‘Nurses Are Worth More’: The 1982 Health Workers’ Dispute
An account by Dale Evans, NHS worker
The 1982 pay dispute was the largest strike in the history of the NHS and greatest show of solidarity across the trade union movement since the 1926 General Strike. Unfortunately this complex and often contradictory dispute that coincided with the Falklands/Malvinas War has been forgotten. Historians of trade unionism and the Thatcher era have not recorded it. This is not hard to understand, after all nurses and other women health workers rarely count in the arena of male dominated trade unionism; their disputes – because they lack ‘industrial muscle’ are hardly noticed. But the 1982 health service pay dispute is a great story. It was a strike that involved the workforce of the single largest employer in the whole of Europe, lasted for several months, challenged new anti-trade union legislation, gained enormous public support, received solidarity action from across the trade union movement and was the largest pay dispute of the Thatcher era.
Background to the 1982 dispute
From the beginning of the NHS in 1948 nurses’ pay was regularly falling behind comparable occupations in other sectors. Nurses found themselves campaigning to catch up as their salaries were eroded by government policies on wage restraint and post war price inflation. In 1974 the Halsbury enquiry into nurses’ pay awarded them increases of between 20 and 40 per cent. The severe inflationary period of the 1970s quickly undermined the gains of 1974 and a further enquiry – the Clegg commission of 1979 – awarded nurses 9% plus additional payments. The new Tory government of 1979 implemented the Clegg awards. However, by 1982 continuing inflation and limited public sector pay increases had left the nurses’ pay lagging behind again.
There were other paternalistic and structural reasons for successive governments not taking the remuneration of nurses seriously. Nursing was overwhelmingly staffed by women and nursing was viewed as an extension of caring for a family, that is not a professional occupation. Nurses’ pay was viewed as secondary income for families where the main income was provided by men. However nearly one third of nurses were single, and in places where the economic recession of the early 1980s hit hardest nurses became the main family wage earner. The NHS policy making mechanisms were dominated by doctors and their interests came first. On a structural level the NHS was expanding. Between 1976 and 1983 the number of nurses increased by 16% to nearly 400,000. At the same time the hours worked by nurses also decreased hence increasing the overall wage bill. In 1950 they worked 48 hours per week, by 1982 this had been reduced to 371/2. Successive governments fought to contain the costs of the NHS by restricting pay increases to nurses and other non-medical employees in the NHS, by far the largest section of the NHS workforce. By 1974-75, nurses real income had increased by only 9% since the beginning of the NHS. From this peak the real value of nurses went into decline and by 1982 had decreased by 18% since the mid-1970s.
In order to redress the decline in pay for nurses and low pay for other NHS workers the unions argued for a 12% increase across the board for the 1982 pay round. However, the Tory government had already announced that public sector pay increases would be limited to 4%, but by March Norman Fowler, the Secretary of State for Social Services, issued a statement that more money was available for nurses, midwives, and the allied health professions (radiographers and physiotherapists etc.) and that an offer in the region of 6% would be made. All other non-medical staff (that is porters, cleaners, ambulance personnel, clerical staff) were to receive the 4%. To what was an obvious provocation, the health service unions had to respond.
Beginnings of the Dispute
The trade unions responded to the offer with derision; one NUPE (National Union of Public Employees) official denounced the offer as an ‘unacceptable prescription which will do nothing to alleviate the problem of low pay affecting thousands of health service workers’.
In 1981 health service trade unions affiliated to the TUC had formed the TUC health services committee under the chair of Alan Spanswick from the Confederation of Health Service Employees (COHSE). The 1982 date for the pay round was April 1; for the first time in NHS all staff except doctors were to receive their annual pay increase from the same date. This gave the unions an organisational advantage in being able to organise and negotiate for all employees on the same basis from the same date. The unions believed that their claim of 12% for all NHS staff was reasonable. The rejection of this claim by the government quickly led to industrial action by the TUC affiliated unions.
All the unions were conscious of the fact that public support for their campaign was paramount; they had no wish to alienate the public as they believed the public workers’ dispute had done in 1979’s ‘winter of discontent.’ Although an all out strike was discussed most action in the course of the dispute consisted of work stoppages by nurses and nursing auxiliaries, porters, cleaners and other staff that would not endanger patients. This was the course taken by COHSE and NUPE and the other TUC unions. The first days of action took place in May. These actions were varied across the country. In some places the NHS only offered emergency services on these days, in other areas staff worked by only performing limited duties.
At a local level unions officials received support from other public sector workers. As the summer progressed the Scottish miners came out on strike in support of the day of action. By the end of June sympathy strikes had taken place with miners, shipyard workers, factory workers and staff from government and council offices all taking part. Examples of this solidarity action came from all over the UK. Shipyard workers joined a demonstration by health workers in Glasgow, 77 schools in Nottinghamshire were affected, swimming pools in Yorkshire were closed, stoppages occurred at some of the major power stations in Yorkshire, council workers in Hackney and Tottenham also took action. By July 750 hospitals had only emergency cover. In Wakefield 4 hospitals did not have any services at all on days of action. Further solidarity action saw seamen stop a ferry leaving Felixstowe for 2 days. All of this action was in breach of the 1980 Industrial Relations Act that outlawed secondary action by one group of workers in support of another. However in August the Electricians Union managed to stop the Fleet Street printing presses rolling with a 24 hour stoppage. Sean Geraghty, the shop steward involved. was fined £1300 for contempt of court after ignoring an injunction banning the stoppage. Hundreds of health workers demonstrated in his support on the day of his hearing.
In spite of the stoppages and inconvenience to patients the dispute was widely supported by the public who perceived that the nurses were being given a raw deal. Of course patient care was compromised as waiting lists soared and operations were cancelled but this did not undermine public support.
Divisions between the unions
Outside of the TUC affiliated health service unions were the Royal College of Nursing (RCN) who represented 180,000 nurses, and other smaller unions such as the midwives, health visitors and those representing the allied health professions. These organisations were also professional bodies as well as trade unions. As professional bodies they had a regulatory role over members, provided education, and set professional standards just as the BMA (British Medical Association), and the Royal Colleges do in medicine. For these reasons the RCN did not sit easily with trade unions affiliated with the TUC, COHSE and NUPE, which had 135,000 and 80,000 nurses in their membership respectively and were also the unions representing tens of thousands of other NHS workers. This split between TUC affiliated bodies and non-affiliated unions such as the RCN was to prove crucial in the conduct of the dispute, and its final resolution.
The RCN argued that because of the public support shown for the nurses’ cause it was not necessary to engage in industrial action. Indeed its president Trevor Clay later wrote:
‘The nurses had the high moral ground through balloting at a time when the government were lambasting other unions about their lack of balloting and unrepresentative activity.’
During the days of action members of the RCN worked normally, because strike action would have been in breach of its rules (Rule 12). The RCN had only become a trade union in 1977 and in 1979 its membership had rejected the opportunity to join the TUC. A debate in 1982 concerning amending Rule 12 came to nothing.
Throughout the dispute the RCN acted independently of the TUC health unions, often meeting ministers and engaging in talks without any acknowledgement of the need for greater unity. The RCN only paid lip service to supporting non-nursing NHS staff but made it apparent that it wanted a settlement whereby porters, clerical staff and nursing auxiliaries would receive a lower pay rise than qualified nurses. Unlike the TUC unions it was willing to support the government’s idea of establishing a permanent pay review body (PRB) for nurses that would be similar to that already set up for doctors. The PRB would annually compare nurses’ pay with other sectors of the economy and make recommendations to the government.
The RCN wanted to have its cake and eat it. Its President Trevor Clay genuinely believed that its position of no strike action and talking to the government whilst constantly balloting the membership of the RCN on various matters was the most productive way to settle the dispute. This of course allowed the government to split the campaign effectively into two camps, those for and those against industrial action. Norman Fowler’s statement to the House of Commons on 18 October 1982 clearly thanked the RCN for continuing to work and lambasted the TUC unions.
COHSE and NUPE felt that the RCN was only gaining advantages with the government because of the strength of their action. Without industrial conflict the RCN would not have been invited to the negotiating table. Rodney Bickerstaffe, general secretary of NUPE, diplomatically expressed the differences:
‘I think that the RCN line ….has been that whilst they are still talking there is still hope. I don’t wish to drive any more wedges between ourselves and the RCN. It’s fine to say that whilst we are talking there is still hope, but less people would be hurt if we all threw our weight behind the industrial campaign to get proper talks.’
For both COHSE and NUPE it was a matter of principle that all the health service workers received 12%. They had major concerns about low pay in the NHS that they felt the government should address. These unions had a different approach to striking. COHSE’s 1982 conference rejected an all-out indefinite strike and supported the call for extra days of action with emergency cover only. NUPE’s conference on the other hand voted in favour of an indefinite strike with only basic emergency cover. COHSE’s position was strongly influenced by the winter of discontent. After that the union had drawn up a code of conduct for disputes whereby its members were expected to provide emergency cover and ensure that the dignity and welfare of the patients is paramount. Both unions rejected the idea of the government’s PRB, as both unions believed in annual pay negotiations based on the principles of collective bargaining.
During the course of the dispute the RCN balloted its membership on two offers both of which were rejected by the membership. From the views of the membership its seems clear that the RCN wanted to extricate itself from the dispute as quickly as possible. The members of one RCN branch wrote to the Nursing Times:
‘We find it distasteful that you [Dame Catherine Hall, an RCN negotiator] held a press conference without first referring the detail of your discussions with the secretary of state to the RCN labour relations committee for a vote….There is no mention in your misrepresented statement of referral back to the membership.’
And another member complained
‘I have just received my RCN News. Cutting through the waffle it seems that the College is attempting to sell us out for an extra 11/2p in the pound.’
Such was the divergence of views that the RCN issued a leaflet in which it fully defended its position against the accusations levelled against it.
The government also exploited the split to argue that the TUC unions had a political agenda, that is that the strike was not about health service pay but was to undermine recent trade union legislation and re-establish the former power that the unions supposedly enjoyed. On the 21 September the Health Minister Kenneth Clarke said:
‘The TUC hopes to smash the cash limits of the National Health Service in order to end pay restraint in the public sector and prepare the way for bigger claims for miners and others this winter. They are taking secondary action in order to challenge the Government’s legislation and defend their old immunities above the law.’
This lack of unity and the government’s endorsement of the RCN’s position undermined the strength and purpose of the TUC unions after the largest day of action on 22 September.
22 September 1982
22 September saw a huge show of solidarity for the NHS dispute right across the country; an estimated 2.25 million people took part in one form or another. In London 120,000 demonstrated, Aberdeen 12,000, Edinburgh 10,000, Liverpool 20,000, Norwich 2,000, Derry 3,000 – and these were just some of the many demonstrations that took place all over the country. Strikes were evident in many hospitals with only emergency cover provided. Some ambulance crews walked out and refused to provide emergency cover.
Secondary support for health workers was also very significant, 80% of the mines were closed as were 43 of 65 docks. Fleet Street workers stopped the publication of the national newspapers and many local newspapers were disrupted as well. There was some disruption to television programmes broadcast by Granada and Ulster TV. Local government services were affected with many schools being closed for part of the day. Supporting strike action was also taken by car workers at Ford and Vauxhall, and Post Offices were closed.
This day was an undoubted success and was the high point of the whole dispute for the TUC unions. Such enthusiasm would be difficult to repeat and the time for indefinite strike action had passed. The RCN was still talking to the government and seeking a way to end the dispute. And the government, very much buoyed by it victory in the Falklands/Malvinas war, took a hard line, proclaiming that the day of action had changed nothing. As many nurses pointed out the government could always find money for wars but not for funding the health service.
The fact that this historic day of action had failed to move the government left the unions in a quandary: what to do next?
The end of the dispute
Attempts to organise further days of action petered out. The dispute dragged on with only a few local actions occurring. COHSE called a delegates’ conference for 14 December to discuss the possibility of an all-out strike. In reality the split in the nursing profession between the RCN and the TUC unions had undermined the possibility of further action. Most of the action had been carried out by the other health workers. As one participant commented:
‘There was considerable resentment among the ancillaries about the nurses. The press had gone on about the nurses this the nurses that. The cleaners knew that they had stayed solid for months. Most of the nurses had crossed the picket line time after time. The cleaners felt used’.
Many of the nurses did however recognise the contribution to the dispute by other NHS workers:
‘The ancillary workers are helping us by taking action, as well as themselves…
Nurses do not have the power to fight the government on their own, they need other workers’.
By December the RCN was effectively leading the dispute with most of the discussion centred on the establishing of the PRB, which the TUC unions still rejected. The government improved its offer to 12.3% for nurses over 2 years with 7.5% to be received in the current year, and the promise of a pay review body for 1984. The RCN put the offer to its members, 80% of whom accepted. NUPE and COHSE tried to scupper the deal by recommending to its members 6.5% for the coming year without any conditions for future years. The membership rejected this. NUPE and COHSE also found themselves outvoted in the TUC health services committee where each member (14 in all) had one vote even though NUPE and COHSE represented the majority of health service workers between them. Furthermore the RCN and the other professional bodies such as the Royal College of Midwives had a slender majority on the national negotiating committee, the Whitley Council. NUPE and COHSE had been effectively outmanoeuvred. Ancillary staff received a 10.5 % deal over 2 years, receiving 6% in the current year. Both pay deals were only backdated to July even though the date for a new pay rise was the 1 April. No doubt this was an extra punishment for a workforce that had fought for a living wage.
The conservative government won the 1983 general election and the PRB was set up. Nurses were awarded between 9 and 14% in 1985 and 8% the following year. Work done by ancillary workers (porters, cleaners) were increasingly privatised with two thirds of contracts awarded to private contractors by the end of 1984. This section of the workforce was reduced by 40,000 by 1988. COHSE’s membership had peaked at 231,000 in 1982 had fallen to 218,000 by 1988. The RCN membership which had been 162,000 in 1979 reached 282,000 in 1988.
Christopher Hart, Behind the Mask: Nurses, their Unions and Nursing Policy, London 1994
Jonathan Neale, Memoirs of a Callous Picket, London, 1983
Trevor Clay Nurses, Power and Politics, London, 1987
Mick Carpenter, Working for Health: the History of COHSE, London 1988
Lifted from ‘The NHS is 60‘, a collection of radical articles on health, working in the health service and the history of the NHS, published in 2008 by the Radical History Network of North-East London
According to the COHSE history blog,
“Wednesday 22 September 1982 was one of the largest acts of solidarity in the British trade union history, with millions on strike and a national rally in London with 120,000 taking part. There were demonstrations in the following towns (not full list)
St Helens 2,000
Milton Keynes 1,200
Kings Lynn 300
There were also many rallies/marches in London eg in Hackney and Hillingdon.”