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Inside the St Monica Strike

Workers at St Monica's care homes in Bristol and the South West are striking against fire and rehire. If they win, it could galvanise action across the care sector – and after the pandemic, care workers urgently need change.

A nurse helps an elderly man along a corridor. (Maskot / Getty Images)

We hear constantly of the angelic heroism and self-sacrifice of the nation’s nursing and social care workers. From the ‘clap for carers’ to the production of military-style medals and awards, an alien would reasonably assume they are among the best-paid and best-respected staff in the country. Fast forward a year or so, though, to a decades-long crisis in staffing, funding, and pay amplified by a cost of living crisis, and nurses and social care staff are feeling the squeeze more than ever.

Some have turned that discontent into action. Nurses and social care staff at four care homes in South Gloucestershire, North and North East Somerset, and Bath, run by St Monica Trust, have made the decision to strike today and on selected dates through the first half of July over their employer’s derisory ‘fire and rehire’ process. Unison, which represents the more than 100 striking staff members across the four care homes, balloted members back in May on a range of issues presented by the Trust’s issuing of new contracts, which it says compromised pre-existing terms and conditions for staff. Eighty-two percent of respondents voted in favour of action.

Specifically, the trust proposed cuts to sick pay and pay enhancements for working weekends and evenings. It also aimed to reduce contractual hours, to force housekeeping and catering staff to do jobs outside their contracts, and to reduce the time staff can take over small elements of care initiated during handover.

Martha (not her real name), a worker at one of the residential homes, told Tribune how these new contracts pushed staff to organise. ‘The new proposals at the moment are directed at all nursing staff, catering assistants, and housekeeping staff, and we are all the lowest paid sector in St Monica’s,’ she says. ‘These staff stand to lose anything from £500 to £3,500 per year. Shift patterns will also be changing, cutting one hour per day from nursing care assistants.’

Staff were initially hesitant about taking action, but say the trust’s failure to engage and alleged intimidatory tactics towards staff left them with no choice. Josh Connor, head organiser for the Bristol branch of Unison, told Tribune: ‘If it’s not a negotiation, we can only escalate. After we approached the employers saying that the workers were prepared to strike, and they still ignored it, the only option left was to take the formal ballot.’

The Trust, he continues, has placed pressure on staff to accept new contracts or risk being replaced by agency staff on a higher wage. ‘Members have contacted me to say that they’ve been in these one-to-one meetings with management, where they’ve been told that they’re being selfish, that they’re not taking care of residents, that they don’t care, that strike action is dangerous, and that they’re letting their colleagues down,’ Josh says. As a result, he adds, a number of members have gone off sick, some due to the stress of the process, and some have chosen to leave altogether.

Martha describes her personal experience. ‘I sat in a meeting with an HR person who I’d never met before, and she told me that if I strike, that just shows I don’t care for the residents.’ Martha worked throughout the pandemic, and was, and remains, there ‘holding residents’ hands when they’re dying,’ she adds.

If terms and conditions are slashed, there is no guarantee the quality of care can be maintained. As Martha points out, the use of agency workers to fill staffing gaps and undermine strikes will ultimately lower standards. ‘Many of the agency staff have had very little training, if any. Some agency staff say they’re not competent with the complex needs of some of the residents, and have limited knowledge of working with dementia patients.’ Residents, she adds, need and deserve continuity with familiar staff dedicated to their care. The strike isn’t only about the workers, then—it’s also, crucially, about the wellbeing of those they look after, putting paid to any argument that those who strike ‘don’t care’.

Moving Forward

Despite the approach taken by management, there is confidence that this action could have real impact. The length of time that striking staff have often spent working at St Monica makes them unusual in a sector widely dominated by precarity and instability. ‘Most of the social care sector has a really high turnover due to poor terms and conditions, but St Monica doesn’t,’ Josh explains. ‘People have been working there for decades, they’ve spent their careers and lives there. And having a base of workers like that is much more similar to traditionally unionised sectors, where you have people who are building up relationships for years, and have always been in that role with that employer.’

But the degradation of what might have once been good relationships goes well beyond Bristol and North Somerset. Workers across health and care are holding or facing ballots on industrial action, as a result of the widespread crises the sector has been undergoing for years. A recent survey from the Royal College of Nursing found that fifty-seven percent of nursing staff across different healthcare settings are thinking of leaving. In care homes, too, workers are leaving en masse over pay and inhumanly long shifts. When one remembers that a growing number of nurses and care workers are being forced to rely on food banks to survive—with six NHS trusts alone setting up food banks or dedicated food voucher schemes to help staff—this is hardly surprising.

Josh explained how this action could therefore set a benchmark for strike action in different health and social care settings in the future, as these crises continue to bite. If the St Monica workers are successful, he says, ‘that can then be used to show what can be achieved with strike action, and to show what standards could look like if the care sector wasn’t so bad. People will see that and think, actually, maybe we can do that too, because clearly that action brought those results, so it’s within the realm of possibility.’

That means that as the summer of strikes continues, St Monica workers are leading the way for their sector. ‘There’s a narrative that nurses’ strikes are impossible because of the job that they do,’ Josh adds. ‘I think this action is going to affect that, and I’ve already had conversations with different people who’ve been saying, “Why don’t care workers get paid more?” or, “It’s so unfair that they can’t strike.” I’ve been able to use this example, and say that actually next week, these care workers are going on strike.’ The outcome remains to be seen—but in the meantime, their fight for better is one we can all get behind.

David Williams, CEO of St Monica Trust, issued a statement regarding the strike action, claiming that the trust was subject to ‘a campaign of misinformation regarding the proposed restructure of our care homes.’ The statement says:

To be clear, our intention is not to “fire and rehire”, but to reach agreement with our care home colleagues on the best way forward.

You can read the trust’s full response to the strikes on their website.