The Prime Minister has said he is not able to “wave a magic wand” to resolve the bitter dispute over pay among NHS staff.
Rishi Sunak said that giving pay rises to striking staff – including ambulance workers and nurses – would lead to money being taken away from “elsewhere in the NHS budget”.
But he insisted that the Government would continue to “engage in dialogue with the unions”.
Earlier, the Prime Minister was accused of being “missing in action” during the dispute, with one union pointing to an “abdication of leadership”.
Unite said that Health Secretary Steve Barclay “does not have authority” to negotiate pay deals, as it urged Mr Sunak to call a meeting with union leaders.
It comes as thousands of ambulance workers are staging the third strike in five weeks in the bitter dispute over pay.
Up to 15,000 Unison ambulance workers are on picket lines and have been joined by up to 5,000 of their NHS colleagues at two hospital trusts in Liverpool.
Further strikes are planned in the coming weeks by nurses and other NHS workers.
Pressed on whether there would be a point where he would have to sit down and negotiate with unions, the Prime Minister told ITV News: “Taking a step back, of course it would be lovely to be able to wave a magic wand and just give everyone what they were demanding when it came to pay.
“But my job as Prime Minister is to make the right decisions for the country, and they are, more often than not, not easy decisions.
“But that’s my job, and that’s what I will always do in this job, and… when you think about this, how would we pay for these things? Where’s the money going to come from?
“Actually, it’s probably going to have to come from elsewhere in the NHS budget, and that means fewer nurses, fewer doctors, fewer MRI scanners and CT scanners that are diagnosing people with cancer or indeed fewer mental health ambulances that we’re announcing today that are going to save people from going to A&E.
“My job is to balance all of those things and do what I believe is right for the country. And that’s what we’re doing.
“I need to do, and the government needs to do, what is right for the country long term.”
The Prime Minister had earlier told the BBC: “What we have said on pay is that the Government is of course happy to discuss these things with all the unions, but we have to make sure that conversations about pay are grounded in what’s fair and what’s reasonable and responsible for the country and what’s affordable – and that’s why the dialogue is important, and I’m glad that that’s happening.
“We’ve talked about our approach to pay very, very clearly and transparently and the NHS are doing a very good job of trying to minimise the impact of these strikes on people’s care.”
Asked if there was any possibility of talks in the next few weeks, Mr Sunak said: “I’d always like to be optimistic that we can find a way through on this and what I’d say to union leaders is continue to engage in these talks and we want to have a dialogue on pay.
“The easy political thing to do is obviously say we’d love to do all of the things that people are asking us to do – but at the beginning of the year I set out my priorities, very clearly, and the first one was to half inflation.
“The biggest pressure people are feeling right now is with the cost of living, it’s with their bills, and I’m determined to deliver that.
“Part of doing that is making sure that we’re responsible when it comes to pay and what the Government can afford.
“It’s not going to be good for nurses, ambulance workers or indeed anybody else if we can’t combat inflation – because that’s ultimately the thing that is causing people the most difficulty and that’s the plan that we’ve got.
“Sometimes that involves doing some things that are difficult, but ultimately, the right long-term things to do for the country, and that’s what I’m here to do as Prime Minister.”
Taking a step back, of course it would be lovely to be able to wave a magic wand and just give everyone what they were demanding when it came to pay.— Rishi Sunak
Thousands of nurses and ambulance workers are due to stage walkouts on February 6 if no deal has been reached by then – potentially the biggest day of strikes in the history of the health service.
And as nurses take strike action on February 7, they will be joined by midwives in Wales.
Members of the Royal College of Midwives in Wales are to stage an eight-hour walkout from 8am to 4pm but will provide “bank holiday cover” for women in labour.
Sharon Graham, general secretary of Unite, told LBC radio: “There’s many, many days between now and February 6, and I hope the Government come to their senses, get the general secretaries around the table – we will be there any time, any place, anywhere – and do this deal.
“So, I really hope that February 6 doesn’t go ahead because the Government puts an offer on the table.
“If they don’t do that, of course it will go ahead (and) it will be a very bad day for the NHS, everybody will feel that.”
Mr Barclay has described “constructive talks with unions about this coming year’s pay process for 2023/24”, but unions have been calling for the 2022/23 pay award to be reviewed.
Ms Graham added: “The Prime Minister is missing in action.
“There has been not one meeting that has been about 22/23 pay and, quite frankly, we’re almost negotiating with the Government on the airways (sic).
“They’ve gone on airways talking about constructive meetings. I don’t know what meetings they’re in, because they’re certainly not the same ones I’m in – I can’t put ‘constructive meetings’ on a ballot form. I need them to come with an offer.”
She told Sky News: “I want Rishi Sunak now to come to the table. It’s very clear that Steve Barclay does not have any authority, he doesn’t have the authority to do the deal.
“The Prime Minister has absolutely not spoken to us about this in any way, shape or form.
“This is his responsibility. This is the biggest abdication of leadership that I have seen in negotiations ever in 30 years of negotiating. He needs to do the job he’s paid for – get around the table so these people now can get back to work.
“I’m the leader of the biggest private sector union – the private sector wouldn’t operate like this in negotiations of this calibre… the CEO will be in a room with me, would be negotiating and put a deal back to the members. That’s what the Government needs to do.
“Either Rishi Sunak isn’t up to the job and he doesn’t know how to negotiate, or there’s something more sinister going on here.”
Thousands of members of Unison, Unite and the GMB unions staged walk outs across England and Wales on Monday.
Paramedics, emergency care assistants, ambulance technicians, other 999 crew members and control room staff across five services in England – London, Yorkshire, the North West, North East and South West – joined picket lines.
Porters, cleaners, nurses, midwives, healthcare assistants, theatre staff and other NHS workers at the Liverpool University Hospitals Trust and the city’s Heart and Chest Hospital are also out on strike.
NHS medical director Professor Sir Stephen Powis said: “As with other ambulance strikes, the message to patients remains that it is vital to come forward and seek emergency care if needed.
“This includes calling 999 for life-threatening emergencies as well as using 111 online for other health needs where you will receive clinical advice on the best next steps to take.
“People should also continue to use local services such as pharmacies and general practice as they normally would which aren’t impacted by strike action.”
