Pat Cullen originally joined the world’s biggest nursing union because it never went on strike but has become the first head of the Royal College of Nursing to lead a walk-out in its 106-year history.
“When I joined the Royal College of Nursing 41 years ago, I joined because it was a non-striking union,” she told the Guardian on the day that the union’s long-running industrial action formally came to an end on 27 June.
“But as time has moved on, and the crisis within nursing has heightened and the government has seemed unwilling to listen, it has become clear that the only way to have nurses’ voices heard was to withdraw their labour.”
Cullen was speaking hours after it was confirmed that the union had not secured enough votes to restart strikes, bringing to an end a series of walkouts that lasted the best part of six months and threatened at times to cripple the NHS.
The vote, in which 84% of respondents voted for strike action but only 43% of members responded – below the 50% threshold needed to approve a new round of strikes – also brought an end to a turbulent few months for Cullen herself.
Having been heralded as a champion of the labour movement at the height of the strikes, Cullen then suffered a backlash from many of her own members when she recommended they accept the government’s offer of a 5% pay rise, plus a one-off payment of at least £1,655. Some believe this week’s failure to secure enough votes to go back on strike is a further blow to her authority.
“Pat was great at energising members when we first went out on strike,” says one RCN member who did not want to be identified. “But after that she made a series of strategic failures: she struck a below-inflation pay deal, she lost a vote to approve it and then failed to explain to members why she wanted to go back on strike over a deal she negotiated.”
Cullen insists such criticism is unfair: she negotiated the best deal she could, and when it was rejected by members, she had to reflect their concerns by balloting again for strikes.
“I was in those negotiations day and night with the government, and I’ve said all along that we got everything off the table that we could possibly get off it,” she says. “I told the government that the non-consolidate [one-off] payment was going to be a major challenge, and so it proved.”
However, she adds the union’s campaign for higher pay has not ended. “There is a mandate from nursing staff to have their voices heard,” she says. “We have taken strike action for the first time in 106 years. You can’t just ignore their voice because we haven’t met these thresholds this time around.”
Cullen, 59, started as a nurse in Belfast in 1982. She was one of seven siblings, five of whom became nurses. None of her sisters who still work as nurses were affected by her pay negotiations, as they all work in Northern Ireland, but she says they were cheering her on from the sidelines.
“They are all very very supportive,” she says. “And I suppose would say that they wouldn’t expect anything less from me.”
Those who negotiated with Cullen during an intense three-week round of talks earlier this year say she was a formidable interlocutor: steely, but ready to puncture the tension with a flash of humour. They also say she occasionally misrepresented what happened in the negotiating room to the press afterwards: something she denies.
Having insisted for months they would not re-open the 2022/23 pay deal, ministers eventually backed down with their offer of a one-off sum. Cullen says her success was down to nurses’ willingness to stay out on strike and the continued public support for them during that period.
Cullen separately secured a promise from ministers to look into a separate pay structure in future years, which infuriated other unions, who warn their negotiating position would be weakened.
“[The collective pay arrangement] does not recognise the modern, transformative skills and expertise of the nurses within the complex systems we work in in 2023,” she says. RCN officials say the union now wants to leave the collective system, known as Agenda for Change, entirely – a move that would fundamentally change the way NHS pay is negotiated.
Cullen’s real problems started after the deal was agreed. Having organised a highly successful strike campaign, the RCN boss found it harder to persuade a fired-up membership they should now stand down. A faction within the union known as NHS Workers Say No successfully led a push to vote it down, which members did by 54% to 46%.
Cullen bats away suggestions she might have resigned at that point. “I never quit when a job’s not done,” she says. “It never entered my psyche for one minute to actually walk away and leave those and abandon the profession at a time when they needed this college.”
Nevertheless, the ballot left scars. Some members organised a petition to call an extraordinary general meeting to oust her; the leadership threatened to call in the police, alleging that signatures had been forged.
And when she went back to members once more over the last few weeks to urge them to strike again, frictions resurfaced, with many members saying they were confused as to why she had backed the deal but was now urging them to strike over it.
The RCN recently fired three organisers after they sent out material to members which was deemed to be critical of its leadership. As agency workers, they were dismissed summarily and, they allege, without recourse to union representation of their own. Cullen refuses to comment, saying the RCN is investigating the circumstances that led up to their dismissal.
Cullen however insists her job is not done, and that she intends to remain as head of the union for the foreseeable future. “We’re on a journey,” she says. “I started that journey with the profession with our first strike in 106 years. And I will continue on this journey until every single one of our nurses’ voices are heard.”
• This article was amended on 29 June 2023 to clarify that the agreement to look into a pay structure for nurses in future years was not part of the agreement secured alongside other unions, but a separate promise made to the RCN.
