It’s time for the Royal College of Nursing to


to save the NHS

to defeat this Tory government

and to defend all public services

When the Royal College of Nursing went on strike in December last year for the first time in its existence, it was a momentous event not only in its own history, but in the history of the National Health Service (NHS) and the development of the current strike movement. It signalled the depth of the crisis facing our public services under the current Tory government and the urgency of the fight to save the NHS. 

RCN members in Scotland and then, in April, in England electrified the strike movement and shook the government again, by rejecting completely inadequate offers and returning to strike action. That encouraged similar decisions by NHS workers in Unite and RCN members in Wales. And in another ‘first’ the Royal College of Paediatrics and Child Health has started a 3-day strike on the first day of the RCN Congress, to be followed by three more days in the following week.  

The launching of the NHS by the post-war Labour government in 1948, with its promise of health care “Free at the point of delivery” was central, along the massive expansion of subsidised public housing, to Labour’s Welfare State promise of security “From the Cradle to Grave.” The Tories voted against the creation of the NHS, but by 1951, when they squeaked back into government, it was so popular, even with middle-class Tory voters, that they didn’t dare to touch it (for similar reasons they maintained and expanded public housing). 

It was only with the election of Margaret Thatcher and the defeat of the unions in the ‘80s that the Tories felt able to attack the NHS and public housing, but with the NHS they moved very slowly. They knew that the NHS was the most treasured institution in the UK – and it still is today. 

That is why the health-workers’ strikes have the highest popularity rating of all the public-sector strikes. Millions of people across British society understand that if this government can inflict a defeat on health workers, the NHS will be finished. The initials might be incorporated in the logos of various private companies, but everything the institution stands for will be dead.

The current government wants complete privatisation of health-care, with hospitals, ambulance services, GPs’ practices, etc., becoming mere financial assets and articles of trade to increase the profits of some of the world’s most unscrupulous parasites. We know what that means because it has already happened to the care home sector. It means less security, even worse conditions and lower pay, it means deteriorating standards of treatment, and it inevitably means more abuse.

The NHS strikes are far more than ordinary trade union struggles. They are a social and political struggle. That requires clear aims and strategy and strong allies. Fortunately, our strikes are part of a broad, developing, and popular struggle across the public services.

The new workers’ movement

The ongoing wave of strikes across the public services is the most powerful and effective opposition to the present government and its policies. All those strikes are social and political struggles. They are challenging not just the current government, but the whole course of economic policy since 2010, and they have revived and rebuilt a trade union movement that had been in decline for nearly 40 years. Our strike movement has already dealt significant blows to government policies and plans – but most of all we have changed Britain. We – millions of striking workers and community supporters – are the real opposition to this vicious government. 

The Movement for Justice (MFJ) was established as an anti-racist, immigrant rights and civil rights organisation. Our membership is overwhelmingly made up of first or second generation immigrants and refugees and includes long-standing trade union activists. This has put us in a good position to appreciate and respond to the dynamism of what is effectively a new labour movement. 

The working class in Britain has never been as multiracial, multinational and integrated as it is now, and the frontline activists in most of the strikes are part of a young generation that is the most integrated element in British society. We are not tied to the bureaucratic routines and sectional divisions of an older generation of trade unionists, and we are not weighed down by the defeats those routines and divisions led to.

MFJ makes those statements because we, the strike movement, need to understand the totality of our power and achievements – the ‘big picture’ of what we have accomplished. We have to understand the nature and extent of our power in order to build on our achievements and win real victory.    

How the strength of the strike movement has grown

Our strike movement really began in the latter part of 2021, when the return of inflation began to tip many low-paid workers into deeper poverty. It started with rail strikes and the long struggle of Coventry refuse workers, and it has grown, expanded, and become more powerful from then on. As the cost of living continues to rise and undermine the standard of living of even relatively better paid workers, it has drawn in a wider range of public sector workers and aroused ever-broader community support. 

Last year the government thought it could whip up public opposition to the strikes, especially from middle class people, so it slandered the unions and the workers and it refused to negotiate. That policy completely backfired. The strikes won massive public support. They have roused the hopes and morale of communities across the country, especially working class, struggling middle class, and black & Asian communities. 

Millions of people have suffered the dire effects of government austerity policies since 2010. They have seen the public services they rely on trashed and privatised at an increasing rate. They have lived and worked through the most disastrous mishandling of the Covid-19 pandemic of any government in Europe. They have seen the corruption and cronyism at the heart of government, and now they are trying to cope with the worst inflation in any major economy, along with the economic wreckage of Brexit.  

No wonder they welcome the strikes as the real defence of public services. No wonder the strike movement is the main reason for them to have hope for a better future. Those millions of people know it is the policies of successive Tory governments – not the nurses, doctors, train drivers and other workers – that are responsible for the lengthening waiting lists and all the growing problems they experience with the public services.

Each new attack from the government has strengthened that support. Every horn honked, every thumbs-up, every expression of solidarity that has encouraged workers on picket lines and demonstrations has been a political act, a blow to the government. That support has sustained the whole strike movement – and together, strikers and community, they forced the government to the negotiating tables.

Most of the outcomes of negotiation have been disappointing, with pay rises below the inflation of food and energy prices and rents, but there have been many cases where groups of workers – dockers, refuse collectors, bus drivers, Scottish RCN and GMB members, Network Rail workers – have won some significant concessions or backed management off some new attack, certainly more than they would have got without determined strike action, and often after rejecting a series of earlier offers.

Those workers are learning from experience and are ready to take up the struggle again. And since a victory for one is a victory for all, they have given hope to public service workers in other disputes.

How the government has been weakened

The constant and growing challenge of our strike movement has dramatically weakened the authority and limited the power of the government.     

The government cannot respond to this challenge in any constructive way. It resorts to more heavy-handed repression, it brings in more laws to take our rights away (many of which it won’t be able to implement or won’t get through Parliament before a general election), and it hypes up the ‘culture wars’ rhetoric with more inhuman cruelty towards refugees and immigrants, more racism, and more homophobia and transphobia. 

Those responses are proving counter-productive and increase the tensions and divisions in the government, and between the government and other sections of the ruling class.

The Tories are stuck with these responses because they are stuck with Brexit. These are the ideologies the Tory right wing used to “Get Brexit Done” and push through more austerity and privatisation, but they are no longer working for the Tories. The majority of people in Britain, including many who voted for Brexit, recognise that it has been an unmitigated disaster that made them poorer and made their lives more difficult. Now, crucially, they have a resistance movement, a cause for hope, in our strike movement. 

Our strikes are bringing about a real shift in the balance of power between, on the one hand, working class, poor & oppressed people, and, on the other hand, the divided government and divided ruling class. It is the first significant, sustained shift in that balance of power for more than 50 years. In the late 1970s & early ‘80s, it was a shift in favour of the rich and powerful. It heralded the era of constant de-regulation, privatisation, so-called free markets, welfare cuts for the poor, tax cuts for the rich, etc. 

Those policies have broken down and become a block on any real progress. That crisis has pushed the Tories towards more extreme racist measures, authoritarianism, and to some extent towards fascism. That has produced the new and powerful resistance – our strike movement, sustained and growing for a year and a half – and as a result the balance of power is moving in our favour. 

The lessons of the English local elections

The recent local elections in England are a testimony to this change. They were largely held in the most favourable areas for the Tories. There were no council elections in Scotland, Wales, Greater London, or several major English cities – they were mostly in smaller towns and suburban or rural areas with more elderly populations. Despite that, the Tories lost over 1000 council seats that were up for election, and Labour, the Liberal Democrats and the Greens made big gains – simply because they were not Tories and, in any particular contest, they were the candidates most likely to beat the Tories. 

In addition, there was a complete wipe-out of the small number of far-right candidates for UKIP, Brexit fanatic Nigel Farage’s former party, and Reform UK, the group he is now linked to. It is most likely that their supporters voted for the Tories.

This may seem a trivial detail – but look back to the Brexit campaign when Farage was riding high and the 2019 EU election when UKIP got the biggest share of the vote in Britain. Recall the period when Boris Johnson was Prime Minister and the Tories were in fear of the growth of UKIP – when some Tory MPs were talking about an alliance with Farage and Johnson needed to get assurances of his support. 

And remember how depressing it was during the height of the Covid pandemic, when assorted fascists, right-wing conspiracy theorists, and anti-vaxxers were out on the streets and even outside hospitals, calling Covid a hoax. Remember how nurses, doctors and the Chief Medical Officer of England faced physical harassment and attacks.

Brexit has been a disaster, but why haven’t the Faragists and fascists seized on that to blame the mess on the government for supposedly making too many concessions to the EU and the banks. That has been the Tories’ fear in the recent past. It would not be rational, but Covid should have taught us that fear and uncertainty can make people act irrationally. 

Our movement is the reason why that isn’t happening now. Workers across the public sector have pushed the trade union leaderships to organise strike action, and that has grown into our present strike movement, which has won mass community support, based on rational hope. That is a victory for reason over irrationality, a shift to the left and the basis of the shift in the balance of power.

Organise to win! Strike to win!

Our strike movement is at a turning point. That is chiefly because the opportunities to win substantial victories against the government are more realisable, as a result of the shift we have created in the balance of power between our movement and the Tory government’s deepening internal crisis (even today, 13/05/23, the right-wing backers of Boris Johnson in the Conservative Democracy Group have held a conference and launched a bitter attack on the current leadership).

The same opportunities, however, mean that we can’t wait any longer to address the problems that have already held us back from achieving all we could. The principal problems are:   

  • The recurrence in nearly all the striking unions of a procedure for which there is no legal requirement and very little precedent in trade union practice: calling off strike action the moment the government or employer offers to negotiate – just when the union most needs to keep up the pressure.
  • The on-again off-again character of most strikes, calling strikes in different areas at different times, the low number of strike days in most unions – this policy of ‘little fires everywhere’ is more like a strategy for publicity than a strategy for victory.
  • The lack of coordinated strike action; despite all the ‘strike together’ talk in the early months of the strike-wave, it has rarely happened and then for special occasions like 1 February and 15 March – those have been great and tremendously powerful events where the movement can see itself, but they are not sufficient to win.

That method of conducting the struggle is determined by the top leaders and full-time officials of the unions – the managerial layer of the trade unions, who are long-time, weak, routinist bureaucrats, out of touch with the dynamism of their memberships and the communities who have so strongly supported the strike wave. They are, in effect, a pro-management managerial layer of the trade unions, who see themselves as managers of their members whose main job is to be a transmission belt of management policies to their unions, not fighters for their rank and file. They have come to view their regular connections with the state and other managements as making them a part of the same elite. Their identification with the government and capitalist managements that exploit and oppress their memberships has made them historically incapable of leading a real fight for the organised labour movement that they ostensibly head. They share the same disability with the political leadership of the Labour Party on which they impotently rely. 

Almost all these Labour tops share this same disability, whether or not they are affiliated to Labour – and regardless of any nasty things that leaders like Sharon Graham of Unite and Mike Lynch of the RMT say publicly about the present Labour leadership. 

All the pressure for action and all the dynamism in action has come from the rank-and-file membership. In nearly all cases the campaigns to reject unacceptable offers have been initiated by rank-and-file activists who are close to thinking of the mass of union members because they work with them share the same problems. And in every case, even in the few cases where national leaders have called for rejection, it is those rank and file activists who have done the real work of getting the vote out.

The most urgent task now is for rank-and-file activists to assert their authority and take control of the strikes. For that to happen there must be an organised campaign to set up elected action committees or strike committees, on an inter-union basis where possible, in every hospital, clinic, school, bus garage and other public service workplace, and to hold all-member meetings as often as possible during strikes.

Networks of these committees should consolidate connections and support in their local communities, replace current weak routinist national leaders and full-time officials where possible, and prepare to act independently when that becomes necessary.

The central purpose of these democratic rank-and-file bodies can be stated simply and is sure to be popular: Strike to Win and Defeat the Tory Government and Bring It Down.                

To achieve real victory, we need national all out indefinite strike action and extended strikes if that is not possible, we need more active mobilisation of community support, and we need strikes to be coordinated at least across sectors, such as the NHS, the education system (where it is essential to mobilise and organise together with students), the Royal Mail and postal services, and the public transport system. 

Now is the time to build those action committees, create new leadership to realise the potential of our powerful strike movement, deepen and broaden the connections and support for this new labour movement in our communities, and adopt a consistent policy of coordinated strikes. With the courage and determination of rank and file workers and community supporters committed to these policies, our strike-wave struggle can truly win. We really can save the NHS and all our public services. We really can defeat and bring down this crumbling racist Tory government. We really can renew the struggle for the humane, democratic, and equal Britain the British people deserve and increasingly crave. 


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