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18 December 2022

Rishi Sunak is fighting a losing battle against the nurses

If we don’t pay nurses enough, the NHS as we know it will begin to collapse. This should be ministers’ biggest concern.

By Andrew Marr

Against the nurses, the government cannot win. Journalists making predictions are in general unconvincing: like old boats in a stiff breeze, they mainly reveal their bias and frailty. But I say again, ministers cannot win this one.

Nurses are not like other workers. They tuck us in. They roll us over when we cannot move. When we are in pain, they bring us relief. They take and test the blood. They administer life-saving injections. They wrap us when we are born and they close our eyes when we die.

They are not angels, any more than the average patient is heroic. But they are mostly women – according to the Nursing and Midwifery Council, around 89 per cent are female.

The Royal College of Nursing (RCN) is immensely proud of its royal heritage – the late queen was its patron for more than 65 years – and has resisted striking since it was founded during the First World War. Is it squandering public support and behaving like an ordinary trade union, as Conservative commentators say? Maybe. But it retains plenty of support. Since November, when the strikes were first announced, public support has fallen but still stands at 52 per cent, against around 27 per cent of voters who are hostile to the strike action.

I don’t believe that a government dominated by men who “understand the numbers” is going to win majority public support against a female profession, whose physical care most of us have experienced – except under the most catastrophic circumstances, with additional deaths piling up, by when ministers will have lost all the larger arguments anyway.

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The most important of those larger arguments, about the future of the NHS itself, cannot be disentangled from its inability to retain key staff. Last year around 25,000 nurses and midwives left nursing, and around one in ten jobs are currently vacant. If you don’t pay nurses enough – and let’s be clear, by allowing their wages to remain below their 2010 real-terms level, we certainly don’t – then eventually too many will give up and the service, in general, will begin to collapse. That is what we should really be concentrating on right now.

Jake Berry, the former chairman of the Conservative Party and not, in my experience, one of life’s natural wets, says the current pay offer of 4 per cent is too low and ministers are going to have to compromise; privately, almost every Tory MP I talk to agrees with this. Settling with the nurses does not inevitably mean settling with everybody else.

Nor will the tactic of hiding behind the pay review body recommendation last forever. Yes, playing it by the book is in general a good thing and something that Tories in power need to get more practice in.

But in these circumstances, for ministers to decline to refuse in-person conversations with the RCN about pay seems unsustainable. The Scottish government, which settled on an average pay offer of 7.5 per cent, shows the kind of compromise that can be found. If we see chaotic or tragic scenes in hospitals over the Christmas and New Year break, government ministers will be blamed as much, if not more, than union leaders. 

Let’s not let it get to that stage. Rishi Sunak is attempting to lead a more “common sense” administration than his predecessors but he is still inexperienced at genuine crisis management. Sunak may not be inclined to take advice from the New Statesman, but if he did, I think we’d say: the line between steely and obstinate is a thin one.

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