The NHS Crumbling is a Feminist Issue

BY LAUREN JONES

The NHS is a source of national pride for Britain. But after years of government neglect, pay freezes and a serious lack of respect for NHS workers – not to mention a global pandemic – the NHS is crumbling. While this is indeed a crisis, what most don’t realise is that it’s also an important feminist issue.

Healthcare workers fall under the umbrella term ‘pink-collar workers’, which refers to those working in care-oriented fields or other roles that have historically been considered women’s work. Pink-collar workers are not afforded adequate respect for their roles because of the traditional perception of these roles as easy work or unskilled vocations. According to NHS Digital, professionally qualified clinical staff make up 52.8% of full-time equivalent NHS Hospital and Community Health Service (HCHS) staff, meaning that over half of full-time NHS workers have a degree and/or other specialised training – so they should be considered working professionals as opposed to unskilled workers.

Many of us have a very basic understanding of how our healthcare system actually works. There is widespread awareness of different roles within healthcare, such as nurses, midwives, doctors, and health care assistants (HCAs), but what these roles actually entail and the differences between them are shrouded in a degree of mystery. Nurses, for example, are responsible for administering medications, monitoring patients and informing doctors of any change in patient status – not just paperwork and helping patients shower. Doctors and nurses work in partnership and depend on each other’s skills and specialist knowledge to provide high-quality patient care: it is not the case that doctors are solely responsible for the most serious decisions.

Healthcare professionals are not fairly paid for their work, which is at least partially due to the ignorance surrounding what exactly a job in healthcare entails. As well as literally being the difference between a patient living or dying in some cases, hours are long and shift patterns are gruelling. Nurses, HCAs, midwives, doctors and paramedics are all required to provide aroundthe-clock care, working undesirable hours such as night shifts and public holidays like Christmas.

Some HCAs, according to NHS employers, earn as little as £10.95 per hour. New nurses and midwives earn, not including tax or pensions, £27,055 (nurses.co.uk), which works out as approximately £1,650-£1,850 per month. When broken down into an hourly wage, an HCA or nurse earns little more than a supermarket worker. In fact, some healthcare professionals are walking away from the healthcare sector entirely to work a job that is less stressful and less responsibility for comparable pay.

Other workers choose to leave NHS hospitals and trusts but do not quit the profession entirely. Nursing in the private sector offers more flexibility, a less stressful working environment and sometimes other benefits such as private healthcare. Agency nursing is another alternative, which again offers increased flexibility, among other advantages such as shorter shifts and better pay. Working for a private institution or as an agency nurse allows healthcare workers (a large proportion of whom identify as female) to maintain a work-life balance and to spend valuable time with their families, contributing toward better overall well-being.

Challenges that healthcare professionals face are widespread throughout the NHS, and they need addressing urgently. Part of resolving these issues is identifying them, their effects and the people who are being impacted. According to NHS employers, 77% of NHS staff in 2018 were female, but only 37% of senior roles were held by women; women are not proportionally represented. This begs the question: who is representing and protecting feminist interests in the NHS?

The short answer is… not the government. At least, not as well as they could be. Since 2012, the Secretaries of State for Health and Social Care (previously Secretary of State for Health) have included Jeremy Hunt, Matt Hancock, Sajid Javid and Steve Barclay – none of whom have worked in the healthcare sector. These male politicians are, firstly, not representative of the NHS’s largely female workforce and, secondly, are not personally familiar with the challenges that NHS staff face on a day-to-day basis; they are not qualified to act in the best interests of NHS staff.

It’s no secret that during the Covid-19 pandemic, NHS staff faced awful working conditions and extreme stress. From dodgy PPE deals, extensive hours and harrowing shifts to some staff moving into hotels to protect their loved ones, it’s safe to say that healthcare workers went above and beyond. The government encouraged us to ‘Clap for Our Carers’, but did not back this sentiment up with action. While it is undeniable that healthcare workers deserve applause, these ‘angels’ and ‘heroes’ deserve justice – not gesture politics and empty words. They deserve action to improve their working conditions; they deserve respect as working professionals. What they do not deserve is being taken for granted as kind people who are doing their jobs out of the goodness of their hearts.

Even once the Covid-19 pandemic is a thing of the distant past, staff on NHS wards will still face issues like abuse from patients, lack of respect and massive understaffing. Student nurses and midwives – who pay university tuition fees and are no longer offered a government bursary – are supposedly supernumerary. In practice, they are just another pair of hands on a busy ward. The pay rise for NHS workers in July 2022, after years of pay freezes, is not in line with inflation and is of little comfort in the face of the cost-of-living crisis. Some nurses are already being forced to use food banks to get by.

It shouldn’t matter that nursing, midwifery and HCAs are traditionally female roles. We still need to ensure that all healthcare workers and future healthcare professionals are respected, paid fairly and recognised for their hard work. Until the ingrained misogynistic perception of these roles is tackled, and it is acknowledged that healthcare roles like nurses, midwives and HCAs are not easy or women’s work, then this is unlikely to happen. The staffing crisis will likely continue, and the NHS will continue to crumble, taking the women that make up the majority of it along with it. ✦