Hundreds of thousands of nurses are taking part in the biggest strike since the National Health Service (NHS) was founded 75 year ago. The two-day action (strikes held over 12 hours each day from 7.30 a.m.) by the Royal College of Nursing (RCN) Monday and Tuesday was joined by almost 12,000 ambulance staff, paramedics, emergency care assistants and call handlers.

Nurses and ambulance staff have staged separate strikes since December in protracted pay disputes, but Monday was the first time they have taken co-ordinated action.

NHS staff are fighting a government imposed £1,400 pay award backdated to last April, worth on average just 4 percent. This is less than half the rate of CPI inflation (10.5 percent) and even further below the more accurate RPI measure (over 13 percent).

Nurses struck at 73 NHS trusts in England, an increase on the 44 trusts hit in a strike December and 55 in January. Some trusts contain multiple hospitals, with hundreds impacted during the strike.

As with every NHS strike, cover for emergencies was provided by nursing and ambulance staff. Ambulance staff in the GMB union walked out in seven of the 10 English ambulance services, along with the national Welsh service.

Thousands of ambulance crews in Unison are set to walk out Friday. Striking the same day will be 4,200 NHS physiotherapy staff across 100 trusts in England.

While this was the largest ever strike among the more than one million NHS staff, the health unions continue to do all they can to divide workers at a regional level and across borders. This week’s strikes were originally to include not just nurses in England, with a health service serving over 55 million people, but also thousands of nurses and 1,500 ambulance workers in the smaller service in Wales. But action by Welsh nurses was called off Friday, with unions agreeing to ballot on a pay deal proposed by the Labour Party-run devolved Welsh government. The deal offers a miserly extra three percent in pay for the current financial year, taking it overall to just seven percent. Just 1.5 percent will be consolidated and the rest made up of a one-off payment—more than 12 percentage points below the initial pay claim of 19.2 percent RCN workers voted to fight for in last year’s ballot.

Unite was unable to reach its own sellout deal over ambulance worker members in last-minute talks Sunday with Wales Health Minister Eluned Morgan. General Secretary Sharon Graham stated Monday, “We’re close, but we do need to move a little bit more on the wages, rather than just a one-off payment,” indicating how close Unite had been to a sell-out deal.

The fight by NHS workers is being strangled by the trade union bureaucracy. The moves in Wales follow the unions’ promotion of the revised deal cooked up by the Scottish National Party/Greens devolved government in Edinburgh, worth an average of just 7.5 percent, 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 RCN said Monday that negotiations in Scotland “continue over the deal for the current year”, with the assurance that “there are no planned strikes.”

The same press release saw RCN leader Pat Cullen offer to end strikes in England based on a similar deal. She told Conservative Prime Minister Rishi Sunak, “Your government looks increasingly isolated in refusing to reopen discussions about the 2022-23 NHS pay award… which would stop nursing strikes.”

The union bureaucracy also ensured that no health workers were involved in strikes last week to coincide with action by 500,000 teachers, university staff, civil servants and rail workers—the only significant coordinated action organised by the trade unions during a strike wave stretching back to last summer.

The government doubled down Monday on their refusal to increase workers’ pay. Health Minister Steve Barclay stated that last year’s pay offer was done and dusted at four percent, declaring, “I don’t think it’s right to go back to last year, to last April, retrospectively. We should be looking forward to the pay review body that is taking evidence now and working constructively with the trade unions.”

Socialist Equality Party members spoke to NHS workers on picket lines, angry over the below-inflation pay deal and their appalling working conditions, and increasingly disillusioned with the unions.

Carlos, a paramedic in Bradford, said, “We’ve had 10 to 13 years of austerity with cuts here there and everywhere. Looking back at the pay over the last 10 years or so is a 25 percent reduction in ambulance staff wages, and with inflation it’s affecting us massively. We’ve got staff going to foodbanks and we’ve got our own foodbank here on station, because our staff can’t afford the basics--teabags, milk, bread, the simplest of things.

“I think the demand for 19 percent is realistic. We have not just got nurses, we’ve got ambulance staff, teachers, postal strikes. There’s so many people coming together because there’s been decade of austerity and it will get worse if we don’t stand up. Even the doctors are looking at striking. I think a general strike would make a big impact—all of us united.

“The unions aren’t what they used to be. Unfortunately, there’s been some intermingling between unions and governments and that happens in many other countries. The unions are more on the employers’ side rather than the workers’.”

Ethnea, a practice development nurse at St Thomas’ Hospital, London, said, “It has been 10 years of underappreciating the nurses. And I’ve felt that. We constantly get lower pay rises than inflation, and you feel so undervalued.” Her colleague Rebecca added, “Blame Labour [in power between 1997 and 2010] for that; they got rid of inflation rate pay rises.”

Annie, a newly qualified nurse at the Christie hospital in Manchester, said, “It’s not ideal for me to be given nine or 10 patients who are very poorly in an oncology hospital, which will just put off future young nurses. The government is trying to mask the actual reasons for what is going on in the NHS, and that it depends on our good will to carry on. But that’s running out now, because patients are not safe.

“I also think that there’s not been a big enough push back from the Labour Party and that the public is finally starting to work this out, with all of the strike action across the country. We’ve had rallies across the country, but we need everyone to come together across the public sector, firefighters, nurses, postage, rail workers, everyone. I agree with a general strike. There needs to be a big change in how the public sector is run.”

SEP members distributed the NHS FightBack article, NHS nurses and ambulance workers strike in England as union bureaucracy push sellout Wales deal. The statement explained, “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.”

NHS workers contact and join NHS FightBack today!