Thousands of nurses are staging a second round of strikes for two days this Wednesday and Thursday at 55 NHS Trusts across England. Members of the Royal College of Nursing (RCN) mounted their first national strike with two days of action on December 15 and 20.

The strikes are the first in the 106-year history of the RCN, taken in response to the imposition by Prime Minister Rishi Sunak’s Conservative government of a major real terms pay cut on over a million National Health Service (NHS) workers under the Agenda for Change. The £1,400 pay award backdated to last April is worth on average 4 percent—well below the current rate of inflation at 14 percent as measured by the Retail Prices Index.

Resistance has built up over many years, triggered by the highest cost of living crisis in four decades with the salary of an experienced nurse having fallen by 20 percent since 2010, meaning they are working the equivalent of one day a week unpaid. The RCN put an initial pay demand of RPI plus 5 percent.

Nurses have already been joined by thousands of ambulance workers fighting the same pay cut, with one day national stoppages in December and this month.

The demand for an above inflation pay deal by nurses takes place amid a growing strike movement, which began last summer. Claims that the pay demand is unaffordable come from a government imposing crippling budget cuts in the NHS and demanding further “efficiencies” extracted from its overworked and underpaid staff.

This is leading to a deliberate collapse in health care provision, aimed at legitimising plans for further privatisation.

Last year more than 27,000 nurses and midwives left the NHS, leaving 47,000 nursing vacancies as part of 133,400 unfilled posts in the NHS in England. The haemorrhaging of professionals with a further detrimental impact on patient care is fuelling militant opposition seeking to reverse the collapse of the NHS and the contemptuous treatment of frontline staff.

The follow up strike by nurses is the first since the government announced it would bring forward its Strikes Bill, aimed at outlawing the type of industrial action being held by nurses and ambulance staff by imposing Minimum Services Levels during strikes. The health service is one of three sectors in which the repressive measures will be imposed. Under the draft law workers who have voted to strike can be named and compelled to work during strikes and if they refuse can be sacked. Massive fines will be levelled on unions who do not comply.

The unions are boosting the Labour Party’s claim to oppose the legislation, a nauseating political pantomime. Party leader Sir Keir Starmer has spent the past year disowning growing strike action, echoed Sunak’s insistence that the nurses’ pay demand is unaffordable and pledging a Labour government to further privatisation.

In the face of these attacks, the RCN leadership along with the health unions affiliated to the Trades Union Congress (TUC) met last week to reject any co-ordinated strike action. They agreed only to back a day of protests scheduled for February 1—although subsequently strikes have been announced for that day by the National Education Union; Public and Commercial Services Union; ASLEF train drivers union, Rail, Maritime and Transport Workers union (train driver members); and the University and College Union. Going forward TUC General Secretary Paul Nowak has promised to work within the anti-strike laws while mounting a legal challenge they know is futile.

According to a Guardian report of the TUC meeting, RCN General Secretary Pat Cullen “made clear her opposition to coordinated action by different unions and said the RCN would not join such a move.” It noted, “Officials in other unions said they feared that any concerted stoppage, involving massive disruption to a range of key public services, could reduce public support for the ongoing campaign of strikes.”

This is a contemptible lie. Public support is growing for striking health workers against a government hated for representing the exclusive interests of the super-rich presiding over a social disaster threatening the existence of the NHS. A poll published by the pro-Tory Telegraph ahead of this week’s strikes found that 59 percent of voters support walkouts by doctors and nurses, up from 50 percent on November 30.

The RCN along with the Unison, Unite and GMB unions traipsed into a meeting with Health Secretary Steve Barclay on January 10, as part of pay talks in the health, education and railways sector—at the same time as the government brought forward its repressive legislation to criminalise strikes.

Cullen showed her contempt for the demand of nurses by stating that the RCN would meet the government “halfway” on pay and settle for 10 percent. The humiliating climbdown was not taken up by the Tory government.

In a comment to the Independent Cullen said, “The nurse shortage costs lives—Sunak cannot put a price on a safe NHS.” The Tories in fact put a price on everything, making clear during the pandemic that countless lives will be sacrificed for corporate profit. More than 200,000 lives were taken in Britain, with COVID still the third highest cause of deaths in the world. How valued were the lives of 1,500 health and social care workers killed by COVID, given inadequate protection while the pandemic profiteers reaped millions from government contracts supplying faulty PPE?

The health secretary insists that any additional pay will have to come from the NHS’s cash strapped budget. The Guardian revealed, “A government source said that the Treasury is waiting for Barclay to set out which NHS services could be scaled back in order to release what health service insiders estimated would be the £2bn to £3bn needed to offer more than 1 million workers an improved deal for 2022-23.”

The RCN is stifling action by its 100,000 members eligible to strike, as it makes overtures to the Tories. While the number of Trusts involved in strike action has increased from 45 to 55 in this second stage (70 NHS employers in total, including Integrated Care Boards) it will not include nurses in Wales and Northern Ireland as was the case in December. No further action will be held by the RCN until strikes in England and Wales on February 6/7.

The action by nurses and other NHS workers faces sabotage at the hands of the apparatus of all the health unions. This has taken the form of promoting the revised offer from the Scottish National Party (SNP)-led devolved government in Edinburgh as a fair deal contrasted with an intransigent Tory government. The NHS Scotland pay deal was worth an average of just 7.5 percent and was used to block mandated strike action, with Unison and Unite pushing the agreement through in subsequent ballots.

This was used by the SNP government to enforce the agreement on all NHS workers in Scotland. The membership of the GMB, RCN and Royal College of Midwives all voted down the deal. But rather than honour this mandate by around 50,000 health workers, all the unions agreed to close down action before starting to begin “intensive negotiations” for the next 2023 pay award.

The opposition of the unions to a unified struggle against the government’s onslaught against the NHS and its repressive anti-strike legislation is a warning to workers that their struggles must be wrested from the union bureaucracy and a genuine fight launched.

The vice like grip of the corporate and financial oligarchy (with the top FTSE 350 companies reporting an increase in profits from pre-pandemic levels of 73 percent in 2021) over all aspects of life must be ended.

The defence of the NHS demands a combined struggle against the Tory government and its de facto Labour Party ally, who agree on all major issues from backing war on Russia, to “living with COVID.” This means building rank and file committees to co-ordinate an industrial and political offensive by the entire working class. We urge workers to join and support NHS FightBack, initiated by the Socialist Equality Party.