The 1 per cent pay rise offer to nurses has unleashed an extraordinary wave of opposition. Polling shows that 72 per cent of the public consider the offer inadequate, including 58 per cent of Tory voters. Moreover, 35 per cent of those polled declare themselves “angry.” This Thursday, it is likely that many of the millions who stood and applauded the NHS in the past will gather again to slow handclap this insult to NHS workers.
But why? At a time when the public finances are in such a mess, when millions will be grateful to hang on to a job at all and most are expecting no pay rise for themselves, why has such fury crystalised around a minimal pay increase for nurses? The answer is that it isn’t just about the nurses, but about our moral and political response to the pandemic as a whole.
The Covid-19 pandemic has been like a barium meal for the body politic—and what it has revealed about the innards of our society has been far from pretty. To start with, it has shown how basic public services have been hollowed out by a decade of austerity, leaving the country ill-prepared for a crisis and those dependent on such services exposed.
We have seen a decline in hospital beds (from 144,445 in 2010 to 127,255 in 2019), putting the NHS under greater stress; an increase in school class sizes to their largest in two decades, making socially distanced classrooms a practical impossibility; and the evisceration of Health and Safety infrastructure (with the number of full-time equivalent local authority inspectors down from 1,020 in 2010 to 543 in 2017), meaning that scrutiny of workplaces, bars and restaurants to ensure Covid-19 safety standards simply did not happen. Indeed, nearly 100,000 safety issues have been raised with the Health and Safety Executive during the pandemic, yet not one single company has been prosecuted for breaching Covid safety laws.
And, of course, as the welfare state atrophies, those who suffer most are the poorest, who are most likely to be infected, to be hospitalised, to enter intensive care and to die.
Over time, there is a very real danger that Covid-19—like tuberculosis—will become almost entirely a disease of poverty. Vaccine take-up is heavily skewed by deprivation—in the most deprived communities, little over 20 per cent of people are vaccinated to date, whereas among the most affluent it is just shy of 40 per cent, and the broad pattern holds independent of age.
Combine that with the greater exposure of poorer populations to the virus and their worse general health and, without urgent action, we face a future in which Covid-19 is all but eliminated from large parts of the population but still persists in pockets of poverty. If you add to all this the prospect that access to venues and even work could depend on having a vaccine certificate, then the insult of social exclusion is added to the injury of disease. At worst, vaccine inequity plus vaccine passports could equal a form of poverty apartheid.
But even if this nightmare scenario is avoided, the inequalities of the pandemic are already reaching far further than the public health. Those who are deprived are far more likely to have been made unemployed; those who are poorer have been spending more during the pandemic and depleting already scarce savings (while the more affluent have been saving more); children in more deprived areas have missed more schooling (at one point, when schools were “open,” 39 per cent of children from Knowsley in Merseyside were at home self-isolating) and had less opportunity to study remotely. Indeed, at the end of the first lockdown, the National Foundation for Educational Research said that the learning gap between disadvantaged students and their peers had grown by 46 per cent, as a conservative estimate.
But even this welter of evidence only tells a small part of the story. What compounds the sense of injustice is not just the way in which the deprived and the vulnerable are—on virtually any metric you care to look at—suffering more than the privileged. It is the fact that they have played the major part in fighting the pandemic. The key workers who staff the hospitals and the care homes, who keep essential shops open and public transport running, are more likely to be from a BAME background, to be born outside the UK and to earn less than the average income.
In some areas the discrepancies are particularly stark. In London, for instance, 54 per cent of those working in food retail and production and 48 per cent in health and social care are ethnic minorities. What is more, not only are vulnerable groups more likely to be on the front line, but they are most likely to die in the service of their duties. This was clear as far back as last May, when evidence was published that two-thirds of healthcare workers who had died from Covid-19 were from an ethnic minority background.
At the risk of stretching an analogy a little too far, the situation feels a bit like that in 1918, as the poor, bloody infantry returned from the trenches to a land allegedly fit for heroes, but in practice, more fit for profiteers. In the short period from April to July 2020, the wealth of the world’s billionaires rose by 27.5 per cent, to $10.2 trillion. By January 2021, the wealth of just ten men had risen by $540bn, enough to buy vaccines for everyone on the planet. Jeff Bezos alone had increased his worth by over $100bn, enough to give a bonus of over $100,000 to each of his 876,000 Amazon employees.
Closer to home, there have been multiple revelations of companies profiting unjustly from the pandemic. The most prominent case is that of SERCO which, boosted by its multiple contracts for the heavily criticised UK “test-and-trace” system, announced annual profit of some £160m in October 2020, leading to an 18 per cent surge in its share price and, later, a decision to resume dividend payments to shareholders.
All in all, the pandemic seems like an inequality wrapped up in an injustice inside a travesty. And on the day of the budget itself, another £15bn was allocated to the largely privatised test-and-trace system, while a paltry 1 per cent pay rise was offered to nurses.
It is now too late to do anything about the inequalities of death and suffering during the pandemic. But we are in a position to determine whether those who suffered more, despite contributing more, should be made to pay the costs of the response. And that general question has crystalised around the specific issue of nurses’ pay. That is why so many people are concerned, and why there is such anger.
In short, nurses’ pay is about far more than nurses’ pay. This issue encapsulates an inchoate sense that there is something rotten in the state of Britain, that we must learn from what Covid has revealed about us and that we must rebuild better. The task is to translate that visceral demand for justice into a broad movement that can translate anger into concrete achievements.
