With disputes among Ford workers and lorry drivers in the immediate recesses of memory, public sector strikes like those among gravediggers and school meals workers added to the continuing pressure on the British public and the Labour government. All of these disputes, nevertheless, came to a resounding crescendo with action taken in the NHS. Already emboldened by her attacks on secondary picketing, Thatcher appeared on the Jimmy Young Programme on January 31, 1979, directly challenging the striking workers in the health service. ‘Some of the unions are confronting the sick […] If someone is inflicting injury, harm, and damage on the sick, my God, I will confront them.’

Thatcher's bold assurances, however, obscured a more complex dynamic of accumulative factors within the health service since its foundation. Acute staff shortages and the government's need for cheap labour created low-paid, working-class vocations within the NHS. Three major groups were recruited: men left redundant from de-industrialization; white working-class women who were primary and/or essential breadwinners, and overseas workers, particularly from the West Indies, restricted to such work partly by racism. NUPE was one of the major unions to mobilize this workforce. During the Winter of Discontent, as the workers pushed for improved wages and conditions, they were also reshaping new forms of industrial militancy.

Although the NHS was a key beneficiary of increasing public expenditure under both Labour and Conservative governments, two major problems developed: budgets and staffing. From its inception in the Beveridge Report, politicians assumed that there was a ‘fixed quantity of illness in the community,’ so as people became healthier, their need for a health service would taper off, and expenditure on the NHS would as well. Politicians failed to foresee that the number of individuals seeking health care would actually increase. Therefore, from 1950 to 1958, the NHS’ budget grew by a modest 12.8 per cent, but in both periods 1958 to 1968 and 1968 to 1978, governments more than doubled the NHS budget by 26 per cent.

Governments could not prevent the number of patients being served by the NHS, but they could control staff wages. Therefore, ‘unskilled’ ancillary grades were created in order to help the hospital with essential work such as cleaning and cooking.