that the profession is split on this issue, and is in no way unified. There is a history of fragmented apathy within Nursing, the classic case study of who best to deploy divide and conquer tactics on, because we would be too busy bitching amongst ourselves and bending over to emotional blackmail. 'We can't leave our patients', rubbish, who will be left to care for them at all if they cut our staffing levels anymore?

However, I think that a Nursing strike WOULD work, even within the current disparate state we are in, at best it will give the government a knockdown blow to show them the underdogs are coming off the ropes swinging; at worst, it may even act as a battle cry to the rest of the profession to show that we CAN do something to stand up for ourselves and change the circumstances we have to live with.

However, the strike would be truly spectacular if it is done right. If the profession came together, under the banner of not only fighting for our profession, our pay, our pensions, our status, and so on, but also fighting for our patients, fighting to increase the staffing levels that would increase patient care, then we could win. We could DEMAND the professional status, pay and working conditions that we deserve.

But we do need to come together on this issue.

If Nurses went on strike, as a whole, as a collective, as a true profession, we would effectively shut down the provision of health service in this country. We would SHOW just how indispensable we are as a profession and show the government that we are no longer an easy target. If we went on strike, we will show the government that they will mess with us at their peril, and we would WIN every single DEMAND (not negotiation) that we make very, very quickly.

Imagine a profession with a decent starting wage that reflects our status as highly skilled and qualified professionals.

Imagine protected time for, CPD, training and development, given within our working hours.

Imagine the government too afraid to even think of attacking our pensions or increments etc as they are with the GMC.

Imagine a unified profession with a single, powerful leader that represents us at governmental level on equal par with the CMO.

Imagine a LEGALISED Nurse/patient ratio (say for example 1 Nurse and a HCA or two to 6 patients) that will significantly raise the levels of patient care, allow for much more patient centered care, reduce complications and reduce the billions spent in negligence claims, etc etc etc.

I have a list of demands like this as long as the proverbial, but to get all this, to DEMAND all of this, we NEED to strike! And to do that we NEED to come together, we NEED to act as a unified, powerful collective!
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Adrian Bolt | 20-Aug-2011 10:30 am
And I don’t believe a strike would be effective, mostly because a large number of nurses wouldn’t join it.

Something we agree on although any strike would inevitably put patients lives at risk and result in nurses quicly loosing all support with the general public.
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mike | 20-Aug-2011 6:03 pm
Welander, "Something we agree on although any strike would inevitably put patients lives at risk and result in nurses quicly loosing all support with the general public." No it wouldn't. That is a common misconception.

First of all, patient lives are ALREADY at risk by piss poor staffing levels, hospital and staff cuts, etc etc etc. Any action taken by us to rectify that cannot therefore put the blame on US for endangering patients. The common cry that 'we are too important/vital to go on strike' or 'patients will suffer' are simply tools for emotional blackmail and should simply serve to remind those in power how important we are and not to mess with us or accept the consequences.

Secondly, as for public support, did the firefighters lose public support? No. They didn't. And they won their strike. Do teachers? Well, by and large they don't have public support anyway, but they still win! And once people realise that we would be fighting for THEIR services and THEIR NHS as well, then I'll bet that public support would come firmly down on our side. And on a theoretical note, what if we did lose public support? So what? A clear message HAS to be sent out to the powers that be that if they want the vital healthcare service that nurses provide, then they will have to bow to our demands, because we will not accept these conditions any longer.
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Anonymous | 21-Aug-2011 12:09 pm
"Nurses in Australia have gone on strike, although widespread industrial action was not undertaken until the 1980s, when lengthy industrial campaigns, including strikes, were used in an effort to achieve enhanced status for the profession, improved career paths and increased salaries".
-http://nej.sagepub.com/content/4/4/294.abstract

Even in recession, the UK has the 6th Highest GDP per capita in the world. However, the nurses are amongst the worst paid in the English speaking world. Do a comparison with the US , Canada and Ireland , Aus, NZ and see for yourself. I for one have worked around the globe a bit and without doubt can say that UK nurses are the most stressed and overworked I have seen. Being a nurse does not command the same respect in the UK as in other countries. Key issue : pay and conditions!

Answer : get out on the streets and strike fail once, strike again, fail better. At least you will get some respect for putting up a fight.

As soon as we get it in to our thick heads that patients will actually benefit in the long term from well looked after nurses the better. Happy nurse=happy patient.

Geddit?!
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mike | 21-Aug-2011 3:03 pm
Anonymous | 21-Aug-2011 12:09 pm HEAR HEAR!!!
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Adrian Bolt | 21-Aug-2011 6:00 pm
@ Mike

"First of all, patient lives are ALREADY at risk by piss poor staffing levels, hospital and staff cuts, etc etc etc"

And that would be improved by the rest of us going on strike how exactly?

Secondly, as for public support, did the firefighters lose public support?

No

"Support for strike action drops considerably if fire fighters do not respond to emergency calls — one in five (19%) support fire fighters taking industrial action compared with three-quarters (74%) who oppose it. This demonstrates that public concerns over safety override their support for a strike of fire fighters"

IPSOS Mori Poll dated October 2002

So firefighers can stop rescuing cats stuck up trees and retian support for their "strike" but as soon as peoples houses start burning down that's a different issue isn't it.

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mike | 21-Aug-2011 11:03 pm
"And that would be improved by the rest of us going on strike how exactly?"

Do I really need to spell it out AGAIN for you welander?

By us DEMANDING, and GETTING a legalised Nurse patient ratio and improved working conditions amongst a long list of demands. More Nurses = better care, happier Nurses = happier patients. It isn't rocket science, you really shouldn't need me to tell you that.

Okay, so public concerns outweighed the support. As I said before, so bloody what? First of all, they still won. Also, the fact that so many were so concerned that a vital service would be removed just goes to show how VITAL they are, and how IMPORTANT they are, so isn't it just common sense to give that essential service what it needs to do the job and keep the personnel happy? Because if you don't, you won't have the service you so rely on! Exactly the same goes for Nurses and healthcare! If the general public and the government rely on us so much, need us so much, consider us so essential and vital that they do not consider it acceptable for us to strike, then they damn well better give us what we need to do our job safely and well, and give us what we want to keep the personnel happy! It isn't rocket science!

Besides, I really do not think we would even need a sustained strike. How long do you think the government would be able to last when the public realise that THEY would be the ones denying them their health service by not giving us what we want?

The fact of the matter is, strikes WORK. It is a fact. Public support or not, they WORK.

And what is the alternative, would you have the status quo continue? You may be happy to bend over and take whatever the powers that be force upon our profession, but many of us are not.
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Anonymous | 23-Aug-2011 2:38 am
Well Said Mike,

Strikes are normally more about pubilicity value than anaything else. I am not aware of a nursing strike where the wards were not staffed. In alot of cases it just means the wards run on skelton crew (happening already) and people rotate at a picket during the day.

If we did want a strike with maximum publicity impact and minimum disruption we could have 'rotating' strikes and hit Manchester hospitals on one day London on the next etc. It may end up that you would only be on strike one day in two or three weeks. If neccessary those not on strike could supplement the wages of those on strike.

The reason UK nurses get such a raw deal is largely becuase of weak unions...but I believe this is changing.

You would have to strike in the interests of patients and propose some rock solid arguements for this. Not just striking for money, although practically this is a huge issue in terms of attracting good people into the profession....look at other developed countries....look at ours!
Mid-staffs is one very good example of why striking in the interests of patients is a good idea and for which a good 'moral' arguement could be proposed.

There is no doubt at this stage that a strike is 'moral' and in the interests of patients but things get particulrlay vicious during strikes and the PR battle needs to be prepared well in advance.

But I fear this is all bluster and blow....again...weak unions...weak union membership.

Overseas looks good!
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Adrian Bolt | 23-Aug-2011 7:17 am
By us DEMANDING, and GETTING a legalised Nurse patient ratio etc etc........

Mike it doesn't matter how often you throw your toys out of the pram no one is going to listen to you or your demands. And no the Firefighters didn't "win" as you put it they settled after threatening industrial action which never actually materialised in any meaningful form. And as for strikes working well it didn't work for the mine workers in 1984, or the steel workers or the ship builders or.............
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mike | 23-Aug-2011 10:06 am
Welander that is a ridiculous and weak argument. The firefighters DID strike (remember the green goddesses coming in?) And They DID win, I seem to remember the government having to back down rather quickly? Even the THREATS of further action was enough after that. And for every example you gave there, I can give one back of strikes that DID work in the end, Teachers, BA workers, tube and train workers... or here's a direct comparison for you, NURSES IN AUSTRALIA STRIKE OR THREATEN TO REGULARLY AND WIN!

And as for the miners, what is the comparison? Are the government really going to send the police in to smash the Nurses striking or get rid of Nurses as they did with the miners? Don't be a fool!

Oh, and would you like to explain why you think DEMANDING, and GETTING a legalised Nurse patient ratio wouldn't be a good thing? I wouldn't call it throwing my toys out of the pram, I'd call it trying to improve my profession and patient care.

It is a shame there are so many people with views like yours in the profession, it is why we are so weak.

Anonymous | 23-Aug-2011 2:38 am exactly. But fighting for better patient care and working conditions can be done at the same time as fighting for improved pay and status, there is no reason why the two cannot be fought for together. I think the PR battle is quite frankly already weighted very heavily in our favour. There is already widespread criticism of the governments plans for the NHS and the previous governments handling of it, there are already a large amount of people out there who have been fed a constant stream of NHS/health care scare stories by the media (mid staffs etc) who would welcome Nurses fighting to improve the conditions that allow those things to happen. As for our pay, I realise that there is a recession on and this may be a sticking point with many, but why can we not use the same argument the banks did when trying to justify their ridiculous bonuses? 'To attract and keep the best people, we must pay the best wage'. It would actually make sense to apply that to us! And it is just plain fair play to demand a higher salary considering the level of skill, education, qualifications we have, (at the moment we don't earn much more than a HCA or a till worker at Aldi or Tesco with no quals, its pathetic!) Use the argument that if they want to recruit and retain the best people instead of losing them all to a brain drain to Oz and Canada, then they best start paying us a FAIR starting wage. All we would be doing is demanding parity with other countries and public services. Also, to demand a cease to the constant attacks on our pensions/increments etc, is not I do not think an unreasonable demand either, therefore what exactly would the general public find to complain about? If they do not like the fact that the NHS isn't running and little johnny won't get seen to as quickly as he should have been because there are no Nurses left to run it, perhaps they should be reminded that if we are so essential, they should turn their attention to the government and demand that they give us what we want to get us back on the wards?

It is just a huge shame as you say that we have such a pathetic and weak union, and there are a large number of Nurses out there, as Welander aptly demonstrates, who either do not have the balls or backbone to fight, or are woefully misguided enough to swallow the emotional blackmail that has been forced on us. As Mark pointed out in the article, the ONLY reason a strike will not work, is because Nurses are so disparate and disbanded instead of working together as a collective whole.

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Adrian Bolt | 23-Aug-2011 1:57 pm
Dear God Mike how many more times are we going to go round this argument? I rally am beginning to loose the will to live now.

I have not said nor have I ever said that industrial action is ineffective just that it would not work for the nursing profession for reasons that I really can’t be bothered to explain, again. Whether the fire-fighters “won” is a debateable point they don’t seem terribly happy with their lot at the moment and no doubt will threaten more industrial action if they face substantial cuts in the current round of spending cuts.

My point about the miners strike is that even the most determined and well organised strike will fail if there is sufficient political will; the means that are employed to defeat the strike depend on the situation and the strike. Strong arm tactics were used against the miners in 1984 because they were mounting a political challenge as much as anything a challenge that was backed up with a significant amount of violence. The same tactics are hardly likely to be used to defeat a nursing strike, should one ever materialise.

A legalised nurse/ patient ratio may be a good idea in theory but rather harder to apply in practice (exactly how long is a piece of string) so demanding one is unlikely to bear fruit. So you demanding one is analogous to you personally throwing your toys out of this particular pram.

It is a relief that there are not more people with views as poorly thought out as yours but enjoy life back in the 1970’s anyway.
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Anonymous | 23-Aug-2011 2:36 pm
Dear Welander

sorry to comment but I'm just curious on your perspective of this. Are you saying that as strikes don't work at all we shouldn't even think of striking because there is no point?

Nurses in Australia striked (struck?) back in the eightes and won better pay, conditions and opportunities to advance their careers.
people, communities, even countries throughout history have striked against what they see as bad working conditions or unfair demands from those above them. I think short of rioting it's the only weapon the working classes have against those in office. You are saying this is now impotent in the 21st century?

Do I think nurses in the UK ought to strike currently? No.
But then if you told me 5 years ago that the situations such as the Stafford Trust debacle would occur I wouldn't have believed you either.
and i do think if the government continue down this road of taxation, pay freezes and cutting the numbers I don't see people wanting to come into the profession in 10-15 years time. that's the grim reality.
What do you propose Welander? Because anyone who says the NHS currently is a pillar of UK society from an economic and social perspective is at best gleefully misguided or at worst utterly bonkers.

Like 'Chemical Ali' or Gaddafi. They won't believe the house is on fire even as their clothes catch alight.

sorry but i had to say
D.
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Anonymous | 23-Aug-2011 2:44 pm
I am not nurse but I am a meber of the public. Nurses would not loose my support if they were to strike. It is about time they were united as one and shook off their chains. What price public support anyway-why do nurses care? Public support will not pay the bills The government dont care about a nurses strike because they think it will never happen-those nurses who hold the view that its not something a caring profession should do only reenforce government complacency. When Bob Crowe looks after nurses interests they will be properly rewarded like his transport workers are-the public does not hold it against them once its all over. The NMC and Unison are part of the problem-they shopuld be more aggresively pro active in gettting nurses a better deal-the only thing these unions have been able to demonstrate is the ability to keep thier members poor-stop paying subs and they would soon get the message that as union execs they have to work for a living.
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Adrian Bolt | 23-Aug-2011 4:25 pm
Pleeeeease listen to what I am saying because this really is the last time I am going to say this.

For some workers some of the time industrial action can be an extremely effective means of getting what you want. It amounts to economic blackmail but even today it can still be an effective economic weapon which depending on the circumstances may or may not be justified.

But not, in my opinion for nurses, leaving side the question of if striking is morally justifiable or not for nurses (in the current economic climate and bearing in mind the pay and conditions we already get compared to the private sector no in my opinion) strike action would be ineffective for other reasons and so for that reason alone it is a mistake for the likes of Mike to advocate it. But then Mike is obviously living in a socialist utopia of his own where Red Robbo and King Coal still hold supreme and the labour party still hold to clause 4 and sing the red flag at conferences. Sweet but hopelessly deluded, times have moved on sorry to say.

What do I propose? Privatise the NHS and replace it with an insurance based system such as they have in the rest of Europe. Let private companies provide the routine blood tests and investigations and rationalise what is left into fewer but larger centres of excellence. We have too many middling sized DGH’s, even Peter carter accepts that point. The NHS has become a huge bloated bureaucratic behemoth and it is time someone put it out of its misery.
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Anonymous | 23-Aug-2011 4:30 pm
There is some truth in what you say Welander regarding the running of the NHS-while I dont really agree on your comments regarding a strike I do think the service would be much more efficient if it were run by Tesco-I would personally welcome the day if only to see some complacent colleagues get a dose of reality
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P. Damien | 23-Aug-2011 11:34 pm
Welander Linh..are you a nurse? Your comments are a perfect example of the apathy within nursing and why things will never change. Privatise the NHS indeed.....you must be a raving tory.

Sections of the NHS are already in private hands with disastrous consequences for patient health..eg Eccleshill treatment centre (bradford)....managed to kill a patient who went for his gallbladder removing...there are scores more examples.

Mike you are spot on in your analysis.

Ultimately the RCN are to blame in my book. The blue rinsed hand maidens are completely to blame for the state of nursing in the UK.
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Yvonne Bates | 24-Aug-2011 11:59 am
Welander-Linh

Research Strike Victoria Australia 1980s
Successful and safe.
Well planned
Eventually this state got patient ratios!
And more.
Tsk
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mike | 24-Aug-2011 11:03 pm
Welander, it is your own foolish argument that is leading everyone on this merry go round. You mentioned numerous erroneous examples to try and prove a point that strike action is not feasible, and are wholly wrong in saying that it will not work for Nurses. It WILL. As others beside myself have aptly demonstrated. And to simply cast me off as a socialist shows how blind and misguided you truly are, as that is the last thing anyone could call me. Advocating a strike is not the sole preserve of the socialist. But now that you have admitted that strike action is an effective weapon, what possible reason would it not work for Nurses if we banded together and took action? There is none. It is as simple as that. If we went on strike as a whole profession, there is no way we could lose. It would not matter what the political will was, they would be forced into realising that if they did not give us exactly what we wanted, the country would have no healthcare system; that is something no government could survive, regardless of their political views or will.

I agree with you that the NHS could be much better run. But how do you think this will happen? It certainly won't be by Nurses burying their heads in the sand again.

P.Damien and Yvonne, well said.
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Adrian Bolt | 3-Sep-2011 8:46 pm
@ P.Damien I'm sure you will not let the facts get in the way of a good argument but have you considered:

The Valencia region in Spain, where 20% of health services are provided by private sector organisations, do so at a cost 25% lower than the public sector.

In Germany, a third of hospitals are run by for-profit organisations and a further third by not-for-profit organisations. All hospitals are accessible to German citizens through the national programme.

In Britain, private sector companies have operated prisons for some years. In 2010, an independent evaluation of HMP Doncaster, operated by Serco, found that “the prison is considered to be leading the way in terms of the rehabilitation revolution”.

A number of failing Local Education Authorities have been run by for-profit companies since 1999. Cambridge Education @ Islington became the education partner of the London Borough of Islington in 2000. By last year, the borough's GCSE results have nearly caught up with the national average, having once being among the worst.

In 2008 Northamptonshire County Council agreed a three-year contract with the for-profit company Edison Learning to improve seventeen primary schools and four secondary schools in the council's remit. In the first two years of the contract, the proportion of 15-year-olds achieving five good GCSEs increased from 24.8% to 33.3%.

These are just a few examples of how the private sector can and does run things better, cheaper and more efficiently than the bloated public sector you admire so much.

@Yvonne

Successful but how a wholesale walk out of nurses in acute care be considered safe. I don’t know about you but I am not sure if I would want that on my conscience. I was out in Australia in the 1990’s (not nursing at the time) but I remember the Unions were pretty strong and militant then. They were threatening to pull all the public sector workers out on strike because the NSW government wanted to cut their holiday uplift pay (a marvellous scheme whereby public sector workers were paid extra to compensate them for money they would have earned in overtime and unsocial hours payments had they not been on holiday). It was like going back in time to the 1970’s Mike would have been in heaven, still the old joke about adjusting your watches back 30 years when landing at Sydney international airport had more than a ring of truth about it. The other thing to bear in mind is that 68% of people are employed by the public sector in Australia so any strike is likely to have a bigger impact especially if it is backed up by other public sector workers. But do you really think striking is the responsible and justified thing to do at the present time with the economy just beginning to crawl out of recession?

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Yvonne Bates | 8-Sep-2011 1:17 pm
Welander Linh
Oh my!! You are ill informed.
Let me you I am English and UK trained...for starters.
I came out here as the strikes were just starting and I worked my little butt along with many others to make the wards a safe place during the strike. I presume you are thinking there were mass walkouts with no staff....Tsk! It was very well planned with work to rule attempts prior. and patient safety was always a priority.
As for " Militant" unions....we have an amazing union that fights for the rights of nurses and for the rights of patient safety.
The ultimate goals are to bring better conditions for nurses and ultimately better care for patients.
We " Militant " nurses got the 1:4 patient ratios along with other agreements with the union in the front line fully supporting our cause...and we had the full support of the public. Called respect.
This next month our " Militant " union is again working for us in our next EBA (Enterprise Bargaining Agreement ) with government to again further improve conditions for both staff and patients.It covers proposals for acute care/ mental health/ aged care, and many other issues including wages. Admitted we will not get all that we propose, but we will no doubt be treated fairly and to the benefit of patients.
We have a brilliant union, which is more than I can say for UK.
I feel very sad for nurses over there, as they seem to be the scapegoats in doing an amazing job without support.
They are fighting this because they DO care and they are still nursing..or don't you realise that?

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