The World Mind

American University's Undergraduate Foreign Policy Magazine

National Pride and a National Healthcare System: The Strikes Defining the UK’s Future

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In December of 2022, months of separate public service worker protests spiraled into the largest national health service strikes ever witnessed in British history.. Now, more than three months on since their start, Britain’s National Health Service workers show no signs of stopping as the stakes have only strengthened. At the core of these strikes are key demands by employees that have been routinely denied by the British government. The workers are asking for pay raises due to historic levels of inflation and greater overall funding for the NHS. 

This marks the NHS’ largest strike, and yet the government is still refusing to meet union demands. The government is refusing to meet the pay raises of NHS workers because they claim to be unable to afford it and for fear of increased pay leading to higher prices, thus worsening inflation and raising interest rates and mortgage payments. 

The UK has undergone a ‘cost of living crisis’ since late 2021 which has led to an decrease in British disposable incomes thanks to inflation. Although the government has attempted to aid in this crisis through support packages, such as capping household energy prices, many NHS workers say that this is still not sufficient support. Over 120 NHS trusts are expected to strike, including nurses in cancer wards, A&E departments and intensive care units.

The strikers are adamant that the public understand their need to protest. David Hendy, a 34 year old nurse, revealed his thoughts on the issue: “This job is slowly killing nurses. The nursing workforce in the last 10 years has been through hell and back. We've got through COVID, I've got colleagues who died from COVID. I myself have had it three times…morale is rock bottom.” Hendy is not alone in his experience, after decades of poor pay and the trauma of the COVID-19 pandemic, nurses are fed up. Despite being publicly supported for their heroism throughout the pandemic, many NHS workers feel unappreciated and ignored. Victoria Banerjee, a nurse for over two decades, stated that "The workload is phenomenal now and our patients are sicker than they’ve ever been.” 

Many nurses feel unable to keep up with the pressing demands placed upon them. There is a resource and staffing crisis within the NHS, magnified by over 25,000 nurses leaving the profession in the last year alone. The staff shortage means that many nurses are forced to double up on shifts and patients, performing unprecedented levels of care. Nurses have expressed their fear at endangering patients simply because they cannot adequately attend to each and every one. Pediatric nurse, Jessie Collins, revealed that “During one of my worst shifts I was the only nurse to 28 unwell children … it’s not safe and we cannot deliver the care that these children need at times.” Nurses on the picket lines have described their working conditions as dangerous and scary and their testaments reveal not just anger, but blatant fear for themselves and their patients. 

A Department of Health and Social Care spokesperson stated in an interview that “Ministers have had constructive talks with unions, including the RCN and Unison,” however these talks have not led to any sufficient action. The RCN (Royal College of Nursing) have rejected pay deals that do not properly address the impact of inflation. The core argument of the government is one of financial prudence. They refuse to increase salaries given the increase it will lead to in regards to the national budget and its potential to only worsen inflation. 

The National Health Service has played an influential role in the national fabric for decades, ever since its creation in 1948. It is regarded as a source of pride and unity for all citizens, which adds to the intensity of the recent strikes. 

History of the NHS

In 1948, following the devastation of World War II, a recently established Labour Party prime minister, Clement Attlee, set about establishing a radical new system for the British people. Atlee’s government implemented the economic reforms advocated by famed economist, John Keynes, that prioritized nationalizing industries, improving national infrastructure, and developing a welfare state designed to actively take care of three vulnerable groups in society: the young, the old, and the working class. Perhaps the most pivotal creation brought about by the new welfare state was the National Health Service, founded in 1948. 

The NHS did not provide new forms of medicine or care, but it radically transformed the average British individual’s relationship to healthcare. No longer did people pay for healthcare service on an individual basis, instead they paid collectively as taxpayers. The NHS redistributed and equalized the healthcare process, allowing everyone access to care for the first time in British history. British citizens no longer had to worry about affording care or going into debt due to high medical bills. Aneurin Bevan served as Minister of Health under Atlee’s government and was directly responsible for the creation of the NHS. The son of a coal miner, he spent his political career advocating for the working class. His foundational philosophy of the NHS can best be understood through his poignant statement that “Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community.”

The NHS continued to grow all throughout the latter of the 20th century despite major economic crises, such as the Winter of Discontent in 1978 and the rise of mass striking and inflation. Developments in healthy living and improved national knowledge surrounding daily health habits brought about lower mortality rates and changes in fatal diseases. The NHS sought to expand their care process and better understand how more external factors, such as diet, exercise, geography, and economic class were playing a role in the health of British citizens. Changes in daily habits and medical breakthroughs transformed people's understanding of the modern medicine and the NHS was capable of. 

The Politicization of Healthcare 

By the end of the 20th century, the NHS was widely beloved and respected for its life-changing impact on the British public; but it was also becoming an increasingly controversial institution in politics, with both Labour and Conservative using the NHS as a campaign and voting strategy. The demand of the NHS seemed endless and the services continued to grow in number, but this constant growth fueled by media and political attention only created a gap in which “what was possible and what was provided seemed to be widening.”

As the NHS continued to grow, so did the political debates surrounding it. Both Labour and Conservative argued over funding and regulation. In particular, many of the debates focused on the distribution of the financial burden to taxpayers and overall distribution of the national budget. Increases in immigration and national health crises became key factors in helping to politicize this institution. 

The British government has been defined by Conservative, Tory rule and a large variety of prime ministers for the past decade. As a result, the changes made to the NHS are rooted in Conservative policies. The recent downfall of the NHS is rooted in over a decade of underfunding from a Conservative government. 

A lack of staff and available resources destroyed the NHS. Waitlists for appointments are now a factor of daily life, forcing many citizens to wait months to receive basic care. This shortage has a death toll; in November of 2022, at least “1,488 patients are estimated to have died in Scotland as a result of waiting too long in emergency departments.” British citizens are dying in emergency rooms because nurses and doctors cannot tend to them with the urgency required but they are also slowly dying at home as they wait for an appointment. Delayed appointments are affecting overall well being according to a survey in which 25% of individuals said the wait for treatment has a “serious impact on their mental health” as over 7.2 million people are currently waiting for treatment. The inability of the NHS to properly support its citizens reveals a profound failure in matters of funding and organization. 

Identity Lost

Viewing the NHS strikes solely as a salary issue does not accurately portray the true issue at large. NHS employees are striking because the system is failing and the UK government is unwilling to help. The inability of the NHS to effectively provide for its patients reveals a far darker issue that goes beyond low salaries and inflation: The United Kingdom can no longer afford to take care of itself. 

The NHS is a tremendous source of pride for individuals all across the United Kingdom. In a recent study by Engage Britain, over 77% of British citizens polled stated that the NHS makes them feel proud to be British. However 20% of those surveyed also revealed that they had been forced to turn to private sector care due to limited appointments and resources. Private healthcare companies are growing rapidly as the “market for private health care in the United Kingdom has doubled since before the pandemic.” The growing influence of private healthcare across the UK demonstrates the dire nature of the situation. 

Perhaps that is why these strikes feel more intense than any other historically, and not just due to record turnout. The strikers are asking for more than a living wage; they are asking for a sense of dignity and pride that they can collectively unite behind, and above all they are asking for a sense of hope. The NHS strikes show a healthcare system that is clearly in shambles, but they also show a nation destroyed and without a unifying identity to rally behind. Even if the strikers and the government can come to an agreement based on each of their demands, it is unlikely that the true underlying issues of the strike will be solved anytime soon.