LONDON — Nurses across Britain went on strike on Thursday for the first time in the 74-year history of the National Health Service, underscoring critical challenges facing the long-revered system after years of underfunding and as the government contends with a burgeoning fiscal crisis.
On a bitterly cold day, nurses and their supporters walked on picket lines in England, Wales and Northern Ireland, demanding a 19 percent pay increase and better working conditions that they say will help make the profession more attractive and help address severe staffing shortages.
“It’s been incredibly difficult,’’ said Melanie Denison, an intensive care nurse who worked in the N.H.S. for 25 years, as she picketed outside St. Mary’s Hospital in North London. Around her, a crowd of striking nurses, wearing hats and gloves and heavy coats, marched with signs that read, “Staffing shortages cost lives.”
“The years since Covid have been the most challenging I have ever experienced,” she added.
The government has said the pay demands are “unaffordable” and has pointed to recent pay rises and new funding plans for the health service as evidence of the government’s support.
The strike reflects a growing discontent among health care workers, and many members of the public, over the degradation of service in recent years. The free health-care model that provided an egalitarian service for everyone in the country, regardless of income, has long been a national point of pride
The 12-hour strike was the first of two planned walkouts, with another one scheduled for next Tuesday. Nurses were still staffing the most vital services, such as intensive care units and chemotherapy, dialysis and some pediatric services, but officials said non-urgent medical attention would be much less available. Hospitals and other health facilities say that they have tried to manage schedules to ensure the safety of patients during the action.
The nursing strike is one of a series of job actions taking place across Britain this month as sky-high inflation, rising interest rates and a recession put pressure on workers. Rail employees, airport baggage handlers and ambulance workers are among the others scheduled to stage walkouts over the next several weeks.
The strike comes as the health service is in crisis, with declining working conditions for clinical staff amid the spillover pressures of the pandemic. There have been record delays for ambulance responses and a major backlog for medical procedures, among many other problems.
Created in the aftermath of World War II, the National Health Service is one of the country’s most admired institutions, delivering treatment on the basis of need without money changing hands (with a few exceptions such as dentistry and medication charges).
Paid for mainly through general taxation and payroll deductions, the health care cost £192 billion in 2020-21. But faced with an aging population and seemingly limitless demand, Britain’s health care system has long been creaking at the seams.
After the financial crash in 2008, Britain’s public spending was held down during years of austerity. Resources for the health system increased less rapidly than they had done historically.
In 2021, Prime Minister Boris Johnson announced a hike in payroll levies to help finance health and social care, but that increase was canceled by his successor, Liz Truss.
Under Rishi Sunak, the new prime minister, the government last month instead promised the health service an additional £3.3 billion of funding in both 2023–24 and 2024–25, to help deal with the increased pressures.
The nurse’s union, the Royal College of Nursing, has said it needs a 19 percent raise because small increases in the past have made it hard to attract and retain workers. Nurses are leaving the profession at high rates, citing low pay and staff shortages that force them to work long hours, according to union representatives.
Pat Cullen, general secretary of the Royal College of Nursing, said in a video statement ahead of the strike that her members were “committed to our patients and we always will be.”
But, she added: “When as a society did we stop valuing the very basics of human care and dignity? This is not who we are. It is not unreasonable to demand better.”
The union came to the decision to strike after polling its more than 300,000 members, who make up about a third of the health service’s work force.
The strike on Thursday took place across England, Wales and Northern Ireland after negotiations broke down, though nurses in Scotland called off their strike after a new pay offer. An estimated 100,000 nurses were expected to take part in England alone, encompassing 53 different health service organizations. Nurses in all but one area of Wales took part, and nurses all across Northern Ireland walked out.
Representatives for the union met with the British health secretary, Steve Barclay, on Monday, but union representatives said that the meeting had been brief and had failed to achieve any of their stated aims.
Mr. Sunak, speaking on Wednesday in Parliament, said that the nurses had been offered a “fair” pay deal and that the government had “consistently spoken to all the unions involved in all the pay disputes,” referring to the various strikes planned for this month.
Mr. Sunak added that he wanted to “put it on record what we’ve done for nurses,” noting that they were given a 3 percent raise last year, even as many other public sector wages were frozen.
But amid soaring inflation, that raise does not amount to much, union representatives say, adding that the sector has long been underfunded, leaving nurses struggling to get by.
“It’s pay recovery — it’s not asking for additional monies, if you break it down,” said Ms. Cullen, the union head, speaking to the BBC from a picket line early Thursday. She said that the union had been unable to come to an agreement because the government had refused to consider a further raise.
Ms. Denison, the intensive care nurse, described an exhausted work force that is “really burnt out and they are really broken.” Some can’t afford to live and work in London anymore, she said, as the cost of living skyrockets, and it is extremely difficult to attract new nurses to the profession.
More job actions in the health service are expected. In addition to the second nurses’ walkout next week, the ambulance service has walkouts scheduled for Dec. 21 and Dec. 28.
But it wasn’t just nurses picketing on Thursday. Supporters also joined the nurses outside health care facilities as they demanded better wages.
Zoe Richardson, 61, joined the picket line in the late morning and said she was motivated by her desire to have a better functioning system that continues to be free for all citizens.
“Our N.H.S. is an absolutely important institution, we cannot see it go the way of the U.S. system,” she said.
She said she has found it difficult to read reports about nurses having to rely on food banks, unable to buy groceries for their children or pay their rent as prices rise in the country.
“We were out supposedly clapping for our nurses and all of our N.H.S. workers during the pandemic and here we are treating them like trash,” she said. “I feel as though Britain is coming to its knees through chronic underfunding from a 12-year Conservative government.”
The service also has a large number of health care workers from other countries, and many say it has become difficult to continue to live in Britain. Chiara Colombo, 27, works in the pediatric intensive care but had a day off on Thursday so joined her colleagues on the picket line.
Ms. Colombo, who is originally from Italy, said the rising cost of rent and other living needs, coupled with what she termed meager pay increases for nurses, had driven many of her colleagues from the system.
The clapping that erupted during the pandemic, she added, was nice but it “doesn’t pay the bills.”