‘It feels like I’m working every day just to survive. I’m really scared about the future. If things get any worse and prices go up further, I don’t know how I’ll be able to live.’
These are the words of Mary, a 45-year-old nurse from North London. Hers is the kind of response I’ve become accustomed to when I ask nurses about the cost of living crisis, and one that encapsulates just how tough things have become—not only for nurses, but for workers across every sector, as the crisis continues to bite.
The fight for survival, as Mary describes it, has become more pronounced in the past year or so. But it’s been a problem for far longer, with NHS staff bearing the brunt of their sector being under-resourced and neglected for years. Between 2011 and 2021, NHS nurses’ average basic earnings fell by five percent in real terms, and excessive workloads have become a chronic issue. Now, with further real terms pay cuts on the cards, many have reached their breaking point.
‘I feel angry,’ says Mary. ‘NHS workers like me were classed as essential during the pandemic. Politicians applauded us and sung our praises, but when it comes to a pay rise, they change their tune quicker than anything.’
Mary explains that she sees more and more colleagues leaving the service for better-paid jobs elsewhere. This process, not just in Mary’s workplace but across the country, has become a full-blown retention crisis. More than 40,000 nurses have walked away from the NHS in the past year—one in nine of the workforce, according to analysis by the Nuffield Trust—and it’s self-perpetuating: lower staffing numbers cause further difficulties for those already struggling to stay afloat, driving more out of the Service.
‘Staffing levels in the NHS are becoming increasingly unsafe—I’ve seen it with my own eyes,’ Mary continues. This year’s NHS staff survey found only 21 percent of nurses and midwives saying there were enough staff for them to do their jobs properly, with serious consequences for both patient safety and staff wellbeing. Nonetheless, as Mary says, the spiral continues downwards. ‘More work, less money seems to be the standard in the NHS now.’
The Cost of Living Catastrophe
According to a report by NHS Providers, the membership organisation for NHS workers, 68 percent of trusts are seeing a ‘significant or severe impact’ from staff leaving for other sectors. The report also warns some nurses are skipping meals to feed and clothe their children, and that frontline staff are finding it difficult to make the journey to work because of the rising costs of fuel.
This reflects the experience of Louise, a trainee advanced nursing practitioner. ‘I have been a nurse for 16 years and never thought I’d regret choosing this profession,’ she says. But that was before her fuel costs increased this year from £38 a week to £64—and we speak before 1 October, when prices go up once again. As a result, she was recently pressed to apply for financial assistance from the Cavell Trust, a charity set up to help nurses in financial hardship. She puts it simply: ‘I cannot afford to buy food.’
Louise is not alone. A recent survey of 2,500 nurses and health workers carried out by the Cavell Trust found a shocking 14 percent were using food banks to feed themselves and their families. The survey also revealed that almost a third of nurses have difficulty covering the cost of food and heating their homes. More than a quarter (27 percent) of NHS trusts already operate food banks for staff, and another 19 percent plan to open one, to help relieve the acute financial difficulties workers are increasingly facing.
For Mary, this crisis means she needs to budget every penny. ‘By the time I’ve paid my bills, food, and travel expenses, there’s little to no money for even the most basic of luxuries. I have colleagues who have used foodbanks and know of colleagues who are having to borrow from friends or family just to get by.’
Stories have even emerged of nurses struggling with cancer being forced to work through the exhaustion and pain of chemotherapy because Universal Credit doesn’t pay the bills. Jane, a nurse in Scotland who has worked for the NHS for over fifteen years, is suffering with Long Covid. ‘I’m probably going to be on half pay in the next five months, assuming I still have a job, as I’ve not been fit to work for more than a year,’ she tells Tribune. ‘Over the last two winters, I’ve been off sick at home, but only heated my home for two hours a day. I’m dreading this winter.’
Faced with this sitaution, Jane has been forced into debt, and recently had to turn to the StepChange debt charity for support. ‘I got into a lot of short term, unsecured debt after losing some of my salary due to Long Covid,’ she explains. ‘I’m paying out £400 to these debts, so I really don’t have savings that I can fall back on.’ Again, she’s not alone: nearly three-quarters (72 percent) of NHS Trusts report more people using mental health services because of stress, debt, and poverty at present, and a study by the University of Edinburgh earlier this autumn found that one in ten public sector workers, including NHS staff, were using buy now, pay later services after being turned down for more conventional loans.
In these dire circumstances, it’s hardly a surprise growing numbers of vital workers are being forced to look for better-paid work elsewhere. Louise, for one, has asked her manager if she can have her hours compressed from five days to four, to save her money on fuel. The manager has refused. That, she says, leaves her no alternative ‘but to leave the NHS.’
Enough is Enough
Things are increasingly drastic for nurses, but the situation isn’t entirely without hope. This summer saw a wave of industrial action from workers across the country, including in the NHS, while campaigns like Enough is Enough are demanding real action on the cost of living crisis forcing so many into misery. Helen O’Connor, an NHS nurse for over 28 years, now works as a GMB union organiser, and has spoken at Enough is Enough launch rallies in London and Luton about the plight of nurses, to widespread public support. She believes the campaign is resonating with people above all because it provides a clear alternative and engages en masse—but, as she acknowledges, there’s still a lot of work to do.
‘What needs to go hand in hand with this campaign is organising in the workplace and in local communities,’ she tells Tribune. ‘People will listen to me, but they are far more likely to listen to the colleague who stood beside them every day. It’s important we draw those people in and get them working alongside us. That’s organising.’
And as Enough is Enough swells in size to hundreds of thousands, the prospect of a national nurses’ strike also looms, with a Royal College of Nursing ballot on industrial action set to open in a few days’ time. As has so often been the case with groups of workers this year, trapped in an underfunded and overstretched service haemorrhaging their colleagues, and with a government threatening yet further cuts, growing numbers see industrial action as the only way to achieve a change in direction—and polling reported in Independent Nurse suggests the public is ready to back them. After all, it isn’t just nurses who know that not only saving the NHS as we know it, but ensuring that those who work in it are secure, safe, and properly paid for the work they do, is going to take a fight.
‘Everyone deserves a pay rise,’ says Mary. ‘We are being shafted by the government, who are giving tax cuts to their mates while we, the working-class, have to scrimp, steal and borrow just to get by. We need change and we need it now. Enough really is enough—it’s beyond a joke now.’