The National Health Service (NHS) strike by nurses and ambulance staff must become the focus for the escalating conflict between the working class, the Sunak government and the employers.

This is the most politically significant strike during the UK’s ongoing wave of industrial action that first erupted in the summer. It confirms that the struggle against the worst cost-of-living crisis in living memory brings workers into head-on confrontation with the capitalist state apparatus and a government intent on making them pay for the pandemic bailout of the major corporations, the escalating war against Russia in Ukraine and the economic crisis produced by rising oil, gas, mineral and food prices and the profiteering of the major corporations.

It raises point blank the necessity to organise a general strike to bring down the Conservative government, which is  intent on destroying the NHS and smashing the strikes now hitting the health service, rail, Royal Mail, education and other key sectors.

But organising such action can only proceed in a political and organisational struggle against a trade union bureaucracy intent on isolating and sabotaging every one of these struggles, and a Labour Party that works in tandem with the Tories on behalf of the corporations and the banks.

The scale of this movement shows the immense opposition faced by the Tories as they seek to place the full burden of a deepening crisis of British and world capitalism on the backs of the working class. Hundreds of thousands of workers have already been involved in strikes this year, with more than 1.1 million working days lost between June and October and 417,000 lost in October alone, the highest figure for more than a decade. Between 500,000 and 1 million workers could now strike in the run-up to Christmas.

Britain’s strike wave is part of an explosive outbreak of the class struggle internationally, including general strikes in Italy, Belgium and Greece. But this is only a pale reflection of what the government and the employers would face if not for the concerted efforts of the trade union leaders to prevent a much larger and unified strike movement from emerging.

Ever since being forced to call action by the angry and militant sentiment of rank-and-file union members, one trade union after another has traipsed into meetings with the employers and the government begging them to a sign up to a few percentage points increase on still massively below-inflation pay awards in return for the unions agreeing to a jobs cull, speed-ups and restructuring.

This has resulted in a series of betrayals of bus, rail and local authority disputes, of which the most significant was the Communication Workers Union sell-out of the BT/Open Reach telecoms strike involving 40,000 workers. Worse still would have happened if not for two factors: the determination of workers to fight and of the Tory government to be seen to crush the strike wave and reassert the power of capital in the face of this challenge.

The NHS strikes are a telling example of the role of the trade union bureaucracy. The strikes by up to 100,000 nurses on December 15 and 20 only takes place due to the failure of the fawning appeal of the Royal College of Nursing (RCN) to Tory Health Secretary Steve Barclay to agree to talks at which pay could at least be addressed. The government refused because it wants the strike to take place and be seen to be defeated. But this was not before RCN leader Pat Cullen made clear the union had no intention of fighting for the 5 percent above inflation pay demand that nurses were demanding.

In Scotland, Unison—the largest public sector union with 500,000 members in the NHS—and Unite, have done a rotten deal to end strikes by ambulance staff and other health workers and tried to do the same in Wales.

The pattern is universal, with the CWU going so far as the appeal for King Charles to intervene and convince the government to compromise and Rail, Maritime and Transport union leader Mick Lynch writing a personal letter to Prime Minister Rishi Sunak to hold “good faith” discussions.

There will be no retreat by the government, only by the trade union leaders. The NHS is the UK’s biggest employer, with 1.5 million workers. Defeating the strike is therefore viewed as an existential issue, with hundreds of thousands of public sector workers having already balloted for industrial action and voting for strikes, or in the process of being balloted. It is also vital if the deliberate gutting of the NHS to deprive workers of vital and costly health care and pave the way for further privatisation is to continue.

The Tory government is using the demobilisation of mass opposition by the trade union bureaucracy to prepare a ruthless state offensive, based on minimum service levels legislation backed up by £1 million fines that will effectively outlaw strike action in any sector deemed to involve “critical infrastructure”. An outright ban of NHS strikes has also been mooted.

Time and again the trade union leaders urge complacency, based on the claim that the next Labour government in two years-time will reverse such legislation and ameliorate some of the worst cuts. All lies. Labour leader Sir Keir Starmer and his minions have proclaimed their opposition to strikes and that the nurses pay demand is unreasonable. For the future, he has declared Labour to be the party of “sound money”—a euphemism for cuts and austerity. His Shadow Health Secretary Wes Streeting rails in the Telegraph against a “something-for-nothing culture in the NHS”, pledges to go further than the Tories in using the private sector and that he will “take on” the health unions.

The Telegraph praised Streeting, declaring that “Labour’s rhetoric sounds more conservative than the Conservatives.”

What Streeting means is that Labour will take on the working class. To do this, Starmer has pledged to the Confederation of British Industry that Labour is “ready for partnership” to boost productivity and profits and to impose austerity on workers by forming an Industrial Strategy Council based on “a real partnership between government, business and unions.” This would be the way the “party of NATO” would continue the Tories’ war against workers at home and an escalation of NATO’s war against Russia. At Prime Minister's Questions Wednesday, Starmer assured Sunak that “whatever other difficulties and disagreements we have across this dispatch box, we are and will remain united in our unwavering support for Ukraine’s freedom, its liberty and its victory.”

Workers must answer this political conspiracy to promote austerity, militarism and war. To do so they must seize control of their fate from the trade union apparatus.

Rank-and-file committees, democratically elected, must be formed in every workplace, to unify the growing wave of struggles based on the demand for a general strike to bring down the Tories. This fight must be waged as part of a global offensive of the working class through the building of the International Workers Alliance of Rank-and-File Committees (IWA-RFC).

Any struggle against the Tories must also be a struggle against Labour and the building on an alternative socialist leadership in the working class.

The Socialist Equality Party calls on workers to demand an immediate general election, one held not after the trade union bureaucracy has betrayed and dissipated the mass opposition in the working class but under conditions where the class struggle is now reaching new and explosive dimensions. In any general election, the SEP will stand candidates against the parties of big business, Tory and Labour, to politically organise the necessary mass movement of the working class against austerity, for the elimination of COVID-19 and for an end to war.