Striking to win – use the NHS pay strikes to fight for the NHS

We're now heading towards our third national NHS strike. The decision by UNISON and GMB to call a further 2 days of strike action is welcome, and gives the strikes and the campaign to save the NHS a much needed boost.

The continuation and escalation of the action is a welcome break from the tendency to call off action which has plagued all unions the last several years.

However NHS workers are alone on strike among public sector workers. All the other public sector strikes taking place at the same time as the NHS dispute have been called off; schools, local government, civil service, universities and further education and the London Underground were all cancelled, despite ballots that were as good or better than the NHS unions.

So what is at work here? And what can NHS activists and trade unionist do to make the most of this period of action.

The strikes Labour wants

The strikes in the NHS are, to be clear, the strikes Labour wants. The Labour party has been clear it is fighting the next election on the cost of living, and the Tories handling of the NHS. Strikes by NHS workers over pay serves to keep these issues in the media, and remind the public why they should vote Labour.

Strikes by teachers, railway workers, local government workers, lecturers or civil servants, especially strikes coordinated together, serve to remind people too much of the shared class interests of the majority of us versus the employers, whose interests the Labour Party leadership represents.

So the Labour Party has given the go ahead for more NHS strikes, while working through its links with the unions to ensure all other public sector strike action is called off. This is bad for all other sectors, but that doesn't matter to the union leaderships. What matters is getting Labour elected, which is why NHS workers get to strike (for a tightly controlled time in the run up to the election, only) while others don't.

To put the present action in context, there have been no national strikes over the last 5 years while NHS workers have suffered a 20% NHS budget cut, a nursing staffing crisis, the threat of regional pay schemes, mass privatisation of services, the closure of over a dozen of A&E departments, and the dismantling of the NHS. None of these issues were deemed worthy of striking on by the union leaderships. Yet we are now being given the chance to strike in order to provide street theatre to ensure a Labour election victory.

While fully acknowledging this reality, NHS workers should use these strikes to a keep organising, build momentum behind the pay campaign and the fight against privatisation.

Lets be under no illusions though; what the NHS strikes don't do, is put any serious pressure on NHS employers or the government to give us a pay rise, or halt their ferocious attacks on the NHS.

Four hours per day, a month or two apart only created a public relations inconvenience for the government, and a brief headache for hospital management.

Four hours of cancelled surgery and outpatient appointments can be rescheduled a lot more easily than two or three days worth. They allow the system to keep working as normal. Most staff worked to clear the backlog when they returned to work, either through sense of duty or management pressure. Staff ended up working harder or staying late to ensure patients don't suffer.

The strikes for 12 hours on 29^th January, and for 24 hours on 25^th February will have more impact, but this is still a limited, one day action. The escalation of extremely slow, and at this rate will only see a couple more days of action before the election in May, when we should be ramping up the pressure with the threat of longer and more regular strikes.

So what could be done differently?

Lack of vision

The strikes continuing, and a one day per month strategy is a strategy for sinking the Tories at the election, and possibly winning a 1% pay rise as the government seeks to pay us off to avoid the inconvenience as election day gets closer.

Its far short of what we could be doing though, and reflects a paucity of vision, and dearth of belief in the abilities of NHS workers to take collective action for reasons beyond pay.

Despite low turnouts in ballots, the strike were well supported, and there was energy and anger on the picket lines, especially from staff groups like Midwives who had never take action before.

The turn out on the strikes is only a bit to do with pay, and much more to do with the pent up frustrations of many NHS employees. NHS workers have suffered decades of privatisation initiatives and reorganisations, brutal cuts to services amplifying chronic under-staffing, and bullying, bureaucratic, target obsessed management. They are struggling to keep the health service working as its being consciously dismantled.

We need to present a vision of a democratically run and accountable NHS, in contrast to the top-heavy, bureaucratic and unaccountable monstrosity Labour and the Tories have created.

The crisis in A&E services is the latest calamity to befall NHS staff as a result of the governments policies. Redressing the A&E crisis through extra staff, re-opening closed beds and reversing the cuts in social care should be part of the unions message, that we're striking to save the service from those trying to destroy it.

Fight privatisation and cuts, not just low pay

Fighting on pay is not the best use of our time. While NHS workers have a lot of social capital for the work we do, this is poorly used if its only mobilised to secure higher pay, and not to defend the NHS as a whole.

The strikes are only for a 1% payrise, which means the government could meet our demands, and cause the strikes to be called off. And 1% does nothing to re-redress the 10%+ drop in the value of our pay over the last 5 years due to inflation and the pay freeze.

The biggest issue which NHS workers and the populace agree on is opposition to NHS privatisation. Polls show 84% of people support public ownership of the NHS. Making the strikes about stopping the transfer of the NHS into private hands would earn us more support, and allow us to use the strike, our most powerful weapon, against the private sector vultures preying on the NHS.

We need a strategy which combines the fight for higher pay, with the fight against privatisation, and to transform the NHS into a better healthcare system. Linking pay with demands to renounce the PFI debt, renationalise services, close the internal market and spend the money from those areas on more staff, better services and better equipment would be a message with something for all NHS workers, no matter the grievance, and be a way of appealing to the public which is dependent on the NHS.

Our strikes will receive the strongest support when we make it clear that we are striking for the service and our patients, not for ourselves. The slogan used by the US union, National Nurses United is “Striking till our patients win”. We should adopt something similar here.

Get out on the streets

Contiguous days of action, 24,48, or72 hour strikes or increasing their frequency from monthly to weekly would increase the pressure and create more problems for hospital management and the government.

More and longer strikes would give more time to hold protests and rallies and raise public support. The strikes have been notable for their lack of public outreach. No rallies or marches have been organised by the unions to galvanise the public behind the strikers. Activists should ensure that on the next strike day, pickets march through town centres, or hold a public rally to show their opposition to government policy.

In London, health workers should rally outside the Department of Health on January 29^th to bring home their anger to the government. Given the ongoing A&E crisis, this could be the focus of protest, to push the government on the issue they are currently weakest on.

Organise

So how can we make this happen?

Firstly we need to organise. There are no substantial activists networks across NHS unions. There are few if any ways of spread reports and messages between branches and activists. There are no regular forums where NHS workers can meet to discuss what is happening and collectively plan a response. Without this basic level of communication and organisation, activists have no way of campaigning together to change union policy, and put the necessary pressure on the leaderships to secure a change of strategy.

There are however many local campaign groups involving NHS workers like Keep Our NHS Public, and organisations like the National Health Action Party, mostly made up of NHS staff.

NHS workers in these campaigns could convene a meeting to start developing an activist network which can campaign among NHS workers and within the unions for a more militant strategy.

An NHS workers network could share experiences between branches and activists, could produce an information bulletin for distribution around workplaces and on strike day, could coordinate protests and marches and direct action around the country, and provide an alternative source of leadership to the lacklustre pro-Labour official union leaderships.

At the moment the union leaderships are determining how we fight. They call action if and when they please. If we develop coordination between union branches and between hospitals, we can begin to coordinate protests and rallies, spread our message linking the fight for pay to the fight against privatisation and cuts and push the leadership to act when we want to act, and on the issues which matter to us and our patients. If we don't do this, we will continue to just be a stage army for Labour, and after the election and a Labour victory, the inaction and inertia which bedevilled NHS trade unionism under the last Labour government may return.

The 999 Call for NHS campaign group has called a 999 Convention for the NHS on February 28^th in London. The convention is an opportunity for NHS workers and union activists to meet alongside grassroots campaigns from across the NHS to discuss and plan how to join our struggles.

I would urge all union branches and NHS activists and campaign groups to attend or send delegates to participate in this important meeting, and lay the foundation for an NHS activist network which can begin to rebuild workers organisation within the NHS, and escalate the fight in the run up to the election.

Email 999callforNHS@gmail.com to register for the conference. There is an open planning meeting in Stafford on 24^th January which activists can attend to help organise the convention.

EDIT:
Danger - will the strikes happen?

There is a danger that the strikes may be called off. While this may seem far fetched, given that these strikes are only happening with the assent of the Labour Party, enough pressure from them on the union machine could get them stopped. 

UNISON and GMB have announced strike action, but UNITE has been silent as to whether its members are striking on the 29th. With only three weeks to go, they need to announce now to give members time to organise, or members may question whether the strikes will happen.


Why would the strikes get pulled? Labour is trying to show to the banks and the ruling-class that the economy (read: continuing cuts, privatisation of services and holding down wages) is safe in their hands. What better way for Labour to show it is in charge and willing to act responsibly than to ensure Labour supporting unions call off their NHS strike. They can use the worsening A&E crisis and the excuse of ensuring patient safety to cover what would be a demoralising climb down.

With the government reeling from the A&E crisis, and the withdrawal of Circle from the first privatised NHS hospital contract, we need to be stepping up the pressure, not backing off.
As patient safety is a real concern, the unions should to be demanding that the DOH gives hospitals emergency funds to reopen closed wards and create bed capacity, and shift nurses from non-emergency services to cover those beds while they find extra staff to reopen them permanently. 

For the strikes, they can still be called, but only targeting non-emergency services, and staff who don't want to strike could be moved to where they're needed in those wards and departments struggling because of lack of staff and  bed capacity. 

There is an opportunity for unions to act creatively, and assert their power by demanding hospitals get extra funding and prioritise urgent patient care to alleviate the crisis, and use the strike action to make this happen. The worst action would be to call off the strike, giving the government breathing space to try and recover from the crisis their policies caused.