Defending the NHS: the lessons of 1988

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When 37 night nurses walked out at the end of their shift at North Manchester General Hospital in January 1988 they made an immediate impact. Images of uniformed nurses on a picket line dominated the TV evening news and newspapers the next day.

But this was not a spontaneous action. The hospital had a strong joint union committee which included socialists, and a tradition of militancy. It had discussed how workers could respond to a major offensive by the Thatcher government on NHS pay and conditions. The NUPE union representative for the night staff organised the walkout to highlight threatened cuts to special duty payments.

The example set by the Manchester nurses inspired health workers across the country. Many were angry not just about pay, but also about cuts that meant they couldn't deliver a high standard of care. Nurses were also fed up with the passivity of the Royal College of Nurses in the face of Tory attacks.

At that time, 200 nurses joined NUPE in two weeks at the Royal London Hospital, with similar numbers joining NUPE and the COHSE union at the Middlesex, UCLH, Royal Free and Charing Cross hospitals. There was agreement that we should work for coordinated strikes in at least these five hospitals.

Inside the hospitals activists held open meetings to prepare for the strike, touring the wards and residences with leaflets and posters (often hand written because affordable word processers were not available). They organised strike rotas and negotiated emergency cover. At the height of the dispute London-wide coordinating meetings at the Middlesex Hospital drew dozens of activists. A new generation was drawn into struggle full of energy and confidence. This was summed up in a COHSE poster produced for the London Radical Nurses Group proclaiming "Our Time Has Come".

On 3 February the BBC reported that 40 hospitals across London were hit by strikes. There were also strikes in Leeds, Leicester, Birmingham, Sheffield, Oxford and Southampton. Large pickets of health workers were swollen by other groups of workers.

At the Royal London council workers and teachers were joined by dockers from Tilbury and Kent miners. The miners were returning the solidarity they had received from health workers during the great Miners' Strike.

Two days later there was a huge weekday demonstration in Manchester of health workers that was joined by delegations from major workplaces in the city.

Prime minister Margaret Thatcher attacked the strikers for being uncaring, but a poll for the Daily Telegraph showed that 60 percent of the public supported the strikes.

NUPE and COHSE were happy to back the strikes because they were recruiting new members hand over fist. But they tried to limit the action. London Ambulance workers narrowly rejected a call to come out in February after NUPE officials argued that the strike was "about the nurses". On 5 March the Trade Union Congress (TUC) organised a 100,000 strong demonstration for the NHS - but strikers were not allowed to address the rally.

There were further official national strikes by health workers on 14 and 15 March to coincide with the budget. These strikes were accompanied by solidarity walkouts by dockers in Tilbury, Southampton and Bristol and by bus workers across west London.

The Tories were clearly rattled by the levels of public sympathy for striking health workers. First they did a "U turn" on attempts to cut special duty payments. Then in the summer, they agreed to pay increases for nurses way above the 3 percent public sector limit.

A staff nurse qualified for 2 years received a 20 percent pay rise and a specialist community nurse 36 percent. This was partly an attempt to drive a wedge between nurses on the one hand and nursing assistants, ancillary and administrative workers on the other.

In the best organised hospitals this led to further action to improve pay grades for lower paid staff.

In 2013 the NHS faces the most determined attempt by the Tories to dismantle the NHS since its inception. The lessons of 1988 are best summed up by the words of a striking nurse at the time: "We have proved that we can organise a strike, keep public support and protect our patients."

Jim Fagan is a retired nurse, who was a NUPE nurse steward in east London in 1988