1974 Nurses Action

COHSE and NUPE nurses on the march in 1974, the location looks like Epsom town centre. This campaign led to best pay rises ever under Halsbury (arguably nurses secured better rises under Clinical Grading campaign in 1988)

1974 COHSE Nurses Campaign Diary

CAMPAIGN DIARY 1974 COHSE NURSES STRIKE

Campaign diary

30 April 1974: Staff Side meet the Secretary of State to request that she appoint an independent review body for nurses' pay and that an interim payment be made while the review body sits. COHSE launches its campaign for a major re-examination of nursing pay. Albert Spanswick tells 1,500 nurses outside the Department of Health (Elephant & Castle):

'the Government's action on key social policy questions inherent in the social contact cannot exclude a full re-examination of the pay of people like nurses who form the human side of the equation. It must be clearly stated that nurses are highly-skilled, highly-trained employees carrying a high degree of clinical responsibility and who work constantly under great strain and pressure ... [and] ...that if no movement is forthcoming, we will be forced to explore the possibilities of further action.'

Many more nurses had arrived at the COHSE organised demonstration than expected, and it was the signal for demonstrations all over the country; on one Saturday there were simultaneous demonstrations in seven major cities.

8 May 1974: eleven nurses at Storthes Hall Hospital, Huddersfield, strike for one hour— three wards closed. For the first time, nurses have taken industrial action — 'The possibility', said the Guardian of 13 May 'of strikes by nurses is real for the first time.' Announcement of £18 million to implement minor increases flowing from the implementation of the Briggs Report — only increases anger of most nurses.

13 May 1974: first moves made to restrict hospital admissions

14 May 1974: nurses at Newsham General, Liverpool, strike for one hour.

15 May 1974: Albert Spanswick calls for 'no less than £100 million on the table' and rejects any reference to a standing royal commission — 'I am sad to have to say that it is now no longer possible to assume that nurses will never take strike action.' Over fifty MPs sign a Labour motion calling for nurses' pay to be doubled.

16 May 1974: COHSE's NEC meets in emergency session and decides that industrial action will be imposed if the meeting at 10 Downing Street with the Prime Minister on 20 May does not provide 'cash on the table'. Rcn argues for mass resignations of nurses from the NHS.

20 May 1974: meeting at 10 Downing Street yields a promise only of urgent consideration of the problem and an assurance of the Government's concern.

21 May 1974: emergency meeting of all COHSE regional officers held. Six-point

plan of industrial action announced to come into effect at midnight on 26—27 May, as follows:

(a) a ban on clerical duties;

(b) a ban on domestic duties;

(c) a ban on 'acting-up';

(d) a ban on all overtime;

(e) selected and short withdrawals of labour;

(f) ASC staff asked not to fill-in with domestic jobs normally done by nurses, 200 nurses at Guy's Hospital warn that they will treat only emergency cases from 27 May 1974.

23 May 1974: announcement on industrial action prompts a surprise statement from the Secretary of State — an independent inquiry to be set up under Lord Halsbury and any increases backdated to the date of the announcement. But no word of an interim payment or a fixed date for the inquiry to report by. COHSE dismissed some talk of a 'miners-type inquiry' as 'rather optimistic'.

25 May 1974: COHSE's NEC meets in emergency session to consider the announcement of the inquiry. After the meeting, Albert Spanswick tells the press that the, industrial action stays because there is no interim payment and the inquiry could 'take months' (no specific date other than 'late summer' had been announced).

29 May 1974 : one and two hour stoppages occur every day in all parts of the country. Nearly 20,000 nurses are affected in the North-west on 29 May.

COHSE announces special measures to prevent seriously ill patients being affected.

June 1974: by the end of the first week, over fifty wards have been closed and patient care rearranged, COHSE action committees in local hospitals enjoy for the most part good co-operation with local hospital management.

Dockers in Manchester and other industrial workers stop work in sympathy during the first week. Industrial action spreads to local authority nurses.

During this month, strong support is shown from many nurses, not all of whom are COHSE members. Emergency arrangements stand-up, doctors voice support and wards continue to close. Many hospitals are restricted to emergency-only admissions. Membership of the inquiry is not announced until 7 June.

COHSE Delegate Conference opens in Margate on 10 June. Nursing pay debate on Tuesday. Hard-line position for all-out NEC Emergency Resolution offering complete return to normality if interim payment is offered carried overwhelmingly. John Cronin, MP, Chairman of COHSE's Parliamentary Committee, backs demand for an interim payment.

20 June 1974 : COHSE decides to step-up action, believing that an interim payment is reasonable, because of the absence of a firm date for the report's publication. Nurses give COHSE an overwhelming vote of confidence — May recruiting figures show 14,882 new nurse members. Bans introduced on private patients and agency nurses, and a ban placed on all non-emergency admissions.

28 June 1974: following a week of secret meetings between senior COHSE officers and the Secretary of State, Mrs Castle says that Lord Halsbury will announce the publication date of his report at the end of July, and that she 'will consider asking him to recommend an interim payment' if the report is unduly delayed.

29 June 1974; COHSE's NEC meets in emergency session and agrees to suspend industrial action. Albert Spanswick says that 'the Government has been prepared to move towards us and we have been prepared to move towards them. We have succeeded in defining the date of the report .' Bans on private beds and agency nurses remain. COHSE looks towards the 31 August deadline set by Delegate Conference. Between three and four hundred wards have been closed during the course of the campaign.

July 1974: at the end of July, Mrs Castle tells a special meeting of COHSE's NEC that the report will be published in the week beginning 16 September. NEC agrees not to reimpose industrial action — Albert Spanswick says that COHSE's action has been instrumental in getting the inquiry and that the industrial action had, by expressing the determination of nurses, achieved the establishment of a clear date for the Committee's deliberations. Industrial action had been regrettable, but 'had given nurses their self-respect'.

Report published 17 September. Saga of 1972 revaluation claim finally over.

1974 Nurses Dispute - Background

In late 1971, as the Staff Side of the Nurses and Midwives Whitley Council began their preparations for the submission of the 1972 pay claim, some of its members and their organisations were becoming increasingly worried about the impact of a number of factors on the overall pay position of British nurses.

Not only were serious manpower shortages becoming more than usually apparent, but a rather higher rate of inflation was beginning to depress nurses' salaries in their comparability within the scale of professionally qualified staff, both within and outside the National Health Service.

In addition, both the Government's consultative document on the reorganisation of the NHS (issued in May 1971) and the Committee on Nursing under the chairmanship of Professor Asa Briggs (established in March 1970) posed problems of uncertainty. It was against this background that the Staff Side decided to submit a major claim for revaluation and restructuring of nurses' pay, a decision in which COHSE and its chief negotiator Albert Spanswick, then COHSE Assistant General Secretary, were instrumental.

The claim, shown in Table 1 in much simplified form alongside the then existing ranges of pay, was finally submitted on 12 January 1972. It was this claim, ranging as it did from 26 per cent to 40 per cent for different grades, which more than two years later, was to be the claim on which nurses for the first time in history took sustained industrial action

— including temporary stoppages, withdrawals of labour and restrictions on working practices. It was a unique claim, and was to prove a unique campaign, noted for its exploration and discovery of the sanctions and measures which could be taken by those working in the area of patient care and life and death — an area previously thought immune from industrial action.

Unique, too, in the determination, frustration and desperation which had built up over the years.

The most substantial claim was in respect of student and pupil nurses, who, although unqualified, were involved for a large part of their time in practical nursing and frequently took a great deal of responsibility. The claim for them was between 41% and 49% and was crucial in particular to the nursing trade unions represented on the Staff Side. The claim gave substantial rises to senior qualified staff (nursing officer and above: those largely involved in administration), but in every case gave more to the minimum than the maximum of the range of scales. In the case of clinical nurses, staff nurses, enrolled nurses and ward sisters, however, the revaluation claim attempted to make scale maximums far more generous, particularly at ward sister level, by introducing a second and senior

level which, it was hoped, might provide the basis for a career structure in clinical rather than administrative nursing. In the case of ward sisters, the claim varied from 32 per cent to 48 per cent at minimum and maximum, 26 per cent to 39 per cent in the case of staff nurses, and 25 pei- cent to 39 per cent in the case of enrolled nurses.

On 22 February 1972 the Staff Side accepted an interim award of 8 per cent to become operative on 1 April, but more importantly, obtained the agreement of

Management Side to discuss the revaluation claim and in a joint statement of that date, it was declared that 'agreement was expected in the autumn'. This was a major landmark, as the Staff Side had raised the question of revaluation on the agenda and Management Side had agreed to consider it; thus major pay discussions would continue on throughout the year instead of being shelved until the following spring.

The 8 per cent award provided new ranges of salaries for various grades:

Min. Max.

£ £

Ward sister 1,407 1,821

Staff nurse 1,089 1,299

Enrolled nurse 954 1,134

Student/pupil 621/693/738

But the priority of the Staff Side was clear, as Albert Spanswick spelt out to COHSE's Scarborough Conference in June

. '...but what is vital is to complete the revaluation of the salaries, because this will give the greatest benefit to the greatest number of nurses...'

Discussions on smaller items attached to the revaluation claim extended during the summer and agreement to take effect on 1 October was reached on long-service increments (after three years in post), stand-by and on-call payments, and payment between the passing of exams and registration, but still no news emerged about the substantial revaluation of pay. And then disaster struck.

The Conservative Government announced a total pay-freeze on Tuesday 5 November 1972 'which had the dramatic effect of terminating substantial discussion on the revaluation claim. The detailed effect of that statutory incomes policy is examined elsewhere and shows that nurses, far from gaining their expected revaluation, lost substantial ground in their relative position, or in other words, nurses' earnings declined even more steeply than the national average.

In an urgent attempt to remedy this development, COHSE with others argued for an up-grading revision of the revaluation claim which was eventually agreed at an additional 15 per cent, which was lodged with Management Side on 23 January 1973. The revised revaluation claim now called for:

Min. Max..

£ £

Ward sister 1,971 2,844

Staff nurse 1,464 1,920

Enrolled nurse 1,263 1,674

Student/pupil 978/1,035/1,149

The claim for the ward sister's salary range was now nearing COHSE's long-established salary target of £3,000 per annum. In accordance with Phase Two of the statutory policy. Management Side on 13 February offered £1 plus 4 per cent which amounted to £35.7 million (or about 8 per cent of the gross pay bill of £446 million).

The impact of incomes policy supposedly designed to assist the lower paid had been severe and accordingly the offer was referred back to the COHSE executive committees of the nursing organisations. The day before the next meeting of the Staff Side, the Confederation's National Executive Committee decided, after a long meeting, to argue for equal distribution of the global sum to all nurses. On the following day (3 April) the Royal College of Nursing and the professional associations used their voting majority to defeat COHSE's proposal, which had been supported by all the other nursing trade unions. An increase giving a minimum £102 per annum but then £1 plus 4 percent to all nurses was agreed, with COHSE and the other nursing unions voting against, because the effect of the agreement was to give over £220 to the top of the chief nursing officer scale, while only giving £78 to a first year student/pupil (under 21), and £102 to a staff nurse.

A senior enrolled nurse grade was introduced for psychiatric hospitals on the same scale as for general hospitals but including the psychiatric 'lead'. It was agreed to refer nurses' pay to the Pay Board established by the counter- inflation legislation and to ask for an immediate independent inquiry.

The Government had still to make a move over the Briggs Report — published the previous October — and moreover, two controversies within NHS Reorganisation broke out over the summer: firstly, the argument over 'top posts' (the new regional and area nursing posts were to be paid less than equivalent administrators); and secondly, because special payments for extra work involved in NHS Reorganisation were vetoed by the Pay Board. So, in September 1973 when the Staff Side came to the Pay Board Relativities Inquiry (the procedure whereby nurses could request 'special treatment' under the counter-inflation legislation), morale was low and the pay position even worse than when the revaluation claim had first been lodged.

Evidence was given to the Pay Board on 24 September and 16 November 1973
which was asked to recommend an immediate independent inquiry into nurses' pay because 'at present, many trained nurses — including some ward sisters — have take home pay of less than 60p per hour; less than the take home pay of some women workers in factories and of many women in secretarial and clerical jobs.'

The Pay Board 'should look at whether these levels of pay accurately reflect the responsibilities carried out by nurses and midwives.'

The Pay Board was told that the inquiry should be a broad-ranging one comparing salaries both in and outside the NHS; 'the top of the scale for a ward sister (£1.947) attained after eight years is about the same as the starting salary of the most junior house officer (£1,914)' and 'even the most casual empiricism suggests that this is not a fair reflection of relative responsibilities'. In community nursing 'there should be comparisons between the attached nurse and the general practitioner'. The evidence went on to argue the case in terms of fairness and manpower difficulties, including those caused by agency nurses and night-staff shortages. There was no effective way to discuss manpower within Whitley and as a result 'all the pressures in nursing have been towards dealing with manpower problems by means other than raising pay'.

The Department of Health and Social Security has not produced statistics on manpower shortages for over ten years, but a survey carried out by COHSE's Research Department in September 1973 indicated, on a 10 per cent sample, that the shortage could be as high as 17.3 per cent nationally and as high as 25.2 per cent in Greater London—in other words the nurse in four short. Nationally, this indicated that the NHS required 46,000 full-time and 28,000 part-time nurses.

On 12 December COHSE's National Executive Committee decided unanimously to recommend deregistration under the 1971 Industrial Relations Act and indicated its intention to reaffiliate to the Trades Union Congress and hence reinforce the discussion of NHS problems within the TUC. But within a few days came the worst blow of all. On 17 December the Government announced cuts in public expenditure which would remove £69 million from the capital building budget and £42 million from the current expenditure budget within the NHS. Building contracts of long-overdue hospital development were frozen, decorations postponed and staff replacement trimmed. The effect on morale was dramatic and in many respects, this was the final blow.

In February 1974, COHSE, as the main NHS union, ran a recruiting campaign for nurses. Albert Spanswick, by this time General Secretary-Elect, argued in the union journal: 'unions have a reputation of getting things done' and that 'COHSE is determined to fight'. He was also able to report that the balance between psychiatric and general nurse members in COHSE was evening out.

The recruitment returns for this period showed a marked increase and were about 73 per cent up on the previous month, at 6,087 compared with 3,509.

In the run-up to the February General Election, a Phase Three settlement was forced on the Staff Side which feared yet another total pay-freeze. Pay below £1,671 per annum was increased by £117 and that over £1,671 by 7 per cent, effective from 1 April 1974. An 'unsocial hours' agreement, and a threshold agreement were introduced, stand-by, on-call, and long-service payments increased, and some minor adjustments to annual leave were made. In addition, A and B scales were introduced, one to be used for plain-time calculations and the other for enhancement calculation. The net effect was to make calculations and checks more difficult and pay-slips harder to understand.

The Prime Minister called the General Election on 7 February and during the course of that campaign, several Conservative speakers and election broadcasts presented nurses as having quite happily accepted their Phase Three increase — in other words, as model acceptors of Government policy. COHSE was quick to release strongly worded statements emphasising the contrary, and that agreements were made under duress.

After polling on general election day, 28 February 1974, the incoming Labour Minority Government took office on 4 March. Mrs Barbara Castle was appointed Secretary of State for Social Services, and Mr Michael Foot, Secretary of State for Employment. Shortly afterwards, Mr Foot stated in the House of Commons that an independent inquiry for nurses' pay could not at that stage be set up. The new Government had quite rightly taken immediate steps to solve the miners' dispute which had precipitated the February General Election, but strong feelings of protest and grievance were spreading rapidly amongst most of Britain's nurses, too. After all, pay had been low two years previously when the revaluation claim was first put in; earnings had fallen behind during statutory incomes policy, and morale had suffered several major blows — the last of which was the cut in NHS budgets, budgets which many already thought chronically under- financed. Now, with the announcement that there would be no reference under the relativities procedure, there seemed no longer to be any hope.

Michael Foot's announcement was followed by a quick succession of events:

1974 Nurses Dispute - Hospital Worker

Steve Ludlum

Editor of Hospital Worker/NUPE Steward

MANY of the student and younger nurses now beginning to campaign on pay may not remember the great nurses revolt of 1974, so Hospital Worker has been looking back at its reports from that tremendous year to see what lessons they offer us today.

In February 1974 Hospital Worker No 7 gave no hint of the explosion about to occur. A front page article by a nurse in NALGO outlined the recruitment crisis of the time-the 30 per cent dropout rate, the RCN's stranglehold on the negotiating machinery, the pay delay, and calling for unionisation and pointing to recent successful canteen price campaigns by nurses, concluded,

Our only wav out is to organise ourselves locally into existing trade unions and use them to force changes through. If we build up our muscle over small issues we'll be in a position to take up national issues".

The same Hospital Worker gave an account of the pay position: the gradual abandonment of the 1971 25 per cent plus revaluation claim, the RCN's subsequent welcome to Heath's Phase Three in '73. when the original claim was lodged with the Pay Board (yes it's all happened before!).

Nurses Take Action

In a report by a NUPE nurse we read of a NUPE meeting at the House of Commons to launch a recruitment drive. Amazingly, the two NUPE officials presiding admitted not knowing what the progress of the nurses' pay claim was Perhaps this was because the unions had already accepted the phase 3 offer in January without informing the members! (By the way, at this same meeting, a NUPE steward, explaining to a NUPE sponsored MP Tom Pendry, that we wouldn't seek a full-time union post until they were elected, was advised "Don't get too hung up about democracy!". (Pendry is now appropriately a Labour Whip).

But all this was small beer in the midst of a miners' strike which was soon to bring down the Heath government. Who suspected then what would be going on in a few weeks' time?

For a month later, a Hospital Worker Nurses Special reported on a terrific wave of industrial action over pay from Hammersmith, Edinburgh, Norwich, Ipswich, Mappley, Leeds, Darlington, Balham, Merton, Glasgow, Cumbernauld, Liverpool, Birmingham, Croydon, Bristol, Salford, Manchester, Maidstone, York, and Romford came reports of countless rallies, marches, pickets, short strikes, solidarity meetings, work to rules, bans on paperwork, canteen boycotts, bans on routine admissions, on agency nursing on private patients, on out patients, refusal to act up, even motorcades!

All the big towns had set up joint nurses action committees linking dozens of smaller groups in hospitals, and in SW London this had widened into a multi-union solidarity campaign, led by Wandsworth busmen who struck in support. Hospital Worker together with the big metropolitan committees, had called

a national action groups conference to try and unite the movement and its demands. The new Labour Government wasn't offering any hope. Within weeks of coming to power, Healey had reversed election statements and declared that wages did, after all, cause inflation. And Health Minister, Barbara Castle, former leftie, had announced that the NHS would have to wait for funds as

"most of the additional wealth the country creates in the next few years is likely to be used to salvage our balance of payments situation and to increase investment".

But the warning signs of a sellout were in the air already, and Hospital Worker advised

"Any nurse can tell them that mass action in the hospitals does more to shake up the Government than any expert negotiator. Six months of spontaneous canteen boycotts by nurses started off this whole rumpus, and pushed the National Negotiators into action.

We must make them see that their negotiating strength lies in strong well-organised workers in hospitals. We're in the unions, we are the unions. Through our local organisations we must use them to put forward our demands, fight the way we want to fight and make sure any settlement comes back to us for our approval before it's agreed".

And indeed the next Hospital Worker declared "Nurses Shame the Squablers".

The RCN had issued a circular warning its members not to expect support if they were indulging in action. NUPE in the name of the Social Contract (haven't we heard it all before?) had withdrawn its official support from the nurses, and COHSE was sniping at NUPE instead of leading action. Neverthless, the action committees seized on COHSE's limited support and with NUPE and even RCN members, carried on regardless.

The National Nurses Action Groups Coordinating Committee born at the Hospital Worker Conference had called a national march in London for July 8, eventually 10,000 strong, and was pleading with nurses to unite and appeal to other trade unionists for support— with real success. All over the country ancillary and technical staff joined stoppages etc (by now the technicians were on strike on their own account!). In West London 20 odd Engineering Shop Stewards from the Park Royal Industrial Estate descended on a bewildered Administrator at the Central Middlesex Hospital and warned him that if he victimised a single nurse he would cause a district general strike! The whole Manchester dockforce had stopped for two days in solidarity. 100,000 workers on Tyneside had struck for an hour for us, 4,000 workers at CA Parsons giant factory walked out to join a nurses' march passing the works.

Most dramatically of all perhaps, nurses picketed the pitheads at dawn in South Wales, and the miners struck for the day!

With a steady increase in sympathy strikes taking place, Barbara Castle appointed the Halsbury Committee. The nurses answered with yet more action. The June Hospital Worker records an even larger a list of apologies to many left out for lack of space. But many of the reports and the editorial columns were warning again of the inevitable sell out unless the mass support of local action groups could be changed into one movement in control of the union machinery.

Halsbury Report

A NUPE steward in the North East reported "The fulltime NUPE officials called a meeting of the Nurses Action Committee recently, although they are not members of it-which promptly rejected the official union policy. We feel more pressures must be exerted on the NUPE executive to bring about a speedy and successful conclusion to the nurses claim."

It was not to be. Over the summer months the action fizzled out. Though in most areas , reporting anger at the sellout, action was continuing on local issues. Indeed within a very few weeks, nurses acting in local union branches were beginning to win thousands of pounds in back acting-up pay.

In October, Halsbury reported and gave the nurses their biggest ever rise, averaging 30 per cent. But the lion's share went to the highest grades up to 55 per cent rises worth £20 a week, with only 5 per cent for the lowest grades who had done all the fighting!

A Halsbury Special Hospital Worker reported almost universal rejection of the report and some close shaves for union officials hailing it as a victory at angry mass meetings. Still the tone of all the reports suggested a determined effort to carry the spirit of the campaign into a fight to unionise nurses and fight locally, summe up by Aberdeen nurses:

"We have seen that militancy does pay. We have realised the need for solidarity and cooperation between all Health Service Unions. To ensure this, a Joint Shop Stewards Committee has been formed for the Aberdeen Group of Hospitals and already joint action has been taken over banning private patients. We have learned that only by abandoning the idea of professionalism and becoming actively involved in the trade union movement can conditions in the health service be improved both for the workers and the

patients." '

Lessons

The serious lessons of '74 are to build mass action groups in the unions to unite nurses in different unions, and unite nurses with other NHS workers-demanding from them pledges of protect ion against the victimisation which young nurses are so vulnerable to. Not to turn away from the union machine because it seems a hopeless task to control it. It's not hopeless—in '74 the nurses in NUPE's North East division were highly organised within their branches and forced Fisher to support their action to the end officially,

months after the rest of the country had been told to lay off! And the overwhelming message from '74 is this—if nurses go to other trade unionists, in other industries, the support they get is un-believable. Certainly no other group of workers can command the same solidarity, not even the miners.

ITS THERE FOR THE ASKING!

Are we about to have a re-run? Again, election fever is in the air, again a new Social Contract (Concordat )has been hatched, and the unions are running for cover.

This time COHSE abandoned the ancillaries, and NUPE fought on. Again the RCN adopted its reactionary role and got out the begging bowl—but again the token action had started, again, apparently spontaneously, vigils, meetings, petitionings and small delegations to Westminster were reported with increasing frequency.

At the time of writing the most valuable lesson from '74 is that in a few weeks time anything could have mush-roomed from tiny protests now in progress. Let History repeat itself (at least the good bits!)

NOTE

Hospital Worker was primarily a Socialist Workers Party (International Socialist) publication with a rather simplistic analysis. However the Nurses Action Committees were very important to the dispute (COHSE was keen enough to recruit a number of these nurses as full time officers ie Bob Quick from Chester Nurses Action Committee)