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“I think a lot of people don’t realise how much worse our general quality of life would be without trade unions,” says George Woods, RCN Head of Trade Union Learning and Development. 

“Many things that have been won – and won with a big effort – are now taken for granted and considered part and parcel of our lives.”  

Specific gains include the right to paid holidays, tackling discrimination, enabling collective negotiations on wages and conditions, pensions, maternity and paternity rights, reductions in working hours, and even the weekend.  

“That was achieved incrementally,” George explains. “Only Sunday mornings were given initially for workers to attend church. Unions then began the process of extending time off to the rest of Sunday, before campaigning to add Saturday.”  

If you fight you may sometimes lose, but if you don’t fight, you will always lose

But advancement has rarely been straightforward. “Progress has never been linear, with legislation here waxing and waning,” says George.  

“For some of the past 200 years, it’s been illegal to be a member of a trade union and as a consequence of that conflict, the UK still has some of the most restrictive laws in Europe.”  

In practice, this has often meant trade unions campaigning to preserve what they’ve already won, alongside advocating for further rights.  

“What’s clear from history is that if you fight you may sometimes lose, but if you don’t fight, you will always lose,” says George.  

“The people who make a trade union are not those who work for it, but the members themselves. And when they decide to act, they are formidable.”

Action for nurses campaign, March 1977Above: “Action for Nurses” Campaign March, 1977 

Nursing staff in dispute

The first nursing staff to join a union were those working in asylums, says Claire Chatterton, RCN History of Nursing Forum member and former chair.  

The National Asylum Workers’ Union (NAWU) was set up in 1910 – six years before the RCN came into being.  

“Although the NAWU was founded by male attendants, it was very attractive to female staff, with a strong women’s membership by the 1920s,” says Claire.  

A series of strikes after the First World War were initially successful, although a large sit-in strike, led by women at an asylum in Nottinghamshire, was lost.  

“Historically, we rarely hear about nurses fighting for better care alongside patients, but that’s exactly what happened there,” says Claire.  

“What these women did was incredibly brave. They must have felt a real sense of grievance. Their protest showed that women could be militant, arguing for what they felt was right.” 

The RCN is part of the long history of trade unionism in the UK. Employment rights, pay and terms and conditions have been long and hard fought for, and members have played a crucial part.  

In 1969 we launched our Raise the Roof campaign, which led to nurses publicly campaigning for a pay increase for the first time. It resulted in a 22% uplift.  

Five years later, whilst the unions led nurses to march to Downing Street, demonstrate outside parliament, and host a rally in Hyde Park, the RCN held talks with Barbara Castle based on their report ‘The State of Nursing’. 

They also threatened unprecedented action from their members, despite not yet being a union. Their call for an independent inquiry into nurses’ pay was agreed, with the result an average 30% rise.  

More recent than that, wins have been more modest, with efforts focused on fairness and fighting against caps on public sector pay.

In 2017, thousands of RCN members demonstrated outside parliament demanding the 1% cap on NHS pay rises be scrapped. The chants to “scrap the cap” proved successful and on 10 October, then Health Secretary Jeremy Hunt announced he would indeed bring an end to the seven-year freeze on public sector wage rises. 

Raise the Roof, Campaign Flyer, 1969-1970

Above: Raise the Roof, Campaign Flyer, 1969-1970

On the picket line

Then, in 2019, nursing staff working in health and social care (HSC) in Northern Ireland voted overwhelmingly to strike, with 92% voting in favour in the historic ballot – the first time the RCN had organised this kind of action.

Members campaigned to be paid the same as their colleagues in the rest of the UK, alongside highlighting concerns about the safety of patients, due to understaffing. In January of 2020, a new offer restoring pay parity and a commitment to safe staffing was put forward and accepted. 

Now, of course, new history is being made. For the first time in its 106-year history, the RCN has balloted members working for the NHS across the UK on strike action. It was our biggest ever strike ballot and again, was much about fighting for patient safety as it was for fair pay.  

RCN General Secretary & Chief Executive Pat Cullen says: “Patient care is at risk because of chronic staff shortages. Nursing staff simply can’t afford to join or stay in the profession. 

“There are tens of thousands of unfilled nursing jobs across the UK. Unless governments start to value and pay nursing staff properly, there will be a further exodus, adding more pressure to an overstretched system. 

“Though strike action is a last resort, it is a powerful tool for change. And we must demand that change. Enough is enough.” 

Go to the strike hub to find out more about our strike action.

Northern Ireland strike action picket line

Above: Northern Ireland strike action picket line in 2020
Though strike action is a last resort, it is a powerful tool for change

Key date timeline

  • 1799-1800 – Combination Acts make strike action illegal, punishable with up to three months' imprisonment or two months' hard labour. 
  • 1824-1825 – following widespread protests, the Combination Acts are repealed.  
  • 1834 – six agricultural workers who form a trade union in Tolpuddle, Dorset are arrested and transported to Australia.  
  • 1871 – the Trade Union Act recognises unions as legal entities. The Bank Holiday Act gives workers a few days of paid holidays each year.  
  • 1888 – women workers at the Bryant and May match factory go on strike. After five weeks, the company concedes almost all their demands.  
  • 1911 – the Trades Union Congress (TUC) begins to campaign for paid holidays for workers.  
  • 1926 – the General Strike, this national strike began on 3rd May and lasted nine days.  
  • 1927 – the Trade Disputes and Trade Union Act – makes general strikes and solidarity action illegal, with restrictions on picketing. This remains in force until 1946. 
  • 1938 – the Holidays with Pay Act gives workers whose minimum rates of wages are fixed by trade boards, the right to one weeks’ holiday per year. 
  • 1968 – while campaigning for equal pay dates back to at least the 1830s, in 1968 female sewing machinists at the Ford car plant in Dagenham go on strike, after their pay is cut. One of a number of disputes across the UK, this dispute paves the way for the Equal Pay Act in 1970. 
  • 1976-78 – the Grunwick dispute, involving South Asian women workers. Although the dispute is eventually lost, their leader Jayaben Desai believes they won better conditions for future employees. 
  • 1978-79 – the Winter of Discontent, with widespread strikes by public sector trade unions, including nursing staff.  
  • 1979-90 – the Conservative government passes five major pieces of legislation weakening trade unions’ power. Most is consolidated into the Trade Union and Labour Relations (Consolidation) Act of 1992. It includes restrictions on picketing; and enables employers to apply for injunctions against unions, sue for damages and sequestrate union assets.  
  • 1998 – the UK finally implements the European Union’s Working Time Regulations, giving workers four weeks’ annual leave.  
  • 2016 – Trade Union Act imposes ballot thresholds for industrial action. These include a minimum 50% turnout with, for public services, at least 40% backing of those eligible to vote. 

Video resources 

  • Raising the Roof: A History of Nursing Activism. In November 2020, Professor Anne Marie Rafferty heard more about how nurses have pushed for change over time.
  • Nursing and Politics. In May 2022, RCN Fellows David Benton, Jane Salvage and Neslyn Watson-Druée explored why nurses and the public should engage with the political context of healthcare. 

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