England, Wales and Scotland section of International Socialist Alternative

Is the NHS at breaking point?

Originally published 9 January 2023 

By Matt Hirst 


There is no doubt that the NHS is at breaking point. Over a decade of deliberate underfunding of the NHS and pay cuts for NHS staff have led to this crisis.

Low pay is at the root of many of the problems facing the NHS. Staff shortages, low morale, burnt out staff and longer working weeks are all symptoms of low pay and underfunding. These are part and parcel of conscious political decisions aimed at preparing the ground for further and far-reaching privatisation of the NHS.

Government ministers claim that they follow the “independent” NHS Pay Review Body (PRB) when setting pay rises for NHS staff, despite the fact that Chancellor Jeremy Hunt, then Secretary for Health, ignored the PRB in 2014.

And this week it has been reported that government ministers, including Steve Barclay, have written to the PRB to cap the increase of NHS staff to 2% in 2023–24. This, despite estimates that inflation will be running at 5.5% during this period. When nurses have lost over 17% in real terms wage cuts over the last 13 years, this would be yet another wage cut for workers that during the Covid-19 pandemic were called heroes.

But health workers are done with claps and empty platitudes and are fighting back. Nationally, nurses in the Royal College of Nursing (RCN) took strike action at the end of last year, as well as ambulance workers, who took action across a number of NHS trusts.

But these strikes are more than just about pay. Health workers clearly recognise that these strikes are about the future of the NHS. They can see their colleagues leaving in droves due to exhaustion from being overworked. They see that applications for nursing degrees are down. They can see the grim future of the NHS should the Tories be successful in dismantling the NHS and implementing a US-style private healthcare provider. They are fighting against decades of underfunding, dismantling and the privatisation of the NHS. But striking on their own will not be enough.

Socialist Alternative has put forward demands previously to coordinate, escalate and broaden the strikes. This needs to be taken up immediately. Socialist Alternative calls on all trade unions with live strike action, and current ballots to name February 1 as a coordinated day of action. Such a Day of Action, similar to the public sector pensions strikes of 2011, could force the government onto the back foot, whilst giving confidence and support to all those taking strike action.

This could also serve as a launchpad to re-ballot where workers have failed to meet the anti-democratic Tory strike thresholds and carry the struggle into the spring and win for workers everywhere.

To stop a winter of fuel poverty, profiteering and chaos, Socialist Alternative fights for nationalisation and workers control of the rail, mail and energy companies, alongside the banks and other corporations which dominate the economy. We stand for ending the rule of the super-rich, and building a system based on planning for the needs of people and the planet: socialism.


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