There is widespread anger in the NHS at the government’s refusal to remedy long-standing pay issues, and this will lead to more industrial action, explains Simon Midgley

The Starmer government’s implementation of the Pay Review Body’s meagre 3.6% rise across the board for NHS workers (except doctors), received resounding rejections from the unions last month. GMB, representing NHS workers, announced on Friday 25 July that 69% of its NHS and ambulance-worker members voted to reject the award in a consultative ballot.

Unite, which represents around 100,000 workers in NHS Trusts, ambulance services and national organisations such as NHS England and NHS Blood and Transplant, announced on Tuesday 29 July that in a consultative ballot, 89% voted to reject the award, and in favour of industrial action on pay.

The result of a parallel consultation on the threatened 50% job cuts at NHS England and the Department of Health and Social Care was even higher, with 95% voting to take industrial action to fight the government’s plans.

Then on Thursday 31 July, the Royal College of Nursing (RCN) confirmed that nurses have also rejected the inadequate 3.6%. In England, the turnout in their consultative ballot was 56%, with more than 170,000 nursing staff voting, and 91% of those voting said it was not enough. This was the RCN’s highest ever turnout for such a ballot.

The RCN argues that decent nurses’ pay is crucial if the NHS is to turn around the struggling profession, which is gripped by widespread vacancies, and struggles to keep patients safe amid an NHS corridor-care crisis.

Nurses working in Health and Social Care (HSC) in both Northern Ireland and Wales have also rejected their proposed 3.6% award. Turnout in Northern Ireland was 51%, with nearly 80% rejecting the award. Turnout in Wales was a record 55%.

RCN General Secretary Professor Nicola Ranger says the pay award of 3.6% would be ‘entirely swallowed up by inflation and do nothing to change the status quo – where nursing is not valued, too few enter the profession and too many quit.’

Unison, which represents nearly 500,000 NHS nurses and other health workers, also held a consultative ballot over the 3.6% award. That consultation closed on Wednesday 30 July. The results and the union’s next steps are expected to be announced soon.

With inflation currently standing at 3.6% (CPI) and 4.4% (RPI), a pay award of just 3.6% is actually a pay cut in real terms for every single one of the 1.5 million workers covered by the NHS Agenda for Change pay-banding system. This is on top of fifteen years of pay erosion by low pay rises and pay freezes being out-paced by inflation.

The RCN and Unison are also demanding reform of Agenda for Change, which was introduced more than two decades ago. The RCN says it limits nurses to low starting salaries, and traps tens of thousands of nurses on the same pay band for their entire careers, preventing them from progressing despite years of experience, skills and training.

Unison points out that Agenda for Change Band 1 has already been abolished by the rising minimum wage, and the government decided to implement a 2.3% rise from 1 April, as an ‘advance’ on the 3.6% award, so that Band 2 pay did not remain lower than that legal minimum. This means that workers on Band 2 will only get a 1.2% or 1.3% rise on their current pay rate, not the full 3.6%. This is rightly condemned as unjust.

Meanwhile, Wes Streeting continues to insist that no more money will be invested in NHS pay. With parliament in England now in its summer recess, the health unions will be using this time to press their case on Streeting and Starmer. If they don’t get a significantly improved pay offer, it’s likely we will see a flurry of industrial action ballots this autumn.

Streeting’s propaganda assault on the resident doctors shows that pay disputes in the NHS need to have a political edge. The unions need to respond with a campaign that gives members and the public an alternative narrative.

Seventeen years of underfunding has brought the NHS to its knees, and eroded the value of NHS pay. A world-class NHS needs proper funding, with a well-paid, well-motivated and loyal workforce. To Streeting’s assertion that there is no more money, NHS unions should demand that the government funds welfare not warfare, and taxes the rich to do so.