The leader of the Royal College of Nursing talks about how members are being forced to use food banks, her frustration with the government – and how she learned to be a tough negotiator

When Pat Cullen, the general secretary of the Royal College of Nursing, had her first meeting with Steve Barclay, the health secretary, in November last year, her union had just been balloted on strike action. “We’d just got our mandate,” she says, speaking at the RCN’s office in central London, an august building full of plaques. “And our results were really significant. So I knew that we had one opportunity to prevent a strike that was going to be enormous – the largest nursing strike in the world.”

Cullen is warm yet formidable, with a calm, level manner, but an unsettling habit of really listening and weighing her words. There are no dead zones in her sentences, which puts you on your mettle – although it didn’t, apparently, have that effect on Barclay. “It was an introductory meeting, collegiate and respectful,” she says.

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