Picket line beckons again for NI nurses over pay and patient safety

Heavily pregnant a week before Christmas three years ago, Lyndsay Thomson, a nurse from Co Down, was followed by an English television news crew as she took part in a historic strike.

“‘Pregnant, persistent and on the picket line’ was the headline,” she says. “They filmed me from my house the whole way through. I was marching up and down – I think people were afraid I was going to have the baby on the picket line.

“But I felt so strongly about striking. It was something we felt we had to do. We were the lowest-paid nurses in the UK back then and again nurses in Northern Ireland have found themselves in that position again.”

Then, Thomson was among 9,000 members of the Royal College of Nursing (RCN) trade union in Northern Ireland who staged a mass walkout in December 2019 – the first in its 103-year history – over pay parity and “unsafe” staffing levels.

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Yes, this may have an impact on waiting lists but the waiting lists are already ridiculous compared to the rest of the UK

Soon, she will be back on the picket lines.

Last Wednesday, the RCN in Northern Ireland, Scotland, Wales, and England – though legal turnout thresholds were narrowly missed in almost half of English NHS trusts – voted to strike over pay and patient safety concerns as part of unprecedented UK-wide action.

Representing about two-thirds of the entire NHS nursing workforce, the union is asking for a 5 per cent pay rise above the Retail Price Index (RPI) rate of inflation, which stands at more than 12 per cent. Walkouts are expected to begin before Christmas.

For Thomson, an anaesthetic nurse at the Ulster Hospital in Dundonald, there is no other option.

“I am gutted that we have found ourselves here again. But we are doing this for patient safety as well. Yes, this may have an impact on waiting lists but the waiting lists are already ridiculous compared to the rest of the UK,” she says. “I am also disgusted with our government, locally and nationally, that they have let it get this far. This is not something that’s happened overnight. This has resulted from years of underfunding, understaffing and lack of future planning.”

Unlike their counterparts in the rest of the UK, Northern Ireland’s nurses have not received a recommended minimum pay award due to the collapse of Stormont earlier this year – leaving them the worst paid in the NHS.

[ NHS waiting lists in North driving people towards private healthcare, says provider ]

Parallels between the two strike periods are obvious; by late 2019 Stormont had been in hiatus for almost three years after the two biggest parties, Sinn Féin and the DUP, clashed over a botched green energy scandal. Civil servants were left in charge and had limited powers regarding budgets and major reform programmes – which included a radical plan to overhaul the North’s health service and tackle spiralling waiting lists. Political tensions were also running high over Brexit.

Now, Stormont administrators are grappling with post-Covid NHS challenges, a much harsher economic climate and the ongoing protocol row.

Frontline hospital pressures have also intensified, with a woman in her 70s dying on an trolley at the Royal Victoria Hospital in Belfast on Friday night after waiting several hours to be admitted. On Saturday, Antrim Area Hospital declared a rare ‘major incident’ and closed to new admissions due to “unsafe” conditions. Other acute hospitals faced a similar spike without appropriate staff cover to manage it.

The development led the Department of Health to warn on Monday evening about a “serious mismatch” between the current demand for care and “the capacity of the system to deliver it”.

The former head of the Northern Ireland Civil Service, David Sterling, says the first RCN strike played a key role in the restoration of Stormont in January 2020.

“I have no doubt in my mind that the nurses’ strike was a significant factor in getting the parties back into government because they were under a significant amount of criticism at the time for allowing this situation to develop,” he says. “If you look at New Decade, New Approach [the deal that restored Stormont], one of the first things that was agreed was a pay rise for the nurses. It was there.”

Sterling says he was confident of a breakthrough at the time due to intensive political negotiations, led by former Northern secretary Julian Smith and then-tánaiste Simon Coveney.

“Put it this way; a deal was coming. The nurses’ strike was in a sense a catalyst that allowed this to happen. I would say it was a very significant factor, not the only one, but a very significant one.”

Whilst on paper, it may look as if we have appropriate numbers with new junior and international nurses coming in, the skill mix is not safe for patients

However, he doubts the second nursing strike will help break the current Stormont deadlock. “I think the DUP have backed themselves so tightly into the corner on the protocol. Even with clear signals from the EU and Irish and UK governments that there’s a sign of progress being made, I don’t think you’re going to see the DUP rush back in.

“That could change if we end up with TV screens full of back-ups at emergency departments, and the winter crisis in the health service being compounded by nursing strikes. I think the DUP would come under pressure and it might be something again that encourages them back in. But my view would be, as of today, I couldn’t say it definitely would.”

He also pointed to the absence of a formal talks process to engage the parties – similar to that which took place three years ago – which he described as “vital” in ending the stalemate.

After casting her vote to take to the picket lines for a second time, Thomson also has little faith in the devolved institutions returning.

“I hope that politicians listen to us and get back to Stormont, but I won’t hold my breath,” the RCN rep adds. “The last time we were being used very much as a political football. This time I don’t think our standing will be as good because of the protocol issue.

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“Our rationale for the first strike was pay parity but also to campaign for safe staffing because we had over 2,000 nursing vacancies back then – we still have over 2,000 vacancies now despite massive recruitment drives. Many experienced staff have gone to the private sector, and it’s still happening. A colleague who left a few weeks ago to work in a private clinic had nearly 30 years’ nursing experience, she had just had enough.”

Thomson insists the action was ultimately about improving care standards for patients.

“Whilst on paper, it may look as if we have appropriate numbers with new junior and international nurses coming in, the skill mix is not safe for patients. This is something we need to drive home. Safe staffing is about having the right number of staff in the right place at the right time.

“Patient safety is being compromised right now. We will do everything we can to maintain patient safety throughout strike action – our main action is for patient safety.”