Union leaders threatened on Saturday night to order a fresh wave of more severe strikes in the new year in which nurses would offer “less generous” support inside hospitals, in a dramatic escalation of their pay dispute with the government.
The Royal College of Nursing (RCN), in a marked hardening of its line, said there would be “more hospitals and more nurses taking part than at present” in strikes throughout January, unless ministers backed down by Thursday.
The RCN said it would reveal its timetable of bigger and wider disputes if ministers failed to open new talks on pay within 48 hours of a second day of action planned for this Tuesday.
In a further round of disputes, it would work to ensure nurses restricted the kind of work they were prepared to do on strike days to a shorter list of activities in fewer areas than had been the case on the first strike day last Thursday.
Some nurses claimed they were bullied and threatened with disciplinary action if they tried to limit their duties on the strike day.
The move by the RCN came amid the first signs that ministers may be examining ways to break the deadlock behind the scenes, to prevent the collapse of the NHS over Christmas and the new year.
The Observer has been told that meetings have taken place between senior figures at the Treasury and Department of Health and Social Care (DHSC) over recent days to discuss the dispute and potential ways to end it. Treasury sources said ministers would refuse to move beyond the recommendations of the pay review body but could potentially look at ways to give staff more money through one-off lump sum payments.
Pat Cullen, general secretary of the RCN, said: “The government should get this wrapped up by Christmas. January’s strikes, if they are forced to go ahead, will see more hospitals and more nurses taking part than at present – 2023 needs to be a fresh start for all, not more of the same.”
The latest Opinium poll for the Observer shows support for the nurses’ action has grown, with 60% of those questioned saying they back the strikes. This is an increase of 3 percentage points on a fortnight ago.
With hospital flu admissions rising steeply, the NHS faces the most widespread disruption in decades this week with strikes by nurses and ambulance workers on consecutive days.
The second RCN strike on Tuesday will affect more than 70 trusts and health organisations across England, Wales and Northern Ireland.
Strikes by ambulance workers on Wednesday will then hit 10 out of the 11 trusts in England and Wales. East of England is the only ambulance service that will not be affected. Members of the GMB, Unison and Unite unions are all taking action.
Ambulance services in the north- east and north-west of England will probably be among the most seriously affected, with members of all three unions due to strike. The most widespread action is by the GMB, with more than 10,000 ambulance workers in nine ambulance trusts taking part.
Striking ambulance crews will respond to all “life-threatening” emergencies, but less critical calls will be dealt with by a combination of military drivers, St John Ambulance, taxis and community care teams. NHS England has advised hospitals to try to free up beds in advance of the action.
Rachel Harrison, the GMB national secretary for public services, said striking ambulance workers would come off picket lines to respond to the most serious cases. She said: “I think it is safe to assume that everywhere will have cover for category one cases … how it has worked in the past is we will have picket lines outside the ambulance stations where the members will be and there will be a dedicated team there to respond when calls come in.”
Jason Kirkham, a Unite member and paramedic in the West Midlands, said: “We don’t want to cause any harm to patients. Our aim is to cause disruption to the government so they come and talk to us. We want them to engage with us meaningfully, so we can suspend this action and come to some agreement.
“Every NHS worker is working as hard as they can to protect patients, but we know the service is struggling. Morale is the lowest I have seen in 20 years.”
There will probably be little respite for those travelling overseas for the Christmas break. Border Force officers are to take action for eight days, between 23 December and New Year’s Eve, at Heathrow, Gatwick, Manchester, Birmingham, Cardiff and Glasgow airports. The action will mainly affect those arriving in the UK, rather than departing.
Ministers said their main concern for the weeks ahead was public safety. Arrangements have been made to deploy 1,200 members of the armed forces to backfill roles such as ambulance driving and conducting border checks.
These include 600 drivers and a further 150 personnel providing logistical support direct to members of the armed forces driving ambulances. Community first-responders will also be utilised to help manage demand for medical care.
Unison’s head of health, Sara Gorton, said: “Calling in the army won’t make this dispute go away. Strikes will continue into next year unless ministers stop hiding behind the pay review body and come up with a deal now to improve NHS wages and staffing.”
The health secretary, Steve Barclay, said his main concern was patient safety. He added: “I have listened to unions and am open to further discussions, but their [pay] demands are not affordable in the economic circumstances.”
A DHSC source added: “We very much regret that the RCN is considering escalating strike action which could patient safety at further risk.”
More Tory MPs joined calls for the government to compromise with NHS workers last night. Tobias Ellwood, chair of the Commons select committee on defence, said the gap over pay “needs to narrow”, adding that “both sides need to convene to try to reach agreement”. He said the dispute was “damaging the economy and putting extra pressure on everybody including the armed forces”.
Another senior Tory MP, Charles Walker, said there was “a deal to be done” with nurses. “Any organisation carrying a high level of unfilled vacancies would look at the pay that it is offering,” said Walker, who drew a contrast between NHS workers and staff on the railways, where he said few people left because of pay or conditions.
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