Nurses in the National Health Service: Reflections on Recent Industrial Unrest
| Published date | 01 March 1991 |
| DOI | https://doi.org/10.1108/01425459110140535 |
| Pages | 3-9 |
| Date | 01 March 1991 |
| Author | T. Sullivan,I. Christensen,D. Wan |
| Subject Matter | HR & organizational behaviour |
NURSES
IN THE
NATIONAL HEALTH SERVICE: REFLECTIONS
ON
RECENT INDUSTRIAL UNREST
3
W
hy did the nurses really go on strike
in 1988?
Nurses
in
the National
Health Service:
Reflections on Recent
Industrial Unrest
T. Sullivan, I. Christensen and D. Wan
Employee Relations, Vol. 13 No. 3. 1991, pp. 3-9
© MCB University Press, 0142-5155
The industrial unrest
during
January 1988 among nurses
in the National Health Service (NHS) raises the matter
of the attitudes and behaviour of that group of employees
to the type of industrial action, if
any,
that might be taken
by nurses. The matter became a focus of study for us
because research data collected by David Wan[1] in
September and October 1988 indicated that nurses had
an ambivalent attitude towards industrial
action.
Yet, within
two to three months, the very nurses included in his
sample were withdrawing their labour and manning a
picket line.
The Wan Model
David Wan set out to provide an empirical test of two
analytical approaches outlined by Beaumont and EIIiott[2]
as possible explanations of the union choice and union-
joining process among nurses in the
NHS. Wan
developed
two models which stressed, first, the role of
the
personal
values held by nurses on joining or not joining employee
organisations; their willingness or unwillingness to take
industrial
action;
and the nature of their "professionalism".
Secondly, he examined the institutional pattern of
employee organisations — mainly the Royal College of
Nursing (RCN), National Union of Public Employees
(NUPE) and Confederation of Health Service Employees
(COHSE) — in different parts of the National Health
Service. In addition he sought to identify and ascertain
the relative importance of key determinants that
differentiate RCN and non-RCN membership. The study
was based on a questionnaire survey of 828 qualified
nurses in six district health authorities in the North of
England and covered the full range of hospital types. All
the data had been collected before the much publicised
"strike" by some 34 night nurses on
7
January
1988.
The
stoppage appeared to have wide appeal and support within
the nursing profession. The problem was that the action
and the wide support appeared at first blush to run
contrary to the stated views of nurses in Wan's sample.
This caused us to seek to check the attitudes of nurses
following
this
apparent change
in
their expected behaviour.
This second data collection exercise involved a smaller
sample (N = 236) but it was based on the identical
sampling frame used by
Wan.
The same question on the
willingness or unwillingness of nurses to take industrial
action was used. The usual practice of giving anonymity
to respondents meant that we cannot know whether or
not the same nurses responded to our second
questionnaire.
Some Background
Ever since its birth in 1947 the NHS has had a voracious
appetite for
resources.
The major funding
has
always
been
from general taxation, with marginal relief coming from
introducing rising charges for some items such as
prescriptions, and dental and optical services. Here we
are concerned
only
with the hospitals, and these
have
been
totally funded by the state for
capital,
material and labour
inputs. The major
way
in which costs have been controlled
is by central determination of
pay,
which comprises some
70 per cent of running costs, and central purchasing of
drugs.
Varying degrees of "tightness" and "looseness"
have been applied to NHS pay, and that of other public
sector
employees,
over the years
by
different governments
in order
to
control
costs.
In other words
a
pay or incomes
policy has been, and still is, a major component of cost
control. Since the method, level and structure of nurses'
pay were important in this issue, it
is
necessary to provide
some outline of the process of
wage
determination in the
public sector generally and in nursing in particular.
The
Determination of
Pay
in the
Public
Sector
There have been two main approaches to determining
public sector pay levels in the United Kingdom[3]. First
there is the relative wages approach. Here the relative
wage movements of, say, nurses and other occupations
are compared over some time period. If
the pay
of nurses
has fallen, then the level can be increased so as to restore
the previous relative position. This assumes the relative
position was and still is correct. No account is taken of
To continue reading
Request your trial