A former chief nursing officer for England is among those in the House of Lords who have criticised the government’s controversial anti-strike bill and its attempt to legislate minimum service levels on strike days while year-round unsafe staffing is overlooked.
Dame Sarah Mullally, Lord Bishop of London, said this notion was “unfathomable”, and called on the government to legislate “appropriate staffing levels” for non-strike days.
“I would welcome the government legislating to ensure appropriate staffing levels on non-strike days”
Sarah Mullally
Lords and baronesses debated the Strike (Minimum Service Levels) Bill during its committee stage on Thursday.
The new bill, which has caused widespread concerns across the nursing profession, would give ministers power to impose new minimum service levels when industrial action takes place.
If passed it would allow an employer to bring an injunction to prevent strike action, meaning that nurses who have democratically and lawfully voted to strike could be forced to work.
The legislation also introduces a possibility of nursing staff being sacked if they do not comply with the regulations.
On Thursday, some members of the House of Lords described the bill as “dangerous and undemocratic” and as an “unnecessary piece of legislation”.
And many raised concerns about workforce shortages across health services and whether the new bill could mean there would potentially be “safer or better care” on strike days than on non-strike days.
Their comments came during the Lord’s committee stage of the bill process, where members examine the bill line by line and votes on amendments can take place.
Lord Kamlesh Patel of Bradford tabled an amendment which would mean the government would have to first establish, via primary legislation, “appropriate and legally enforcing staffing levels across health services for non-strike days that are greater than those required on strike days”.
Lord Patel stressed Amendment 18 was about “patient safety”.
Lord Patel
“Daily, patient safety is compromised as a result of staffing problems,” he told the house.
“The NHS should be safely staffed every day of the week.”
Latest data shows there are more than 43,000 registered nurse vacancies across the NHS in England.
Lord Patel added: “I hope the government give further thought to appropriate safe staffing levels on non-strike days before bringing in any minimum service levels in clinical areas.”
Bishop of London and former CNO for England, Dame Mullally, also joined the debate and reminded the government it had “resisted introducing legislation for minimum staffing levels on a number of occasions”.
“It seems incredible that they now want to put in levels of minimum service, which clearly require minimum staffing levels, but are willing to do it only on strike days,” she told the house.
“This amendment goes to the heart of one of the key issues with the bill; namely, that people in the health service who strike do so partly because safe staffing levels are not in place on non-strike days.”
“Every single day patient care is unsafe due to the lack of nursing staff working in our NHS”
Patricia Marquis
Dame Mullally added that health workers on non-strike days were “thinly stretched and cannot provide the level of care that they would like to, which puts huge pressure on their health and wellbeing”.
“The notion that the government could legislate to require minimum service levels in healthcare settings, which are already committed to safe strikes, while there is a lack of investment and workforce planning — which is the reason for the action — is unfathomable,” she said.
“I would welcome the government legislating to ensure appropriate staffing levels on non-strike days that are greater than the strike day cover.
Baroness Watkins
“That would be welcomed by nurses, because it would mean more resources and more workforce planning than the health service has seen for years.
“It would also resolve one of the reasons why nurses are taking strike action.”
Baroness Mary Watkins of Tavistock, a nursing academic as well as a life peer, added that without this amendment, she was “worried” that care would be “safer or better” on strike days than on non-strike days.
“I am also worried that, unless we tackle the workforce shortage, which has driven staff to their current level of discontent in health and care, we will continue to have problems,” she said.
“This is not just about people striking for an increase in salary; it is about people’s real concern about being unable to deliver the service they wish to deliver.”
Thousands of nurses across the UK have walked out on strike in recent months as part of a dispute over pay for 2022-23 and connected issues of staff shortages and patient safety.
Nurse strikes in England are currently on pause while the government and unions continue to engage in pay talks. It is understood additional money, in the form of a one-off payment, could be on the table for NHS staff for 2022-23.
Parliamentary under-secretary of state for energy efficiency and green finance, Lord Martin Callanan, said the government did “not support” amendment 18 because it added “unnecessary limitations to and delays in establishing the minimum service levels”.
He said the amendment “seeks to delay any implementation of minimum service levels in health services on strike days by first requiring the government to establish appropriate staffing levels on non-strike days through primary legislation”.
Lord Callanan
The House of Lords adjourned before a decision was made on amendment 18 and so it is set to be considered again at a later stage of the bill process.
RCN director for England, Patricia Marquis, said amendment 18 “addresses the elephant in the room that we need safe staffing levels every day of the year”.
“Every single day patient care is unsafe due to the lack of nursing staff working in our NHS,” she said.
“Instead of focusing on stifling the right of staff to take strike action, ministers would be better focused on addressing the crisis in the nursing workforce.”
