Britain’s health workers stage biggest-ever walkout as pay negotiations hit stalemate

Tens of thousands of nurses and ambulance workers joined Britain’s largest-ever health sector strike on Monday – the latest walkout to cause disruption at the National Health Service. Public support for striking staff remains high, but negotiations with the government over pay increases have reached a stalemate.

This week is set to be the most disruptive in the 75-year history of Britain’s National Health Service (NHS), according to National Medical Director Stephen Powis.

The start of the week was set to be especially fraught as nurses and ambulance staff staged strikes on the same day, leaving the health service tens of thousands of workers short. Nurses will continue striking on Tuesday, followed by physiotherapists on Thursday and another round of strikes for ambulance staff on Friday.  

This week’s industrial action is the latest in a series of historic walkouts among Britain’s health workers that have grown in scale over the past three months – an extraordinary scenario in a country that views its universal healthcare system almost as more of a national religion than a public service.  

“Nurses are seen as the angels of the health system, and it’s unprecedented for them to actually strike,” said Tony Hockley, senior visiting fellow in the Department of Social Policy at the London School of Economics. “They’ve threatened a few times over the years but it’s never happened before.”  

Top of nurses’ demands is a pay increase to counter Britain’s soaring inflation rate, which as of December 2022 was at 9.2 percent – the worst it has been in four decades. 

Working conditions are also in the spotlight. “NHS Staff do not reach the decision to vote to strike lightly,” said NHS Workers Say No, a grassroots campaign group, in a statement. “We have had enough of our patients receiving unsafe care in an understaffed and underfunded service.”  

‘Pay, recruitment and retention’ 

Amid a cost-of-living crisis, soaring prices have hit health workers especially hard. Nurses in the UK are among the worst paid in Europe, according to OECD data. The average salary for a nurse of between £33,000 – £35,000 (€37,000 – €39,000) has lagged behind pay growth in the public and private sector, and failed to match inflation for the past 10 years.  


In early 2022, 14 percent of nurses were found to be relying on food banks run by charities that support the NHS.  

Low pay is exacerbating poor working conditions. “Pay, recruitment and retention are the biggest issues,” said Hockley. “The main driver of poor working conditions is staff vacancies but nurses are finding it hard financially to stay in the NHS. It’s losing experienced staff because they’re going to work in supermarkets.” 

Some 25,000 nurses have left the profession over just the last year, according to the Royal College of Nurses, and the shortfall of nursing professionals could reach almost 40,000 in 2023.

“They are saying that the NHS is in a serious crisis,” said Dr Jennifer Crane, lecturer in health geography at University of Bristol. “And that to strike is to show care because staff are flagging that their departments are too short-staffed to look after patients.” 

‘A special case’ 

When strikes began in December 2022, the Royal College of Nurses initially asked for a pay rise of 5 percent above inflation and has since said it could meet the government “half way”. The trade union wrote to UK Prime Minister Rishi Sunak on Saturday asking him to bring the nursing strike “to a swift close” by making “meaningful” pay offers. 

Meanwhile, Sunak said in a TalkTV interview last week that he would “love to give the nurses a massive pay rise” but said the government faced tough choices and that it was funding the NHS in other areas, such as by providing medical equipment and ambulances.  

So far, weeks of pay negotiations between workers’ unions and the government have been fruitless. The government has argued that pay increases would be unaffordable and would cause prices to rise even further – and, in turn, increase interest rates and mortgages. 

The health worker walkouts are part of a wave of industrial action sweeping Britain. Since last summer, around 500,000 public and private sector workers have staged strikes disrupting schools, universities, transport networks and the civil service. 

This has contributed to the deadlock with health staff. “The government is very concerned that it will get an inflationary pay cycle in the public sector generally,” said Hockley. “Even though there might be a special case in the NHS, where there are huge vacancy problems, it’s worried about having a special case that then spills over to every other public sector.” 

Saving the NHS 

In April an annual public sector pay review is likely to result in pay rises across a variety of services, although there is no guarantee how much health workers may receive. Pay increases in 2022 were criticised by unions for being far below what was needed to “save the NHS”.  

For now, the government in England is “resolute” about putting off pay increases until spring, “and it seems adamant to stick to that if, politically, it can weather it”, Hockley said.  

“Even if people see their own healthcare disrupted in the strikes, many people have a deep love for the NHS as an ideal and are likely to believe NHS staff when they say that [they need] to fight for change,” said Crane.  

Throughout Britain, ministers are also starting to take a divided approach. Health unions in Scotland paused strikes this week after the Scottish government agreed to start annual pay reviews early, among other measures

In Wales, many health worker strikes were averted on Monday after Health Minister Eluned Morgan offered eight health unions an extra 3 percent on top of the additional £1,400 (€1,570) already promised.  

Nursing unions in England said on Monday they would stop the strikes if Sunak made them the same offer. Otherwise, they are determined to continue. 

“They are adamant that they can’t go on providing unsafe care,” Hockley said. 



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‘Not just about pensions’: French protesters see threat to social justice in Macron’s reform

Huge crowds marched across France on Tuesday in a new round of protests against President Emmanuel Macron’s plan to raise the retirement age, signalling the opposition’s success in framing the pension debate as part of a broader battle against an economic platform they perceive as unfair.

Though police and union figures differed, all agreed the number of demonstrators had increased compared to a first round of protests on January 19, piling pressure on a government that is struggling to convince voters of the need for a pension overhaul that includes raising the legal retirement age from 62 to 64.

In Paris, where an estimated half a million people took to the streets, tens of thousands of marchers were still waiting to set off as daylight faded on the sprawling place d’Italie, several hours after the event kicked off. Reflecting the extent of opposition to the reform, the mass rally included both veteran unionists and novices, young and old, including some who said they had never attended a protest before.

“I never used to protest, but this time the government is pushing too far,” said 58-year-old Geraldine, a lab technician at the nearby Pitié-Salpetrière hospital, who declined to give her full name.

“I’ve worked 38 years already, [Covid] pandemic included, and I’m absolutely exhausted,” she said. “It’s not just two more years that the government wants us to work. It’s two more years under ever worsening conditions – and at an age when most of us are no longer fit for the job.”


People like Geraldine, who got her first full-time job aged 20 and later worked part-time to raise her daughter, have most to lose from the proposed reform, which would require them to work longer to qualify for a full pension.

So do unskilled workers like Ayed, a stock controller at a local supermarket who wore the red vest of the Force Ouvrière trade union as he marched through Paris. “I’m 42 and my back is already bust from carrying heavy loads all day long – how am I supposed to keep going in 20 years’ time?” he asked.

>> ‘I can’t take any more’: Working-class French lament Macron’s push to raise retirement age

The government has signalled there is wiggle room on some measures as parliamentary committees start examining the draft law this week. But promises to improve conditions for people who started working very young, or for mothers who interrupted their careers to look after children, have failed to offset the perception of a reform that hurts the vulnerable most.

Talk of the text’s gender imbalance has gained particular traction, not least since one of Macron’s own ministers admitted last week that it would “leave women a little penalised” – in one of several PR blunders that have marred the government’s attempts to promote its increasingly unpopular plan.

“We always knew women would get screwed – but the fact that they should admit it so casually, is simply baffling,” said 16-year-old Mia outside her high school in Paris, where students showed up at 6 o’clock in the morning hoping to blockade the building – only to find that riot police had got there first.

Elsewhere, students did succeed in occupying a handful of schools and university buildings, while a nationwide strike backed by all of France’s key unions brought disruption to public transport and oil refineries, with more strike action expected in the days and weeks to come.

‘Unnecessary and unfair’

Macron has staked his reformist credentials on passage of his flagship pension overhaul, which polls say around two thirds of the French now oppose – a figure that has risen steadily in recent weeks.

“The more French people find out about the reform, the less they support it,” Frederic Dabi, a prominent pollster at the Ifop institute, told AFP. “This is not good at all for the government.”

While Macron and his government insist on the cost-cutting merits of their proposed reform, their opponents have succeeded in framing the debate in much larger terms, focusing on the questions of how wealth is distributed under Macron, and whether the poorest will carry the burden of his proposals.

“The pension plan is both regressive in terms of quality of life and economically unfair – meaning it is fundamentally at odds with our vision,” argued Sophia Chikirou, a lawmaker from the left-wing France Unbowed (LFI) party, at the rally in Paris.

As 21-year-old protester Lalie Geffriaud put it, “It’s not just about pension reform – it’s about a broader opposition to the direction this country is taking.”

>> Will strikes force Macron to back down over French pension reforms?

The government says its proposals are necessary to keep the pension system solvent as the life expectancy of the French has grown and birth rates have declined. But unions and left-wing parties want big companies or wealthier households to pitch in more to balance the pension budget instead.

Adding to the government’s woes, its main argument was undercut earlier this month when the country’s independent Pension Advisory Council told parliament that “pension spending is not out of control – it’s relatively contained”. The assessment only strengthened a widely held belief that the reform demands needless sacrifices of the French, at a time when they are grappling with an inflation crisis and still recovering from the Covid pandemic.

“This reform is entirely unnecessary – on top of being unfair,” said retired scientist Mireille Cuniot, 69, rallying on Tuesday with dozens of other women dressed as Rosie the Riveter in her iconic blue overalls.

She added: “It’s a reform that changes nothing for the highest earners and weighs entirely on the more vulnerable – you couldn’t make it any more unfair!”

Protesters dressed as feminist icon Rosie the Riveter at the rally in Paris.
Protesters dressed as feminist icon Rosie the Riveter at the rally in Paris. © Benjamin Dodman, FRANCE 24

Talk of the reform’s perceived inequity was a recurrent theme at the protest, which drew from well beyond the ranks of the left.

“It’s the unfairness that is most shocking; it’s always the working classes who end up paying most,” said primary school teacher Eric Schwab, who described himself as leaning to the centre-right. He held up a banner that read, “I refuse to waste my life trying to earn a living”.

Schwab took issue with the government’s habit of comparing France’s legal retirement age – one of the lowest in Europe – with that of its neighbours, noting that existing rules already require many French workers to retire well past the age of 62 in order to qualify for a full pension.

“They only compare us with other countries when it suits them,” he said. “What they won’t acknowledge, is that Germans who do the same job as me earn twice as much and with classes half the size.”

The proposed changes are about more than raising the retirement age, Schwab added, denouncing an “ultra-liberal” economic platform stacked in favour of the rich.

“After the financial crisis in 2008, governments somehow found billions of euros to bail out the banks,” he said. “They know where to find the money when they need to – particularly when it’s our money they’re spending.”

Macron's critics accuse him of pushing the same neoliberal agenda as the former British prime minister, Margaret Thatcher.
Macron’s critics accuse him of pushing the same neoliberal agenda as the former British prime minister, Margaret Thatcher. © Benjamin Dodman, FRANCE 24

 

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Will strikes force Macron to back down over France pension reforms?

France is seeing a wave of strikes against Emmanuel Macron’s pension reforms on Thursday, as trains, flights, schools and even hospitals will be disrupted. Polls show a majority of the French oppose the president’s measures – and analysts say maintaining public support of strikes will be crucial to unions’ chances of forcing a U-turn. 

It is the moment everyone saw coming – the moment after Macron pushed ahead with pension reforms and France sees the huge industrial action it is (in)famous for.

The last time Macron wanted to change the pensions system, during the winter of 2019-2020, France saw its biggest strikes since 1968. Covid soon made that upheaval seem quaint, and prompted Macron to shelve his plans. But Macron was re-elected in April 2022 after promising to re-introduce these reforms, then put them to parliament earlier this month. And now the opposition appears to be even bigger than before: France’s biggest and most moderate major union, the CFDT, has joined the strike action after declining to act the previous time.

“Projections show there’ll be a huge number of people taking to the streets; 1 million to 1.5 million people, which the strike movement will be very pleased with,” noted Arnaud Benedetti, editor-in-chief of specialist French politics publication Revue politique et parlementaire.

‘They don’t want to change it’

Many polls have shown a majority of French oppose Macron’s proposals. The two main planks of the reform both go down badly: 66 percent oppose raising the retirement age from 62 to 64, while 60 percent oppose increasing the length of time paying into the system required for a full pension to 43 years, according to a survey by OpinionWay for Les Échos and Radio Classique.

“A lot of the public opposition comes from this persistent idea of a French model that has to be defended,” explained Paul Smith, a professor of French politics at Nottingham University. “It’s very difficult for the Macron government to get over that and point out that the retirement age is currently higher everywhere else – it doesn’t work because people think this is the French model, the French exception, and they don’t want to change it.”

“As well as the French attachment to the current system, the Macron government has made communication errors in trying to sell the reforms – inconsistencies in their justifications,” Benedetti added. “To start with, Macron said he was opposed to lengthening the amount of time people have to work, and of course changed his position on this. Then the government tried to legitimise the reforms by saying it would free up money for other parts of the public sector like education, before they switched to saying they’re needed to make the pensions system sustainable and thereby save it.”

The unions are hoping to pull off a repeat of what happened in 1995, when prolonged disruptive industrial action combined with broad public support to force then-president Jacques Chirac’s government to ditch pension reforms.

“The unions won in ’95 because they mobilised with massive public sympathy, and they know they need to do the same thing again if they want to win,” Smith put it.

So the big question is whether a majority of the French public would remain on the unions’ side during a protracted standoff with Macron’s government. The two other big factors determining which side will win, Benedetti noted, are “whether the union members have the means to carry on striking during a long standoff and the impact of the strikes on parliamentary politics”.

Macron lost his parliamentary majority in the legislative elections in June – complicating the bill’s passage. Luckily for Macron, France’s traditional conservative party Les Républicains (LR) have the numbers to get the bill through the National Assembly, and the party leadership is in favour.

This was by no means a given, however, seeing as many LR politicians are keen to emphasise their distinctiveness from Macron as he occupies their historic territory on the centre-right of the political spectrum – while LR’s recently elected hard-right leader Eric Ciotti sees himself as closer to far-right ex-presidential candidate Eric Zemmour than he is to Macron.

Nevertheless, LR and its ancestor parties under the likes of Chirac have longed envisaged reforming France’s pensions system in similar ways to Macron. President of the Senate Gérard Larcher, one of LR’s most influential grandees, has been particularly enthusiastic about Macron’s pension reforms – declaring that “even though they are unpopular, these reforms are essential”. Then Ciotti and his lieutenants met Macron’s Prime Minister Élisabeth Borne last week and said they were “listened to” after making demands in exchange for a deal, notably to fix the minimum monthly pension at €1,200. 

“Ciotti is mercurial, and many LR MPs don’t want to look too ‘Macron-compatible’, as they say,” Smith pointed out. “But the bottom line is that pensions reform is something they’ve historically supported, while there’s a general sense that giving Macron the support he needs makes them look important again instead of going up in smoke. And the Républicains in the Senate have been putting pressure on Républicains in the National Assembly to support the compromise struck with Borne. Gérard Larcher is the key figure here.” 

Public opinion to ‘determine’ MPs’ stances 

That said, LR support for the pension reforms is not guaranteed, especially if strikes stretch on for months and maintain broad public support. In the coming months, “LR behaviour will be determined by public opinion and what happens on the street”, Benedetti pointed out.

It is not just LR MPs Macron needs to keep onside. The president’s parliamentary bloc Ensemble owes its name to the French word for “together” – but in reality it is a heterogenous group of MPs ranging from the social democratic left to the neoliberal right. Several MPs on Ensemble’s left wing are sceptical of Macron’s pension reforms. One of the most prominent is Barbara Pompili, Macron’s environment minister from 2020 to 2022, who told BFMTV on Monday that she “couldn’t vote for the reforms at this stage”, saying that increasing the retirement age risks creating “social injustices”.

“Even now, it’s not at all sure that Macron can rely on Ensemble as the biggest party in the National Assembly to help get the reforms through,” Benedetti observed. “And as is the case for LR MPs and others, public opinion and the course of the strikes will determine the behaviour of those in Macron’s party.” 

The National Assembly is scheduled to start debating the pensions reform bill on February 6. Then the lower chamber and the Senate have until March 26 to both vote on it. If parliament rejects the legislation, Macron can always use Article 49.3, the Fifth Republic’s most controversial constitutional instrument. This allows the presidency to pass legislation without a parliamentary vote – although MPs can respond with a vote of no confidence, which if successful would shoot down the bill and the government with it, prompting fresh legislative elections. So far Borne has used it 10 times but over far less contentious matters.

“No president wants to use Article 49.3 unless they really have to,” Smith said. However, if Macron does deploy it, opposition MPs may well be reluctant to trigger new parliamentary polls: “Elections are what politicians hate most, because they’re unknowable.”

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