the paramedics and nurses’ strike, a symptom of a health system on its knees

In the wake of the nurses’ strike, British paramedics stopped work on Wednesday to demand an increase in their pay. A mobilization linked to the record high inflation affecting the UK, but which also highlights the ongoing crisis the public health system is going through.

After a first day of strike in mid-December, nurses took to the streets again in the United Kingdom on Tuesday. A historic mobilization – the first in 106 years – which was followed up by British paramedics on Wednesday 21 December.

In a country struggling with inflation of more than 10%, employees in many sectors, especially those from railways, logistics and border police officers, have decided to strike at the end of the year to denounce the deterioration of their working conditions and demand wage increases.

But in the case of healthcare, the economic crisis and record high inflation are adding to a series of problems that the NHS (National Health Service), an institution created in 1948 and guaranteeing Britons free access to care. Staff shortages, underfunding, repeated scandals… France 24 looks back at the reasons for this malaise.

• Years of underinvestment

While the Conservative government of Rishi Sunak has announced an NHS budget increase of 3.3 billion pounds (3.8 billion euros) next year and the following year, the British health system, whose total costs amount to 190 billion pounds a year ( 221 billion euros), first paying the price for years of austerity under successive conservative governments.

In an interview with the newspaper Le Monde, Tim Gardner, analyst from the Health Foundation and former official in the British Ministry of Health, evokes a turning point in 2015, when David Cameron’s conservative government decided to curb investment in the public sector. Hospital.

For Richard Sullivan, a professor specializing in cancer at King’s College London, the NHS crisis has been latent “for years”. “When you start overheating the engine, you wear it out,” he told AFP.

• A chronic shortage of staff

At the same time, working conditions for hospital staff have continued to deteriorate and reached a climax during the Covid-19 crisis. In particular, a chronic shortage of staff. According to the Royal College of Nursing (RCN), the main nursing trade union, there is currently a shortage of up to 50,000 nurses and 12,000 doctors in England alone. According to Ameera, a London nurse interviewed by AFP, nurses find themselves chained to shifts and under enormous pressure, creating stress and psychological problems.

Furthermore, Brexit had already dealt a blow to the workforce before the pandemic. According to a study commissioned by the British daily The Guardian, Britain’s exit from the European Union led to an estimated shortage of 4,000 doctors from the EU in four major specialties: anaesthesia, paediatrics, cardio-thoracic surgery and psychiatry. Disciplines where European doctors were previously particularly represented. The main reasons for this shortage: the uncertainty of doctors about the new rules for the movement of persons, then the tightening of the rules for issuing visas and finally the “deterioration of working conditions” in general in the health system, the ‘study’ details.

Not to mention that access to general practitioners outside hospitals is also becoming more and more complicated, forcing patients who cannot find an appointment to go to the emergency room for treatment. The situation is the same on the ambulance workers’ side, subject to the same deterioration of working conditions, condemns the GMB, their main union.

• Inadequate salary

Frustration over worsening working conditions is compounded by Britain’s cost of living crisis. According to union estimates, nurses’ real wages have fallen by 20% since 2010, with inflation exceeding 11%. In detail, the annual salary for an entry-level nurse amounts to £27,000 gross (€31,400).

“Before, with a nurse’s salary, if you wanted to treat yourself to a luxury, you could work in shifts and overtime. Now you have to work overtime to make ends meet, and it’s very difficult,” says Pauline at the microphone. in France 24. “When you deduct your pension contribution, your student loan, the cost of parking … there’s not much left to live on. Especially since you still have to add taxes and insurance. We can’t get out of it,” says Emily . Evidence of this massive drop in spending power: One in four hospitals have set up food banks to support staff, according to NHS Providers, which represents hospital groups in England.

Faced with these conditions, 25,000 nurses or midwives working in the public sector will walk out by 2021. “Poor pay is contributing to staff shortages across the UK, affecting patient safety,” the RCN union sums up. More than 7 million people are currently waiting for treatment in UK hospitals, a record high.

• Repeated scandals

Under tension, the NHS has seen its image tarnished in recent years by a series of scandals. In October 2022, a report highlighted a number of “failures” in UK maternity wards in particular. “The care provided in nearly two in five maternity wards is not good enough”, with 6% of services now considered “inadequate” and 32% considered “to be improved”, according to the text.

But it is the ambulance service that is now the most visible part of the crisis. In the British media, many testimonies lament ever longer waiting times for help, or even cases where it never arrives. The case of 18-year-old Jamie Rees, who collapsed after cardiac arrest on 1eh January, caused a wave of emotion in the country. The ambulance took over 17 minutes to arrive, too late to revive the young man.

• A political response is considered insufficient

At the moment, the government is inflexible about these demands. During a trip to Latvia on Monday, Prime Minister Rishi Sunak defended his government’s “responsible and fair” approach and assured that it would be “unsustainable” for UK public finances to meet the unions’ request. “I recognize it is difficult. It is difficult for everyone because inflation is where it is,” he admitted to the leaders of the parliamentary committees in Westminster on Tuesday. “The best way (…) to help everyone in the country is for us to come together and reduce inflation as quickly as possible,” he insisted.

For his part, Health Minister Steve Barclay met the unions on Tuesday, Tuesday, but without moving forward with a solution and condemned demands, according to him, “unaffordable”. A meeting described as “useless” by Onay Kasab, an official from the ambulance union Unite, because of this “refusal” by the minister to discuss salaries. “How does he expect to get things moving and resolve the conflict without discussing the central issue?” he asked.

But faced with the risk of seeing the movement settle in the long term, unity within the Conservatives has fractured in recent days. Some MPs from the prime minister’s camp have called on the government to let go or in any case open a more constructive dialogue with nurses and paramedics.

According to a YouGov poll published on Sunday in the Sunday Times, almost two-thirds of Britons support nurses and half of them support the ambulance strike, compared to 37% in favor of the rail workers’ strike.

With AFP


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