Nurses have been offered a 1 percent play rise in the current round of pay talks with the possibility of an extra half to two percent on top of that to be negotiated locally out of existing budgets. Some trusts may fund the extra pay rise out of existing funds but this would be at the expense of staff redundancies and a reduction in the quality of patient care. The Industrial Relations Services surveyed 180 trusts and found that almost half of them expected staff numbers to fall in the next 12 month (Nursing Times, January 1995).
The government's proposal angered the ruling council of the Royal College of Nursing and, for the first time in the 11-year history of the pay review body, it rejected out of hand, without balloting its 300.000 members, a pay offer.
The Royal College of Nursing has a no-strike policy which has been in force since it was founded in 1916. Five ballots have been held to try to overturn this policy but each time the moves to do so have been defeated by large majorities. But the mood is beginning to change. The RCN is considering balloting its members to end its no-strike rule again and this time it is likely that the policy will be changed.
Nurses seem to be waking up to the fact that withdrawal of labour is the chief weapon in the armoury of trade unionists. Without it, or at least the possibility of strike action if negotiations fail, a union is severely handicapped when fighting employers for better pay and working conditions.
When the previous secretary of the RCN. the late Trevor Clay, wanted to discuss nurses' pay awards with the then Health Secretary, Kenneth Clarke, because of nurses’ anger over the levels of pay. he was not granted an audience. Clarke, of course, was under no obligation to negotiate with an organisation which had abrogated its power to strike and therefore posed no threat.
If the RCN’s campaign to persuade the government to fund the full 3 percent is successful nurses will still be worse off. Inflation is currently running at over 3 percent and could go higher still. Last year's pay rise for public sector workers was only 1.5 percent. Nurses' living standards will continue to fall. But while nurses have received low rises, trust executives have awarded themselves average rises of 6.6 percent and the highest paid of these now receive over £100.000 a year (Nursing Times, January 1995).
The RCN has co-operated with the health service union UNISON (an amalgamation of COHSE, NUPE and NALGO) in recent months and a combined strike by both unions could paralyse British hospitals. But the unions have already backed down from a claim of 8 percent at the end of last year when inflation was running at less than 3 percent. It seems that the RCN. in calling for the government to fund the full 3 percent nationally, is giving the government a chance to retreat from its original position and yet still keep nurses' pay below the level of inflation. The government could feel satisfied with this result and the RCN could claim a victory without having to resort to strike action: only the nurses would be the losers.
Deteriorating conditions
In the meantime, nurses may decide to stop working the average 4.8 hours unpaid overtime that they work each week saving the NHS £180 million a year (Observer, 19 February). Nurses have seen their working conditions deteriorate in other ways: patient turnover has increased while the number of trained nurses to look after them has fallen. Newly qualified nurses, if they can obtain employment at all, are offered part-time, temporary posts. Ward sisters’ posts are being phased out in many hospitals, limiting the career prospects of staff nurses.
Some Health Service trusts have been training support workers to carry out tasks presently performed by trained nurses. A few trusts have tried to downgrade trained nurses to support workers, but the legal protection of nurses' registration may prevent this from happening.
There is no doubt that the exploitation of nurses has worsened: fewer nurses work harder for. in real terms, less pay whilst patient turnover continues to rise. But, due to fraudulent manipulation of statistics, it is difficult to assess just how much working conditions have deteriorated or how badly the trusts are performing. Much higher numbers of part-time nurses are employed, making the total number of staff seem greater whilst the number of hours worked continues to fall. In the drive to increase turnover there is pressure to discharge patients prematurely. If these patients have to return to hospital as a result of being sent home too soon they are counted as new admissions. Poor care masquerades as efficiency in the statistics.
If a patient changes consultants this is recorded as a new patient. Rosie Williams, the RCN's policy adviser, claims that nurses in Casualty Departments are having pressure put on them to record misleading information to help trusts improve their position in hospital league tables. But lengthening waiting lists highlight the continuing shortcomings of the NHS: the waiting list for treatment in London has risen by five percent in the last year (Observer, 19 February).
The increasing number of people needing treatment indicates a problem which capitalist politicians are careful to ignore. Poverty is the main cause of ill-health. Unemployment; lower wages for workers whose labour is in plentiful supply if they are unskilled or in occupations in which the demand for traditional skills is in decline; poorer housing have all affected the working class. Politicians, whether enthusiastic supporters of capitalism or apologists for the system, are unable to remedy the human misery that capitalism causes. It will take more than a strike to permanently improve nurses' conditions and people’s health. It will take a completely new way of organising our lives.
Carl Pinel
No comments:
Post a Comment