By Millie Collins
The resounding rejection of the government’s derisory 3.6% pay offer is a potential turning point in the struggle to restore our ailing NHS.
Nine out of 10 nurses in the RCN voted no and the union will move to a formal strike ballot starting on 13 September and running to 13 October.
Pay insult rejected
Unite the union, representing over 100,000 medical professionals including ambulance workers, porters, and facility staff, has also decisively rejected the deal. While GMB and Unison members both rejected the offer, union leaders are blaming an insufficient turnout for taking no further action. Members must organise and fight against this undemocratic and cowardly decision.
Overall these votes reveal the deep well of militancy that exists beneath the surface of the health service and the profound failure of Health Secretary to resolve the staffing crisis. With over 40,000 nursing vacancies, it is hard to argue the pay is right.
The offer was made to all Agenda for Change staff, a move designed to impose a ‘one size fits all’ pay cut on every NHS worker except doctors. The government’s strategy is clear: to enforce a universal austerity settlement, hoping that by dividing the fight profession by profession, they can wear down resistance. They have failed.
The offer itself is an insult, a real terms pay cut that does nothing to reverse over a decade of declining wages, crushing workloads, and the staffing crisis that threatens patient safety daily. The government and its representatives on the pay review body are not neutral arbiters; they are managers of the capitalist state, tasked with imposing austerity on the NHS to protect the profits of the ruling class. Their offer of 3.6% is a calculation of what they believe they can get away with, not what is needed.
New strategy needed
This also exposes inherent limitations of the current union leadership. Their strategy has been one of pleading and protest, of managing discontent rather than unleashing it. There has been no attempt to draw all the workers in hospitals and health centres together, where they could combine forces in joint meetings, actions and strike committees.
The activists in the RCN and Unite, the BMA doctors who already have a live ballot must launch a united campaign to win the coming strike ballots. If successful a genuine, all-out health sector strike would be possible. To achieve this, we must build militant strike committees in every hospital and clinic. It must be composed of elected reps from every union and every grade.
Rather than conducting this fight, ward by ward, profession by profession, it requires a coordinated, all-out strike across the entire health service, a general strike in the NHS that can bring the system to a halt and force the government to surrender.
The Labour government hopes that the fights will remain separate and workers will burn out, but the answer must be to unite and escalate. The question is whether it will be dampened by the bureaucracy or allowed to ignite a broader explosion.
In 2023 the RCN leadership undemocratically imposed a rotten deal, despite the gallant efforts of NHS Workers Say NO. This time, these militants and new activists need to prepare to prevent any backsliding by the tops and if necessary take control of the dispute.
By organising general assemblies of all health workers, activists can link the fights across every sector of the health service, and transform this wave of rejection into a struggle that defends not just pay, but the very principle of a health service free at the point of use.
