Ambulance workers staged a third national walkout in five weeks yesterday across England and Wales in their fight against the imposition of a 4 percent pay award for 2022-3 for National Health Service (NHS) workers.

The strikes by over 18,000 ambulance workers included paramedics, technicians, call handlers and control room staff in Unison, Unite and the GMB. 

The third one-day stoppage involved 15,000 ambulance workers from Unison with strike action across five regions:  Yorkshire, North West, North East, South West and London. They were joined by around 5,000 NHS staff at two hospital trusts in Liverpool. The action by Unite covered 2,600 ambulance workers in five regions, also including the North West and North East, together with the West Midlands, East Midlands and Wales. Action by the GMB covered around 1,000 ambulance workers in the West Midlands, with a further walkout today in the North West.

Derogations were again agreed to provide “life and limb” cover”, with category 1 calls covered to ensure emergency response for life threatening cases.

The Sunak Conservative government opposition to the demand for a cost-of-living pay increase has hardened. Ambulance workers were again accused of causing “disruption” to NHS services by Health Secretary Steve Barclay, who stated that the only pay talks proceeding concerned the upcoming financial year. This leaves the pay award for 2022-3 worth less than half the rate inflation.

Business Secretary Grant Shapps stated a fortnight ago that the action by ambulance workers was “putting lives at risk.” But public support remains on the side of the strikes, as it is widely recognised that the threat to patient safety comes from the crippling cuts to the NHS by the government now imposing a de facto pay cut on frontline staff.

Armed forces personnel were deployed to break the strike by driving ambulances as they have since the start of the dispute on December 21. Their role is negligible from the standpoint of providing emergency cover. The main purpose is political, to normalise the use of the army to break industrial disputes of key workers as they have against passport officers in the airports during strikes at Christmas and are being lined up to do against firefighters. A strike ballot of over 30,000 members of the Fire Brigades Union (FBU) closes next Monday as another critical section of blue light workers have been handed down an insulting pay offer—in this case of 5 percent.

Shapps is tasked with overseeing the introduction of the Sunak governments’ anti-strike legislation through the Strikes (Minimum Service Levels) Bill to outlaw the type of action taken by ambulance workers and nurses. The fact that this has nothing to do with patient safety is underscored by the worst delays at A&E in December since records began, with up to 500 people dying every week due to delays in emergency treatment.

The GMB and Unite unions last week announced further strike dates, consisting of four and nine days respectively through to March 20 beginning February 6. The respective heads of both unions made references to the Tory government “demonising” ambulance workers but made no mention of the anti-strike legislation the smear campaign seeks to legitimise. 

The Royal College of Nursing as well as the unions affiliated to the Trades Union Congress (TUC) —Unite, GMB and Unison—have conspired to ensure health workers will not even join the official TUC protest on February 1 against the Strikes Bill. This is the case even though hundreds of thousands of civil service workers, teachers and university lecturers are set to take part in a one-day stoppage.

The next one-day stoppage by ambulance workers in the GMB and Unite, on February 6, coincides with the first day of a two-day strike by the RCN, involving 40,000 nurses in England and Wales. 

The demand for unified action has been consistently raised from the picket lines, but Unite General Secretary Sharon Graham stated yesterday to LBC Radio, “There’s many, many days between now and 6 February and I hope what the government do is come to their senses, get the general secretaries around the table – we will be there any time, any place, anywhere – and do this deal.

“So I really hope that 6 February doesn’t go ahead because the government puts an offer on the table.”

The general secretaries are leading an undignified retreat from the pay mandates of their membership. Graham stated on Sky News that Unite would take a “double-digit” pay offer back to its membership—as low as 10 percent—as a pretext to get the strikes off the agenda.

The Unite leader referenced RCN General Secretary Pat Cullen who had unceremoniously ditched the “restoration pay” demand of RPI + 5 percent [19 percent] and offered to meet the government “halfway”. 'We have extended an olive branch, in fact the whole tree, to government. We've said meet us halfway, so now come on,” said Cullen.

Unison General Secretary Christina McAnea has even promoted Chancellor Jeremy Hunt, a former health secretary, as a champion of the cause of NHS workers. She told the Guardian, “Jeremy Hunt knows the NHS better than anyone in the cabinet.

“As health secretary he negotiated the wage deal to end the 2015 strike and pushed for fair pay when health select committee chair. But as chancellor he’s chosen to forget all that. He must come out of hiding and unlock the funding to end the strikes.”

Hunt was a widely despised health secretary. Between 2012-18, Hunt oversaw historically low levels of NHS spending, extended privatisation, abolished the nursing bursaries and took on the junior doctors in 2016 to impose an inferior contract gutting terms and pay.

The bureaucracy of all the health unions have already paved the way for a below inflation deal in Scotland. The revised offer of the Scottish National Party (SNP)-led devolved government amounted to an average uplift of just 7.5 percent—fully 3 percent below even the lower measure of inflation (CPI) which stands at 10.5 percent.

Unison and Unite got the substandard deal over the line but it was voted down by members of RCN, GMB and the Royal College of Midwives collectively representing 50,000 health workers with a mandate to strike. This was overruled by the union heads on the pretext of going into talks with SNP Health Secretary Humza Yousaf on the pay award for 2023-4. The stitch up involves a promissory note that any improved deal would be backdated for just three months to January.

The BBC reported a similar backdating of the pay award for this year is a scenario being explored by Barclay in the rest of the UK. The other option reported was finding an additional £2-3 million from the existing underfunded NHS budget. Last week Barclay wrote a column for the Independent, “Pay hikes for NHS staff are unaffordable – and will cut patient care.”

Labour leader Sir Keir Starmer sang the same tune and set out the party's own pitch for further NHS privatisation in the Telegraph

The RCN estimated last November that the cost of settling the nurses pay claim would be £9 billion if it was rolled out across all NHS staff apart from doctors and dentists. This figure is comparable to the sum paid by the Tory government to the private sector for PPE [personal protective equipment] which had to be written off as not fit for purpose amid criminal profiteering as the pandemic tore through the population.

The unification of health workers against the sabotage of the union apparatus requires the establishment of rank-and-file committees. This must be connected with a broader struggle to mobilise the working class whose interests are excluded by a political set up that places corporate profits above the fundamental needs of society. This will emerge as part of a globally unfolding upsurge of the working class against war, an unending pandemic and unprecedented levels of social inequality through the building of the International Workers Alliance of Rank-and-File Committees.