A ballot of around 100,000 NHS members of the Unite union is under way over possible strike action this winter in protest at a below-inflation pay offer.
Voting by Unite members in England and Wales began as the Royal College of Nursing announced almost half a million members will also take part in a separate strike ballot next month.
Both unions are recommending their members support industrial action, which could begin in October and throw the health service into crisis over the winter.
Unite general secretary Sharon Graham said that a typical 4 per cent pay offer for NHS professionals including scientists, health visitors and speech therapists amounted to a “massive national pay cut” at a time when inflation is forecast to top 13 per cent.
“After everything they have been through with the Covid pandemic and the service this workforce gives this country, day in day out, this is a kick in the teeth from the government and an insult to staff and patients alike,” said Ms Graham.
“This ballot is a chance for our members to have their say, and whatever they decide, they will have the full backing of their union, Unite.”
Unite said that, with no additional cash being made available by government to fund the increase, staff pay was effectively being pitted against patient care in a battle for scarce resources.
Unite’s national officer for the NHS, Colenzo Jarrett-Thorpe, said: “For the government to demand that even this insulting pay offer is funded through existing NHS money is an appalling, irresponsible move.
“The health service is already at breaking point and needs urgent investment to stave off collapse but we also need to reward staff properly.
“There are already 40,000 vacancies across the NHS. This dreadful pay offer will only make it far harder to recruit and retain staff.”
The Unite ballot closes in England on 11 September and in Wales on 15 September.
The RCN postal ballot will run for four weeks from 15 September.
If nurses approve a proposal for total withdrawal of labour, it will be the first ever strike by RCN members in England or Wales.
The college went on strike for the first time in its history in Northern Ireland in 2019.
The RCN also announced it has increased its industrial action strike fund to £50m, up from £35m, to provide financial support towards lost earnings during strikes.
The RCN has called for a pay rise for nursing staff of 5 per cent above RPI inflation, which is currently 11.8 per cent.
The union denounced last month’s pay award as a “national disgrace” after calculating it would leave an experienced nurse more than £1,000 a year worse-off in real terms after inflation is taken into account.
RCN officials said industrial strike action was a last resort, but the current NHS staffing crisis was causing “unacceptable risk” to patients and staff.
A formal pay announcement is still awaited in Northern Ireland, while in Scotland the college has urged its members to reject a 5 per cent offer from the Scottish government.
Pat Cullen, RCN general secretary, said: “Nursing staff will stop at nothing to protect their patients.
“Staff shortages are putting patient safety at risk and the Government’s failure to listen has left us with no choice but to advocate for strike action.
“A lifetime of service must never mean a lifetime of poverty. Ministers’ refusal to recognise the skill and responsibility of the job is pushing people out of the profession.
“The next prime minister must change course urgently.”
