‘We are all equal, so they should treat us like equals,’ says Maria, an NHS domestic worker who has worked at Whipps Cross Hospital in London for the past 18 years. Like the majority of her fellow NHS workers, Maria, who works in a patient-facing role, was on the frontline of the pandemic — a designated keyworker. Despite weekly ‘claps for carers’ and parliamentary awards, the majority of recognition given to workers like Maria in the years since the first lockdown have amounted to nothing but platitudes. Now, Maria and her colleagues are being denied one of the only tangible rewards offered to those workers: the Covid Reward bonus.

The Covid Reward bonus was promised to NHS staff as part of the Agenda for Change pay deal for 2022/2023, and meant staff on the lowest pay bands would receive a lump sum payment of £1655, to recognise their arduous work during the height of the pandemic. But, due to a technicality, a group of largely female, migrant domestic workers at Barts Health Trust in London – which encapsulates St Bartholomew’s Hospital, the Royal London Hospital, Mile End Hospital, Whipps Cross Hospital and Newham Hospital – are being denied the bonus.

The workers, members of Unite the union, are on strike to demand their worth. Originally, outsourced to the private company Serco, those workers have been brought back in-house as direct employees after a successful campaign by Unite — and, for the most part, workers are happy. ‘Things are better for us and for patients,’ Mirela, a domestic worker at St Bart’s for more than a decade, tells Tribune. ‘The quality of equipment and materials has improved, our salaries. which were previously frozen have gone up — but our dispute is that we have been excluded from the Covid Reward, and we have been unrecognised and underappreciated.’

With some 1,800 contracted workers to transfer from one contract to another, Unite agreed to a ‘phased transfer’ beginning with security staff and receptionists in November 2022. The new contract started officially on May 1, 2023, which was when the majority of the domestic workforce — including porters, catering staff and cleaners — were officially brought back in. This meant that, due to technicalities, those who joined the contract after the end of the pay year (31 March) no longer qualified to receive the bonus, while colleagues who were transferred in before the deadline did. 

‘We are not accepting this at all, because our members are now directly employed by the NHS and have been since 1 May,’ Len Hockey, a senior union representative and key organiser in the dispute, tells Tribune. ‘And given that the bonus was in recognition of the contribution that they made during the pandemic, right at its height in 2020 and 2021, it should be paid to them.’

Workers, he says, feel disenfranchised from the rest of their colleagues. Maria agrees: ‘This isn’t how we’re supposed to be treated.’

Domestic workers, who are responsible for keeping workplaces clean and tidy, providing food and catering for patients and staff and making sure things run smoothly, often go unnoticed in the workforce. This can be seen in the conversation around rail strikes, whereby complaints that train drivers are on upwards of £50,000 often overshadow the struggles of the lowest paid, often outsourced domestic workers making far less than a real living wage. It’s no secret that the outsourcing of certain groups of workers creates a two-tier workforce, with those employed directly by the NHS often receiving better pay or terms and conditions than their contracted colleagues. Temporary NHS staff and outsourced workers were initially denied the Covid Reward, before a campaign urged the government to rectify the decision. 

For Ellen, who has worked at St Bart’s Hospital for 13 years, that she and her colleagues have been denied the bonus feels like a ‘slap in the face.’ ‘If it wasn’t for us, I don’t know how the NHS would have survived [the pandemic], because we were the ones that were keeping the hospital going,’ she tells Tribune. That’s without considering the trauma hospital staff experienced, too. ‘We were seeing patients dying, or seeing them in their sickbeds, and then having to go into hospital wards to clean and bring food,’ Ellen continues. ‘And obviously, we lost family, we lost close friends and colleagues as well. It became very, very stressful.’

Mirela remembers this time acutely. ‘It was very hard,’ she says. ‘Our hospital was full of Covid, we had to deep clean everything all the time, we were short on staff, it was confusing… we put our lives at risk.’

All this is compounded by the fact that NHS workers have faced real-terms pay cuts for years, and even more so since the pandemic, as inflation spiralled to new highs. Domestic workers like Maria, Mirela, Len, and Ellen are on the lowest NHS payment band, with a salary of around £22,300 per year. ‘It’s very hard – our pay is the bottom of the line,’ says Mirela. ‘Everyone is facing the cost of living crisis, inflation has been rising for two years, and we have a lot of things we can’t afford — renting in London is expensive, transport [to work] is expensive, food is expensive. We can’t think about anything else.’ Maria says that, if she doesn’t work extra shifts, she doesn’t earn enough money to cover expenses. 

The Barts workers, who have been on strike since September – including over Christmas Day and Boxing Day, which they would usually work – are also facing staff shortages, which are threatening the welfare of both staff and patients, according to Unite. ‘Certain areas and certain wards in the hospital do not, in our view, have a sufficient level of resource,’ explains Hockey. ‘The overwork situation is impacting the staff in those areas, impacting their health and wellbeing, and also consequently impacting patient care.’

‘From the moment we come in, at 7 o’clock, you’re constantly on the go,’ says Ellen, who says that morning staff often have to complete any unfinished tasks from the previous evening before beginning their work for the day. ‘This means that breakfast is sometimes late, or we don’t have sufficient spoons or bowls or certain things we might want for patients,’ she continues. ‘You get some staff who come in earlier to avoid the impacts, but we don’t get paid overtime for that.’

Given that the striking workers are predominantly women and migrant workers, a real sense of structural inequality permeates this dispute. Outsourced workers, disproportionately Black and Asian, are some of the lowest paid workers in the country. While the recent in-sourcing win means they will now be entitled to the statutory sick pay and protection against unfair dismissal that they were previously denied, the struggle for pay justice continues. ‘We’re always the ones to be left behind, and we’re having to go out on strike to be acknowledged, which shouldn’t be the case,’ says Ellen.

Discrepancies in bonus payments aren’t limited to the NHS. Last year, the RMT union accused Eurostar of structural racism when a group of predominantly Black outsourced workers were excluded from a €600 (£512) bonus. That a similar group of workers has been inadvertently excluded from the Covid Reward bonus demonstrates the structural injustice built into the two-tier system hospitals are increasingly run on. ‘It’s grossly unfair,’ says Hockey. 

While workers on the picket line are planting their feet and demanding the ‘respect [they] deserve’, it’s clear that strikes alone aren’t enough to stop the most exploited workers from paying the price of poor policy. What’s needed, now more than ever, is a single status of worker — with a single set of employment rights — for all but the genuinely self employed. With Labour watering down its commitment to such a policy, trade unions must not only support workers in winning back their rights, but campaign politically so that they won’t have to.