The health unions’ attempt to sell out National Health Service (NHS) workers and pull the rug on the UK’s strike wave must be opposed.

On Thursday evening, the Conservative government gleefully announced, “Government and Health Union agree pay deal paving way for an end to strike action”. The agreement is for NHS workers to receive a 6 percent one-off bonus payment for April 2022-23—the enforced 4.75 percent average pay deal for the year remains unchanged—and a 5 percent pay rise for April 2023-24.

The Royal College of Nursing (RCN), GMB and Unison unions all endorsed the deal. RCN General Secretary Pat Cullen declared it would “make a positive impact on the nursing profession”. Unison’s head of health Sara Gorton said it was “a shame it took so long to get here.” General Secretary of the GMB Rachel Harrison cheered the “strength and hard work of GMB’s NHS members” for making the agreement possible.

Unite has sought to distance itself, in the usual cynical fashion, by declining to recommend the offer but doing nothing to oppose it.

The deal is an insult. It has been cooked up in closed-door discussions with Tory ministers in the weeks since all strike action was cancelled by the RCN in February and by Unite, Unison and the GMB in early March. Thursday was the first any nurse, paramedic or other hospital worker heard of it and the response has been overwhelmingly hostile.

Union members can barely believe their eyes; what has been presented is far worse than anything anyone could have possibly imagined.

If accepted, NHS workers will be worse off in April 2024 than they were in April 2021—even with the highly unlikely assumption that inflation doesn’t exceed 5 percent for 2023-24. This is after having worked through the nightmare of COVID in a collapsing health system and after a decade in which health workers have already lost thousands of pounds in real-terms pay.

The unions allowed a 3 percent pay award to be imposed in April 2021-2022. With the average 4.75 percent for the next year added on top, this gives a pay rise over two years of 7.9 percent. This is dwarfed by a rise in RPI inflation between April 2021 to January 2023 (the latest figures available) of 19.7 percent and the lower CPI index of 14.8 percent.

Even with the one-off payments included, workers fall far short. And it is unclear how even this will be funded, with talk of the health service—already underfunded by hundreds of billions—being asked to make additional “efficiency” savings.

How to fight back!

Action must be taken to overturn this rotten deal. The union bureaucracy has decades of experience in pushing through sellouts with intimidation and lies. Health workers must organise to fight back with their own plan of action.

Vote “No” and speak out against the sellout!

It is essential that all NHS workers vote to reject this rotten sellout. But they must also campaign against it. A barrage of propaganda is being produced by the government, the unions and the media to present this agreement as a victory for health workers. This lie must be exposed. Workers have already denounced the deal on social media. We encourage others to share these comments and post their own, using the hashtag #NHSFightBack.

Statements can be sent to the World Socialist Web Site where they will be published for an international audience, breaking the media blockade on criticisms of the deal.

This work is critical to building a resounding NO vote in the upcoming ballots.

Resume and extend the strike!

Throughout the dispute, the trade union bureaucracy has worked to limit and divide walkouts despite mass support among health workers and throughout society. Each strike day has proved the sentiment that exists for all-out action against the Tories and their Labour Party partners which would upend the unions’ pursuit of a filthy deal with the government.

There is no need to wait for the ballot result on what is an illegitimate deal which the unions had no mandate to agree. Emergency branch meetings should be called to agree a new programme of strikes, reaching out to health workers in other unions to organise the joint action that should have been waged from the start.

Remove the union leaderships!

The union leaders, their national executives and negotiating committees are engaged in sabotage. They should be removed from their positions immediately. Emergency branch meetings should pass votes of no confidence in these sellouts and traitors.

This must be the beginning and not the end of a struggle to transfer power out of the hands of the union bureaucracy to the rank-and-file. It will not be easy: after members removed the RCN leadership in September 2018 following the last major NHS pay deal sellout, half were put back in position three months later, producing the leadership responsible for Thursday’s betrayal. What is required is an insurgency against a union apparatus dedicated to the suppression of the membership.

Form rank-and-file committees!

It is not enough for the old leaders to be thrown out.Something new must be built. Victory depends on the formation of workers’ own representative organisations, rank-and-file committees, independent of the structures of the union and free from the pressure of its staff. These would be run by the most trusted workers, popularly elected and committed to fight against sellouts and for workers’ basic interests.

These rank-and-file committees must reach out to other sections of workers facing the same struggle: to university workers currently fighting the University and College Union’s sellout of their strike; to teachers forced to vote on a sellout deal in Scotland by the Educational Institute of Scotland, and in Wales by the National Education Union, which is entering talks with the Westminster government next week; to junior doctors whose British Medical Association leaders are also planning talks; to postal workers being betrayed by the Communication Workers Union; and to rail workers already largely demobilised by Rail, Maritime and Transport union, ASLEF, TSSA and Unite.

NHS workers must also reach out to their brothers and sisters internationally. Millions are striking and protesting all over Europe against low pay and crumbling social infrastructure, with France and Greece in the forefront. Workers all over the world are finding themselves at war with governments determined to slash wages and public services and with trade unions which act to block any struggle against them.

A network of rank-and-file committees will provide the foundation for a counteroffensive by the working class in every country. NHS workers in the UK, over a million strong and one of the largest workforces in the world, will play a critical part.

NHS FightBack, the Socialist Equality Party, the World Socialist Web Site and the International Workers Alliance of Rank-and-File Committees will provide every assistance in this battle. Contact us today and link up with likeminded workers to stop this sellout!