Steve Fouch

Industrial Action: How should Christians in the NHS respond?

Steve Fouch is CMF Connections Manager, and formerly worked in community nursing, HIV & AIDS and palliative care. He serves on the International and European regional boards of Nurses Christian Fellowship International.
The views expressed do not necessarily reflect those of CMF.

Many Christian nurses and allied health professionals have been asking me how they should act in the face of a mounting industrial dispute. Next Wednesday (30 November), around 100,000 health workers in the UK will join an estimated 2 million other public sector employees in a one day strike in protest about the government’s proposal for the future of public sector pensions.

The arguments about the pensions issue are fairly well covered in an opinion piece in last month’s Prospect, needless to say that the issue of lower pensions, bigger contributions and later retirement are not unique to the public sector, – not to this country.

The Herald reports that next Wednesday thousands of elective operations and outpatient appointments in Scotland alone will be postponed, inconveniencing many, causing distress to quite a few. Most trusts in the UK are planning to run Christmas day level services, with full emergency cover, but no clinics or elective procedures.

Not all health sector unions are joining in the day of action.  The BMA and RCN are not officially joining in (although the latter is threatening to ballot on industrial action in the New Year).  Unison, Unite and the GMB, plus several teaching and other public sector unions have all balloted for strike action, with Unison reporting that 82% of health workers who voted were in favour of strike action.

It is worth noting though, that out of 400,000 health workers who are Unison members, less than 90,000 actually voted. Choosing not to vote is still making a choice, one that says in effect ‘I will defer to the decision of the majority who do vote’. As less than one in four Unison members working in the NHS voted, that shows a surprising degree of diffidence over the issue. There is a lot of anger about how the government wants to change pensions, but is it enough to lead to major walk outs in the NHS?  We’ll find out on Wednesday.

So, how should Christians respond? I have found relatively little useful guidance on Christian websites and blogs so far, so here are some thoughts and pointers in relation to the current dispute.  This is not a full theological and practical shake down of the subject, but it is a humble attempt to look at the underlying principles.

The first point to make is that the removal of labour is a coercive act, and therefore should be the last course of action in any dispute.  Consider the implications for your patients, their relatives and carers, your colleagues (not just medical and nursing staff, but ancillary, administrative and managerial), employer (the trust, the NHS as a whole), and your profession if you withdraw your labour. That being said, there are precedents for Christians taking direct action, from boycotting sugar during the anti-slavery campaigns during the eighteenth century, to the bus strikes during the US Civil Rights movement.  These were not purely Christian boycotts, but Christians did join in with them.  Where the cause has been just, Christians (and others) have found it well within their conscience to take direct action and practice civil disobedience.

But are NHS pensions in the same league?  If we have good grounds to believe that some of our colleagues are going to be left far worse off, even destitute as a result of these measures, then the answer is probably a qualified ‘Yes’.  On the other hand, if everyone in the country is going to have to pay more and work longer than we expected, to have a reasonable (or even comfortable) retirement income, are the Government proposals really a major injustice, or just learning to live with the new economic realities of the decade?  I do not offer an answer to those questions, and I myself am not going to be retiring on an NHS pension, so cannot offer a personal perspective.

The Bible has a bit to say in general about industrial relations, although most of the scriptures you will see quoted relate to slaves and their masters.  I won’t go into the arguments about whether modern workers are wage slaves, or that we have rights, and our employers responsibilities (that would be undreamt of New Testament times), let alone the ethics of slavery. Nevertheless, they do highlight some general principles.

Colossians 3:22 ‘Slaves obey your earthly masters in everything’

1 Peter 2:18 ‘Slaves, submit yourselves to your masters with all respect, not only to those who are good and considerate, but also to those who are harsh.’

1 Timothy 6:1 ‘Let all who are under a yoke as slaves regard their own masters as worthy of all honour, so that the name of God and the teachings may not be reviled’.

It is clear that Paul and Peter, in writing these messages were urging slaves not just to do their jobs, but to be exemplary, going over and above the call of duty.  The motivation for this is also clear:

Colossians 3:23-24 ‘Whatever you do, work heartily as for the Lord and not for men. Knowing that from the Lord you will receive an inheritance as your reward. You are serving the Lord Christ’.

Matthew 25:40 ‘The King will reply “I tell you the truth, whatever you did for the least of these brothers of mine, you did for me”

We serve God when we serve our employers (and more importantly, our patients) well. But we are also enjoined throughout the Bible to have a concern for justice and to stand up for those who are disadvantaged or poorly treated: Isaiah 1:17 ‘Learn to do good, seek justice, correct oppression, bring justice to the fatherless, plead the widow’s cause’.

We are also called to make peace where there is conflict – Matthew 5:9 ‘Blessed are the peacemakers’ – and to act with good conscience, putting others needs ahead of our own – Philippians 2:3-4 ‘Do nothing from rivalry or conceit, but in humility count others more significant than ourselves. Let each of you look not only to his own interests but also to the interest of others.’

(Scripture references taken from

So, in Christian workplace ethics, obedience and service are vital, putting the interests of others first, standing up for what is right, but seeking to honour our employers, and in so doing honour God. We serve God ultimately through serving the needs of our patients in obedience to our employers (NHS Trusts and GP practices).

I would suggest that based around these theological principles, when we are facing questions about industrial action there are four key questions to ask when making a decision (listed here in reverse order of priority):

1: Is the cause just – regardless of whether I will be significantly worse off or not, will my colleagues on lower pay be badly affected by these changes? Would I be perpetuating an injustice by not joining in?

2: Have the Unions and Government exhausted all other avenues to settle this dispute?  Is there room for reasonable compromise on either side that has not been taken?

3: Will taking industrial action adversely affect the health, wellbeing and distress of my patients? What level of service will be left if I am striking, and will the cancellation of elective operations, clinics and other procedures cause significant distress?

4: Will I be honouring God in taking this action?

There are several challenges that arise, whatever our conclusions to these questions:

1: We should take trade union membership seriously.  Get onto union committees, become a shop steward in your workplace, be active in influencing the policies of the union and its relations with the NHS in your workplace.  Christians should be right at the coalface of industrial relations, standing for justice and righteousness in the workplace.

2: Following on from that, always make sure that you vote whenever there is a ballot, even if your feelings are not strong either way.  Choosing not to vote implies a passive agreement with the decision of the majority who do vote.  But only those who cast a vote actually decide the action to be taken.

3: Recognise that your colleagues and friends will have different perspectives, so try to act with integrity, grace in pursuit of justice, rather than offering judgements on their decision. Be gracious and forgiving.

4: But be prepared to be unpopular for taking a principled stand – whether to strike or not to strike.

5: Finally, however you choose to act – never lose sight of those higher principles behind your actions and the attitude you adopt. It is God that you serve ultimately, and your conscience should be clear with him throughout.

There is no right or wrong answer about whether to join in on 30 November, or any subsequent industrial action, but thinking and praying through these questions and challenges may help you come to a wise decision.


Posted by Steve Fouch
CMF Head of Allied Professions Ministries



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