Kerrie Flood: Good will alone doesn’t pay the bills

I must confess that seeing our health service struggling this week has rattled me.

I had cause to attend the Emergency Department (ED) at the South West Acute Hospital (SWAH), and subsequently the Children’s Ward, with my eldest child.

She didn’t seem to see what I saw; instead, she was buoyed up by the approach of staff at every turn.

She passed no comment on the patients in beds in the corridor, and somehow didn’t appear to notice how busy each staff member was, any waiting time, or how quickly they managed to grab something quick to eat.

Instead, she noticed the nurse who stopped in her tracks to help someone to drink a cup of tea without hesitation.

She was curious as to why each staff member seemed so happy and was comforted by the kindness of doctors, nurses, and porters, each one seeming to go that little bit out of their way to put her at ease.

“You must have to be a really special person to work here.”

That is the crux of the issue, isn’t it?

Public sector employees serve the public. Many do it because they are called to a career in caring.

But good will can only take you so far. Good will is frequently the currency of women, and of the public sector. Sure, you are a great bunch of girls altogether.

According to NISRA, 65 per cent of the UK’s public sector workforce are female, compared to 42 per cent of the private sector.

Nearly 80 per cent of NHS staff are female, with similar figures for those working in social care. In England in 2022, 76 per cent of teachers were female.

I have talked at length about the consequences of the cost-of-living crisis for women along with the impact of more than a decade of austerity.

Make no mistake – public sector pay is another issue in the growing list of issues facing Northern Ireland that disproportionately impacts women, and relies too heavily on their good will.

As far back as February, 2023, the Trades Union Congress were warning against the gendered impact of the Minimum Service Levels Act for those women who lawfully vote to strike.

While the legislation does not extend to Northern Ireland, those in the public sector today will be acutely aware of its impact across the water.

The Department of Health has warned of significant disruption to services, but what is extremely telling is the joint statement issued by the Chief Executives of our Health and Social Care Trusts.

The strength of the statement in the face of the inevitable disruption is crucial.

“It is a tragedy that our colleagues, who are the backbone of our Health and Social Care Service, feel they have no alternative but to take this action.

“We would repeat our call for all staff to be properly rewarded for their work ... there is so much to put right in Health and Social Care.

“Much-needed progress has been critically hampered by multiple years of political and budgetary instability.”

This is not small-scale – this is a collective call from 14 trade unions with a membership of more than 150,000 members.

This is not disquiet – it is growing anger.

Despite this, strike action can divide opinion.

There are significant childcare costs associated with school closures, lost earnings for those who must stay home to care for children, and difficulties with transport for those of us in rural Fermanagh, not to mention those who need to access healthcare.

It is understandable that this scale of strike leads to frustration for many of us. It is even tempting to question whether it is ethical for the public sector to strike, when we know that services are already stretched beyond capacity.

Those working in the public sector know that strike action inevitably has consequences for those of us in need of their services.

Importantly, industrial action happens when negotiations have failed.

Similar increases have already happened in England, and yet the wage gap continues to grow.

The overriding message from the public sector is that the public are not customers; that a ‘race to the bottom’ approach is not an effective way to manage public services; and we cannot continue to haemorrhage our public sector, often female workforce because of poor pay and conditions, or to cut back services to the point of non-existence on the back of their good will.

My own experience this week and the sentiment of many who voted for strike action today is best reflected in what Lynelle Fenton, the President of Ulster Teacher’s Union has said.

“We have been and are running on good will and not fair pay. So we take part in this strike action in order to protect Northern Ireland’s education system.”

Good will was obvious in the corridors of the SWAH ED, where exhausted staff embodied patient-centred care.

Despite what looked overwhelming to me, they remained outwardly caring, compassionate, and unshakeable.

There is, however, a limit to good will, and no amount of clapping at the door in a global pandemic will pay a nurse’s mortgage.

The fact that our Health Trusts are so vocally supporting their colleagues speaks volumes about how critical the situation is.

If staff are not valued, they will leave. If they leave, so too do the services they provide.

In that scenario, strike action is the lesser of the two harms, and is arguably an ethical obligation.

I have talked at great length to almost anyone who would listen about the repeated message we have all heard: “there is no money”.

It turns out that, much to my surprise, there is some money – around £584m to address this longstanding pay issue, and the crippling of our public services.

This is one slice of the £3.3bn carrot being dangled for a return to Stormont.

How ethical it is to leverage our public services in this way is another question.

Kerrie Flood is Development Manager at Fermanagh Women’s Aid.