The NHS is facing the most disruptive strike action in a generation this winter, as healthcare unions prepare to coordinate walkouts for maximum effect.
Motions being debated at the TUC annual congress in Brighton this week will commit unions in the health service to working together in pursuit of a better deal on pay and conditions.
Speaking to The Independent, Unison general secretary Christina McAnea said coordination could be extended to other sectors, such as transport, with the possibility of a national day of action to kick off an escalating series of time-limited health strikes.
Ms McAnea issued a plea for the prime minister and the health secretary to get involved in talks to try to settle the dispute, complaining that approaches by the union have so far been ignored in Westminster, in contrast to the response of devolved governments in Scotland and Wales.
“I’ve written to Liz Truss and we’ve contacted Thérèse Coffey asking for meetings with them. We get no response whatsoever,” she said.
“We represent 1.3 million public sector workers in this country. They’ll go to receptions with hedge fund managers, but they can’t find time to talk to us. It’s outrageous.”
Any hopes of a more conciliatory stance from the government were dealt a blow by Ms Truss branding trade unions as part of a supposed “anti-growth coalition” in her Conservative conference speech earlier this month, she said.
“Of course trade unions want growth because it’s through growth that you get money to fund jobs and to fund public services,” said Ms McAnea. “And there’s no way in the world we’ll get growth with this current government while they are basically treating people and workers in this country like guinea pigs with their mad policies.”
She said that the public response to recent industrial action by rail and postal workers had “heartened” her that voters will not buy any attempt to demonise health staff who protest against below-inflation pay offers.
“Are they seriously going to tell a healthcare assistant who worked all through Covid and is living on £18-19,000 a year: ‘You’re holding the country to ransom’? Are they going to say they are an enemy of growth?” she asked.
Unison will ballot its healthcare members – including anyone from nurses and physios to cleaners, cooks and managers – in England, Wales and Northern Ireland from 27 October, following a similar vote in Scotland which started on 3 October, bringing the total number of workers consulted to more than 400,000.
Other healthcare unions, including the Royal Colleges of Nursing and Midwives, the Chartered Society of Physiotherapists, Unite and the GMB, are also holding ballots to similar timetables, setting the scene for coordinated action early in the new year, as the busy winter season is at its height.
Ms McAnea dismissed talk of a general strike, which she said would be unlawful under the UK’s harsh trade union laws.
You might actually be safer during the strike. Our members feel that the situation is so bad that they don’t think it will get any worse if they do take action
But she said: “We’ll be working very closely with the other NHS unions that are taking strike action. We will be sitting down as a group to talk about how we manage the strike action and when we take people out on strike and where we take people out on strike.
“There may well come a point where we’re talking to other sectors, like transport.”
Any industrial action in the NHS will observe “life and limb” agreements to provide minimum service levels to deal with emergencies and essential treatment, said Ms McAnea.
But trusts will have to shut down as many as half of operating theatres and dramatically scale back elective procedures and outpatient services, adding to the already lengthy backlog of patients waiting for treatment.
Ballots are being conducted trust by trust, with walkouts possible in any individual organisation where more than 50 per cent of members vote for industrial action.
Ironically, said Ms McAnea, safety agreements stuck with NHS trusts in areas like A&E and paramedics are likely to set higher levels of staffing than are available on non-strike days, in a service whose workforce is permanently stretched to breaking point.
“You might actually be safer during the strike,” she said. “Our members feel that the situation is so bad that they don’t think it will get any worse if they do take action. And what that will do is draw attention to just how bad it is in the NHS.”
The Unison boss said the NHS was currently “haemorrhaging” staff to better-paying and less stressful posts in the private sector, with cleaners and porters leaving to work in supermarkets and distribution warehouses.
The £1,400 flat-rate pay rise offered in April was worth just 4 per cent to typical registered and qualified staff like nurses, physios and occupational health workers, at a time when inflation is running at around 10 per cent, she said.
Even for the worst-paid on £16,000-£17,000, the offer is worth only around 7 per cent. And the 1p cut to the basic rate of income tax announced in Kwasi Kwarteng’s mini-Budget will add only pennies to their weekly pay packets.
With the sharply deteriorating economic position since the offer was made, and many private sector employers making an additional pay award to recognise the cost of living, Ms McAnea said Unison is now looking for an improved settlement around the level of inflation.
“It would be entirely reasonable for the government to come back and say, ‘we recognise the stress and strain NHS workers are under, and we’re prepared to give you a second pay award’.”
She added: “Strikes are not inevitable. I hope that, in the time that we’ve got between now and when we may be taking strike action, the government will actually do something about it, take the initiative, talk to us about what we do to settle this dispute.
“None of my members in the NHS want to take strike action, they just feel at this point in time nobody’s listening to them, and they have no alternative.”
Ms McAnea said that the government’s failure to maintain pay and working conditions in a service coming under ever more strain led her to question whether there was a threat to the NHS’s very existence.
“They are holding pay down and it’s not just at the bottom level,” she said. “Registered professional staff are now telling us they just can’t survive on the pay levels they’ve got. NHS employers are now in some areas putting on food banks for their staff. That’s how bad it’s got.
“We have the worst public ratings since the NHS started in terms of public satisfaction, seven million people on a waiting list – the worst since the NHS started.
“A bit of me wonders, is this a deliberate policy now to run down the NHS so much that they can say: ‘Look, it’s failing, let’s bring in some private company or let’s let American health companies come in and run the NHS for us’? I think the British public would oppose that, but it’s kind of happening by stealth.”
