Behind the strikes: How two women led a million workers into battle against the government

September 05, 2023

"A nurse is the first person you see when you come into this world and nine times out of 10, we're beside you when you leave."

These are the words of Pat Cullen, the union boss who became the public face of the biggest nursing strike in history.

In the wake of the COVID pandemic, with the cost-of-living crisis biting, nurses alongside teachers, were among the hundreds of thousands of workers who took the difficult decision to walk out.

This led to their unions being locked in a bitter battle with the government for more than eight months.

While the strikes have finally ceased, emotions still run high.

'From a young age, I knew nursing was in my blood'

Friendly and warm with a soothing smile, 58-year-old Pat - the Royal College of Nursing's (RCN) general secretary - showed a steely determination in her dealings with the government.

"I grew up in a little village called Carrickmore in County Tyrone, and lived on a farm," she recalls in her soft Northern Irish accent.

Her parents both died when she was a teenager. Her father first, when she was 13, then her mother. The grief still lingers. “I missed my mother immensely. She was the backbone of our family.”

Pat's first job was as a mental health nurse and she has worked in the profession for over four decades. She has five sisters - four are also nurses.

“That created a passion in me for speaking up for those that don't have a voice in society,” she adds.

'Everyone remembers the teacher who saw something in them'

High energy with a no-nonsense air, Dr Mary Bousted, 63, the joint secretary of the National Education Union (NEU), was taught to stand up for her beliefs at a young age.

"My father was the headmaster of the local primary school, and my mother was a teacher," she says. "His way of keeping eight children in order, was to introduce political debate at the dinner table."

Three siblings also trained as teachers, but Mary says she fell into the profession after completing an English degree. When in 2002, a job came up with a teaching union, she thought: "Well, I'll give it a go."

The role was general secretary of the Association of Teachers and Lecturers - Britain's third largest education union. Mary came out on top in a ballot.

"I was elected by the skin of my teeth. Union activists stood against me and said, I knew nothing about unions, which was quite true - but I did know about education," she says, with a wry grin.

On the picket lines

"Hello everyone! How are you all? For any of you who don't know me, I'm Pat. You've probably seen my old face on the television," the RCN boss says through a megaphone.

It's a bitterly cold January morning. Swaddled in a winter coat and pink scarf, she is on the picket line greeting nurses with hugs and supportive words.

There's a carnival spirit outside this south London hospital and Pat is bringing the party, arriving arms aloft to cheers from those holding placards. Some are playing drums and dancing to keep warm as Pat sounds a siren alarm on the loud-hailer.

But she is not taking this action lightly, and gets fired-up detailing the extreme pressures nurses are under.

"We are in a crisis," she says, adding that while nurses thought it couldn't get any worse than it was during the pandemic, the current crisis is "indescribable in terms of how bad it has been".

Her nurses are asking for a 5% pay rise above inflation - which is soaring - meaning an effective hike of around 15%. It's a bold starting point in the negotiations and the government has yet to respond.

"Nurses don't want to do this, that’s why it's taken 106 years to get to this place," she says.

It's 1 February, the first day of the teachers strike. "We are the NEU," chants Mary, wearing red fingerless gloves as she claps and stamps her feet to cheers from the thousands of teachers who have joined the central London rally.

Classrooms are closed and teachers are congregating in city centres across the country. Mary needs these protests to grab headlines - the more publicity the cause gets, the harder it is for politicians to ignore.

Along with her fellow joint leader, Kevin Courtney, she is demanding a pay increase that matches inflation - that's a rise of more than 10%.

"If we don't stand up now and be counted, it goes from crisis to catastrophe," she explains.

'I don't want to let them down'

Days later, Health Secretary Steve Barclay is on a visit to Kingston Hospital in southwest London. Pat is disparaging of his attempt to appear supportive, dismissing it as just another "photoshoot".

"Nurses see through that," she says. "Who's left behind to look after those patients for the next 14 hours? Our nurses!"

After five days of nurses strike action there's still no word from the government. The longer the strike goes on without a response, the wearier her members become.

"I'm so sorry," she says comforting a young cancer nurse picketing outside London's Guy's hospital. "It's tough," the nurse tells her.

Pat is feeling the pressure of representing those "incredible people" who did so much during the pandemic. "It's an absolute honour to lead this profession," she says with obvious pride. "What I don't want to do is let them down."

The RCN's threat of more serious strike action - affecting A&E, intensive care and cancer treatment - seems to have worked. It's 22 February and the government has contacted Pat, who has agreed to call off strikes to enter talks, a move she knows will be unpopular with some members.

She looks anxious as she logs on to a video call with RCN members, gripping her notepad and knotting her fingers together. Her words have been carefully chosen with help from close advisers.

"It's the pressure you placed on this government that has brought them to that decision," she tells her fellow nurses.

"We will push every single button to ensure we get the best deal possible for you."

Although Pat has braced herself for negative feedback, there is a moment of lightness.

"I think you should run for prime minister," a member comments. "The country would be bankrupt as every nurse would be a millionaire as far as I'd be concerned," Pat replies.

Mary is also a source of inspiration to her members.

It's mid-March and she is overseeing the second day of her union's national action, which coincides with the Spring Budget. Her members are walking out along with hundreds of thousands of other workers including civil servants, junior doctors and Tube drivers.

She warms up her troops, pulling Saturday Night Fever-style dance moves to disco classics, as teachers from all over England and Wales march together in central London.

"I always start at the front," says Mary. "I dance to that, then realise I've got a bad hip and move back."

As well as being the main bargaining chip - strikes get teachers together and boost morale. Mary has her arms in the air waving a flag as the crowd dances along to Gala's 1997 hit Freed From Desire.

"It is an honour to represent them," Mary says. "I'm getting quite emotional now," she smiles, adjusting her glasses.

She only has a few months left to win this fight. Her five-year term leading the NEU is ending and she'll bow out of being a trade unionist after two decades.

This strike seems to get results. Two days later, the NEU, together with other teaching unions, enter talks with the government.

Meanwhile, Pat is preparing to reveal the details of the long-awaited pay offer to members. The government has proposed a 5% pay rise for 2024, along with a lump sum payment.

It's not the deal nurses are looking for but it's the best offer available to her. "There wasn't another single penny put on the table for our members," she explains.

Pat finds herself in the firing line. There is backlash from members online, accusing her of selling out by recommending what they see as an insultingly low offer.

Read more:
No signs of infuriated medics backing down as NHS faces grinding to a halt in latest crisis

'Almost all' routine care disrupted as consultants walk out

A "Vote Reject" campaign forms. The "terrible deal" is branded a "slap in the face" and an "insult" on social media as the RCN is accused of "failing England's nurses".

There are even calls for Pat to resign.

"Some of the personal attacks in the last few days I have found very difficult," she says, clearly unsettled.

In April, 54% of RCN members vote to reject the pay offer - going against Pat's recommendations. The result shows a divided union and puts her in a precarious position.

Defiant, she hits back in a video call with members, denying claims she's been offered a damehood by the government.

"I can assure you I've been offered nothing, nor did I ask this government for anything. While I may not have got everything right, I have never set out to undermine the profession or you as members of this college."

But her guard comes down in a follow-up call with other RCN leaders. "There has been a threat made on my life, and we've had police involvement," she says, the emotional toll evident. "I'm human at the end of the day."

In a later interview, Pat compares the attacks to the abuse suffered by domestic violence survivors she has worked with.

"Some patients have said, the more times you get hit, the less it hurts," she says, resolutely. "I have felt a little bit of that as well. These attacks don't have the same impact because it has happened so much."

Despite the fallout from the vote, Pat remains popular on the picket line and is greeted with cheers on the final day of strikes in May under the current RCN mandate.

She has heard the message "loud and clear" and will ask her members if they want to take further industrial action, telling them: "This is not over until you are satisfied with the offer."

But just over a month later, the RCN ballot fails to reach the legal threshold for more strikes to go ahead - the nurses' fight is at a standstill.

For Mary, the path to resolution is equally fraught.

"I'm delivering difficult news," the NEU joint-leader says. It is 27 March and she is about to address around 30,000 teachers, who have joined an emergency video call, anxious to hear the offer put on the table after six days of talks - an average 4.5% pay rise.

Crucially, the government's offer isn't fully funded. They're only offering to pay a fraction of the salary increase - schools will have to fund the rest from their current budgets.

Mary and Kevin ask their members to reject it, citing the government's "failure to compromise".

A week later, at the annual NEU conference in Harrogate, Mary takes to the stage as it's announced that 98% of members have voted to reject the offer.

"Come on Gill, pay the bill," they chant, sending a message to Education Secretary Gillian Keegan.

"That's an amazing result," Mary declares, as further strike action is announced.

The walkout is scheduled to take place in early July, mere weeks before the end of her tenure.

Then on 13 July, with pressure mounting, Rishi Sunak accepts the pay review bodies' recommendations in a surprise news conference.

Mary's teachers are offered a 6.5% pay rise - most of it funded by the government - and they vote to accept. But Pat is not happy with the nurses' settlement.

"Absolutely disgusted," she says angrily. Despite rejecting the government's pay offer in April, her nurses will still get no more than 5%.

"People on the front line won't give up," she says. "They won't give up on the NHS, they won't give up on the profession, and they certainly won't give up on patients."

The government says: "We hugely value the work of nurses and welcome the fact the RCN is no longer taking industrial action.

"We recognise the vital role that teachers play in our country and will ensure teaching continues to be an attractive profession."

As a result of strike action and negotiations, NHS staff in England received a 5% pay increase, and two one-off payments and the government agreed to look at future pay structures for nurses. Pat's tenure as general secretary has been extended until the end of 2024.

Mary, meanwhile, left the NEU in August on a high. "Every so often you get a moment. And I think this year, these eight months have been a moment," she says with pride.

"The trade union movement is littered with a history of honourable defeats. This is an honourable win. It's the biggest award for teachers in over 30 years."

This year, these two women found themselves thrust into the limelight, simultaneously hailed as heroes and, in Pat's case, bombarded with abuse. Through tears and triumphs, they've fought for a better future for their predominantly female workforces.

"I believe in those brilliant, decent people that have stood on picket lines and lost their pay," Pat says. "Do they deserve better and need someone to speak up for them? Yes, they do. And I'll do that until the day I leave this post."

Behind the Strikes will air on the Sky Documentary channel at 8pm on Thursday 7 September and on Sky News at 9pm on Friday 8 September.

Additional reporting and research by Rachel Lynch, Sarah Burke and Jonna McIver.

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