Endemic low pay represents a threat to the very future of the NHS, the head of the biggest union representing health staff has warned ahead of an expected wave of strike action this winter.
While strike action over pay was “not inevitable”, it appeared likely, said Christina McAnea, the general secretary of Unison. A formal ballot of staff in England, Wales and Northern Ireland opens later this month, while the process is ongoing in Scotland.
Unison was likely to coordinate with other unions in the NHS to increase the impact of any stoppages, and could also liaise with strikers in other sectors such as transport, she warned.
It came as the head of the Unite union, Sharon Graham, predicted on Sunday that up to 1 million people in various areas could soon be on strike at once.
Speaking to reporters before the Trades Union Congress conference that begins in Brighton on Tuesday, McAnea, whose union represents more than 400,000 health staff including nurses, cleaners, porters and administrators, said workers felt there was no other way to get their message across.
“It’s this core of the NHS, the registered professional staff, who are telling us they just can’t survive on the pay levels they’ve got,” she said.
While healthcare is devolved across the UK, NHS staff in England, Wales and Northern Ireland, excluding doctors and dentists whose pay is assessed separately, have been offered a pay rise of £1,400 a year.
For many staff such as nurses this amounted to about 4%, McAnea said, compared with an inflation rate of close to 10%. Even for lower-paid staff the lump sum was a pay rise of little more than 7%, she said.
”Strikes are a symptom of things going wrong,” she said. “It’s not a coordinated political campaign to bring down the government. We bring our members out on strike when we reach the point where there’s no other alternative.”
Low pay has been identified as a key reason for NHS staff shortages, with more than a quarter of trusts in England operating food banks for staff. Asked if pay represented an existential threat to the health service if not addressed, McAnea said it did.
“One of the big problems we’ve got with the NHS is the turnover of staff. They can’t recruit staff at a load of grades now,” she said. “The retail sector and Amazon are paying more in some areas. And no disrespect to people who work in retail or in Amazon warehouses, but I think that’s a less stressful job.
“I’m not a great one for conspiracy theories. But I do wonder if this is a deliberate policy, to run down the NHS so much so they can turn round and say, look, it’s failing, let’s bring in some private companies. I think the British public would oppose that, but it’s kind of happening by stealth.”
Stoppages are unlikely to begin before Christmas except in Northern Ireland, where the law on industrial disputes is different. They would probably be short term to begin with and would require the union to negotiate what level of staffing was needed to maintain “life and limb” emergency cover. However, McAnea said, given the staff shortages this may not be notably different to what happens normally.
“We’re pretty certain that they will come back to us with proposed safe staffing levels which are higher than we’ve got at the moment,” she said. “Our members feel that the situation is already so bad, they don’t think it will get any worse when they take action. What it will do is draw attention to just how bad it is in the NHS.”
McAnea said that while the Scottish government seemed open to negotiations – the offer there is 5%, also rejected by the union – Unison had repeatedly sought contact with Liz Truss and Thérèse Coffey, the health secretary, with no response.
“The government, instead of demonising unions, has to recognise that it’s their responsibility to come back and talk to us,” she said. “How is the government going to frame this, when it’s our members taking strike action?
“Are they seriously going to tell a healthcare assistant who worked all through Covid and is on £18,000 or £19,000 a year, ‘You’re holding the country to ransom’? Are they going to say, ‘You’re being irresponsible’? Are they going to say they’re an enemy of progress and an enemy of growth?”
• This article was amended on 17 October 2022. Due to a transcription error, an earlier version omitted the word “not” from Christina McAnea’s statement that strike action over NHS pay was “not inevitable”. This has been corrected.
