Recent upheavals in the Royal College of Nursing are a sign of a wider transformation among nurses and white collar workers, argue Andy Ridley and Mark L Thomas
There were unusual scenes at the end of September in the Royal College of Nursing. Delegates at an Emergency General Meeting in Birmingham clashed with the RCN’s leadership over the way it had sold the 2018 NHS pay deal to members, while the leadership in turn attacked their critics as “political infiltrators”. Such red baiting however failed to stop a motion of no confidence in the RCN Council being overwhelmingly voted through. As a result the bulk of the RCN Council has stepped down to face immediate re-election contests. The RCN’s general secretary, Janet Davies, had already resigned in late August ahead of the EGM.
All this took place in a body normally regarded as a staid, conservative “no strike” organisation that still has the Queen as its official patron! When the RCN was founded 1916 by a Conservative MP as the College of Nursing it was explicitly not to be a trade union but a body with the aim of attracting “the right sort of women” to nursing to turn it into a respectable profession. In 1935 the RCN opposed a TUC-backed Bill for a 48-hour week for all hospital employees and two years into the Second World War it responded to a Ministry of Health announcement for a minimum salary of £40 for nursing students by saying it was too high!
The RCN did not in fact register as a trade union until 1976, a full 60 years after it was founded, and only abandoned its “no strike” policy nearly 20 years later. It still remains unaffiliated to the TUC. Instead, the RCN has cultivated a self-image as an organisation for “non-political” professionals.
So what is going on? The immediate cause of the turmoil in the RCN came over pay. In the face of mounting discontent with the government’s 1 percent pay cap, and a huge recruitment and retention crisis in nursing and other health workers, the RCN launched a “Scrap the Cap” campaign last year. It organised a series of rallies and an online consultation saw 78 percent saying they would be willing to strike.
The RCN was even willing to allow rank and file activists like Danielle Tiplady, who had played a leading role in the campaign to stop the abolition of bursaries for student nurses, to speak from the platform at the rallies. And the RCN publicly announced that it would hold a formal ballot to strike — for the first time in its history — if the pay cap was not lifted. The RCN joined with 13 other health unions to submit a pay claim for 3.9 percent plus an £800 lump sum.
Then came the general election. Corbyn’s assault on austerity and the public sector pay cap touched a raw nerve. The Tories’ traumatic loss of their parliamentary majority in an election they had assumed would be a walkover convinced the government that something had to give over the pay cap.
The offer the government came up with, at 6.5 percent over three years, fell well short of the unions’ demand. With inflation running at over 3 percent, it still amounted to another real terms pay cut, even if better than one percent. But the spin machine from the Tories and the media went into overdrive. This reached ludicrous heights with the headline in The Metro that claimed nurses and other health workers would get rises of “up to” 29 percent!
Much of the inflated promotion of the deal was done by either highlighting pay rises that would only affect very few, or by rolling together the pay rise with annual increments which would be received regardless of the pay deal.
In response to the deal, there was real discontent among a significant number of health workers, perhaps most visibly in Unison where a video by long standing nurse activist Karen Reissman putting the case to reject the deal was viewed over 500,000 times and a third of delegates at Unison health conference voted against the deal.
But for the union leaderships the temptation to grab the deal and proclaim they had smashed the pay cap rather than turn their earlier combative rhetoric into a real attempt to get strike action was all too great. But this also meant, at best, not offering any great challenge to the spin on the deal, and at worst doing the government’s dirty work for it in a way that clearly misled members.
In the absence of any lead from the top, converting the discontent into a rejection of the deal proved impossible. But the final straw came over the summer, when the “pay rises” hit bank accounts and many angry staff discovered that this didn’t match even what the unions’ online pay calculators had told people to expect in many cases.
In particular, tens of thousands of health workers found that they would have to wait until their annual increment date to see half of the initial 3 percent rise due in the first year of the deal — up to eight months in some cases. The explosion of anger this led to has, so far, been greatest in the historically most conservative union to represent nurses, the RCN.
But longer term changes also underlie the discontent over the pay deal. Nursing has seen three trends over the last couple of decades.
Firstly, the need for advanced capitalism to keep the workforce healthy, or at least healthy enough to keep pumping out profit, has seen the number of nurses significantly expand, from 456,000 in 2001 to 639,000 in 2018, a 40 percent increase. Secondly, nursing has become more skilled and nurses more educated, so for example nursing is now an all graduate profession. Finally, nursing, alongside teaching, has been subjected to the most dramatic increases in work intensity of any occupation.
So, the latest Employment and Skills Survey notes, “Teachers and nurses are two professional groups that have experienced especially high levels of required work intensification…nearly three quarters of nurses report that they often or always come home from work exhausted. 57 percent of nurses reported having to work to tight deadlines ‘almost all’ or ‘all the time’ in 2017, as compared with just 28 percent in 2001.”
In such a situation, the failure of pay to keep up with the cost of living feeds real bitterness. Nor has this been unique to nursing. The last few years have seen a swathe of professional bodies representing health workers take action which had either never, or only extremely rarely, struck in the past.
During the 2011 public sector pension, the Society of Chiropodists and Podiatrists joined the strike as did Chartered Society of Physiotherapy (which had only struck once before in 1980). In the NHS pay strikes in 2014, the Society of Radiographers took its first UK wide strike in over 30 years while the Royal College of Midwives struck for the first time since it was founded in 1881. And two years ago, junior doctors, members of the British Medical Association, took sustained strike action for the first time in their history.
Postwar capitalism “proletarianised” much of white collar work, eroding any remaining privileges and subjecting white collar workers to the same pressures over pay and working conditions that manual work had long experienced. This in turn lay behind the wave of militancy by white collar workers in the late 1960s and 1970s as part of a huge upturn in strikes that swept Britain and elsewhere.
But this wasn’t simply the end of the process — nursing, like teaching or social work, has long been turned into a working class job, but there has been a continual process of squeezing more surplus labour out of them through increased capital investment, and hence often greater skill and educational qualifications together with a relentless drive to intensify the work performed.
The new militancy
This is turn has affected some of the bodies that claim to represent such workers but who tended to stay aloof from the new militancy, such as the Association of Teachers and Lecturers (ATL) which struck in 2011 (in both June and November) and which has now merged with the NUT to form the new National Education Union. Similar processes have been at work among lecturers. The most militant dispute this year was the 14 days of strikes by UCU members in the “old” universities — traditionally the most conservative party of the union.
Such realities have turned the whole ideology of “professionalism” on its head. Rather than being counter-posed to militancy, the argument has increasingly won that only by taking strike action could the integrity of the service being provided — whether education or healthcare, for example — be effectively defended.
The task for activists in the RCN is to build on what they have achieved, both by arguing to reopen the pay deal that was mis-sold to members, but also fighting to increase rank and file involvement in local RCN branches and insisting that the RCN rather than pretending to be above politics openly takes political positions. In Unison — as with the other unions that accepted the derisory pay deal — it means arguing that the union cannot put its head in the sand and pretend this is just a problem for the RCN, but that it too must address the flaws in the pay deal.
But the turmoil in the RCN highlights that fact that new forces are arriving on the battlefield.