Tens of thousands of nurses are striking Monday alongside ambulance crews and call handlers, in the largest strike in the history of the National Health Service (NHS). Nurses will continue their strikes with a walkout on Tuesday with NHS hospitals and facilities in 73 health Trusts impacted.

The strikes are the third round of walkouts since an initial strike in December, with a 48-hour strike following last month. NHS staff are fighting an imposed £1,400 pay award backdated to last April, worth on average just 4 percent. They are taking place despite the attempts of the trade union bureaucracy to settle on a deal well below the 19 percent pay rise NHS workers voted overwhelmingly to fight over.

The Royal College of Nursing (RCN) attempted to call off the first strike if the Conservative government health minister would even agree to discuss pay. RCN leader Pat Cullen then declared the union’s readiness to meet the government “halfway” on pay and settle for 10 percent.

Then last Friday, the unions moved to smash up a unified struggle of NHS workers by agreeing a below inflation pay deal with the Labour Party-run devolved Welsh government.

The GMB union and the RCN promptly called off Monday’s strike—set to mobilise thousands of nurses and some 1,500 ambulance workers for 12 hours—after being offered an extra 3 percent in pay, taking it overall to just 7 percent. Of this just 1.5 percent will be consolidated and the rest made up of a non-consolidated, one-off payment. The lowest measure of inflation, CPI, is at 10.5 percent and the more accurate measure, RPI, at over 13 percent. Welsh Health Minister Eluned Morgan said the unions had been “constructive”.

The Wales sellout follows the unions’ promoting the revised deal cooked up by the Scottish National Party/Greens devolved government in Edinburgh, worth an average of just 7.5 percent, in order to block mandated strike action, with Unison and Unite pushing the agreement through in subsequent ballots. The SNP administration then enforced the agreement on all NHS workers in Scotland, in the face of opposition from the membership of the GMB, RCN and Royal College of Midwives.

The Wales deal was immediately offered up to Conservative Prime Minister Rishi Sunak by RCN leader Cullen as the basis for ending all action by nurses in England.

Cullen took to the national media in a desperate attempt to sell the devolved government deals to Sunak, writing a column in the Daily Express Friday declaring, “While politicians in other parts of the UK have shown a willingness to engage in meaningful negotiations on pay, Mr Sunak has steadfastly refused.”

The day before, February 2, an RCN delegation had delivered a petition and open letter to 10 Downing Street signed by “100,000 members of the public, patients, and nursing staff”, stating, “The NHS is the bedrock of modern Britain. And it is crumbling… On behalf of the nursing profession, I implore you to see sense. Protect nursing to protect the public.”

Sunak didn’t bother walking to his front door. Cullen complained in her Express article, “Nurses from across the country came to your front step yesterday to deliver a letter from the public addressed to you. You were home, but still not willing to talk.”

The same refrain was rehearsed by Unite union General Secretary Sharon Graham. Speaking to the BBC’s Sunday with Laura Kuenssberg, Graham complained that the government was refusing to negotiate on pay “at any level”. She said “categorically that there have been no conversations on pay whatsoever with Rishi Sunak or [Health Secretary] Steven Barclay about this dispute in any way, shape, or form.”

She complained, “In 30 years of negotiating, I’ve never seen such an abdication of responsibility in my entire life… Rishi Sunak is the CEO of UK plc. We are trying to sit down with him and do a negotiation. It’s very difficult to do a negotiation to solve a dispute like this if they won’t even come to the table.”

Graham’s outraged pose consists of a complaint that the union leaders are desperate to engineer a sellout and the Tories won’t let them. This is hardly surprising, when the unions keep offering one climb-down after another, including imposing sellout agreements on BT telecom workers and others—in the process undermining and betraying months of strikes by rail, postal and other public sector workers.

Sunak doesn’t need to meet anyone when the trade union bureaucracy in the NHS unions, education sector, Rail, Maritime and Transport union and Communication Workers Union are now down on their hands and knees begging for scraps.

The prostration of the unions has emboldened the Tories to push through its anti-Strikes (Minimum Service Levels) Bill, which sped through parliament within a month and is now making its way through the House of Lords, with a second reading February 21. Scheduled to be on the statute books by the summer, not a single strike has been called by any of the 48 unions affiliated to the Trades Union Congress against the greatest attack on the right to strike ever planned.

Health workers face equally determined opponents in the Labour Party, with its leader Sir Keir Starmer declaring in the pro-Tory Sunday Telegraph, that the NHS should not be “treated as a shrine”. Shadow Health Secretary Wes Streeting told the same newspaper: “We are not going to have a something-for-nothing culture in the NHS with Labour… I’m not prepared to pour money into a black hole.”

NHS workers needs fighting organisations, not ones that help impose government pay cuts and austerity. NHS FightBack, an initiative of the Socialist Equality Party, calls for the building of independent rank-and-file committees in every workplace to take the fight to defend the NHS, along with the pay and conditions of those who work in it, out of the hands of the trade union bureaucracy.

The fight for a living wage in the NHS requires unification of the more than one million health workers alongside the millions more in struggle to defend their pay and conditions throughout the public and private sectors. This fight must be waged based on a socialist programme that would see a massive injection of funds, paid for by taxing the super-rich and taking control of the major corporations, including Big Pharma, freeing medical research and drug production from the constraints of private profit.

All the resources of society must be placed in the hands of the working class and used for the benefit of all, not the enrichment of a few. Such a policy would see the NHS given the necessary hundreds of billions of pounds of which it has been starved.

We urge all those who agree with this perspective to contact NHS FightBack.