The time has come for health workers to take militant action over pay and to defend the NHS, argues Caitlin Southern

Trade unions across the NHS are balloting for industrial action in a display of combined combativity never before seen in the history of the health service. With GMB, Unite, Unison, the Chartered Society of Physiotherapy (CSP) and the RCN all consulting their members over the autumn, and the Junior Doctors Committee (JDC) of the BMA seeking approval to ballot junior doctors in January, NHS staff are gearing up to fight for the future of the health service.

While the strikes are nominally over yet another real-terms pay cut imposed on NHS staff, they must be about so much more. We have to take this opportunity to fight for more staff, to return outsourced services to the NHS, and for adequate funding for essential building maintenance and repairs.

Twelve years of ideologically driven austerity cuts have gutted the NHS, driving staffing and budgets to catastrophically low levels. Burned out workers are leaving in droves after years of cutbacks compounded by the pandemic, while those that remain buckle under the strain due to a failure to replace those leaving.

As successive governments have neglected, either through ideology or incompetence, to produce a workforce plan to address the issue, staff have no faith that the situation will improve. The argument against healthcare staff taking industrial action is that doing so causes patients to suffer, but staffing levels are now so critical that not striking is causing more harm than walking out ever could.

While unions that represent a wide range of staff, such as Unison, Unite and the GMB, have previously been willing to take industrial action, and even the junior doctors have called three strikes in their history, neither the more specialised CSP or RCN have ever gone on strike. The RCN especially has historically been strike averse, so for them to be encouraging their members to take industrial action on this scale is unprecedented. It demonstrates both how the lack of support and the scrapping of the bursary for nursing students have damaged the ability of nurses to maintain patient safety.

Resist the end of the NHS

We’re facing the prospect of Austerity 2.0 as the most recently imposed government seeks to slash public-service spending even further, and the health service, which has stoically borne brutal attacks for the good of patients, is once again in the firing line. If NHS staff and the wider population don’t stand up now and show the Tories that we will fight for a health service that is publicly run and provided, it will be gone before we know it.

Already too many services are outsourced, run under NHS branding and one-sided partnerships, but provided by companies that do not have the best interests of patients at heart. If the government is allowed to push through further cuts, even the pretence of public provision will be dropped. Once the NHS is gone, it will be impossible to have it reinstated, as pressure groups will prevent any future government from ever attempting to provide public healthcare on the same scale.

For this many health-service unions to be balloting for industrial action at the same time is unprecedented, and shows the depths of the crisis that the NHS is facing. Previous disputes have centred around particular hospitals, issues or staff groups, so the possibility of a coordinated national campaign that encompasses the entire NHS is unknown but exciting territory. It is a fight for the future of the entire health service, and therefore a fight for the wellbeing of the working class.

The Tories are pushing the line that we cannot afford the NHS more openly than ever to fit the hard-right agenda of their backers, and Starmer’s Labour has demonstrated that they will not protect public services if doing so is not in the interests of capital. This is a fight that we cannot afford to lose. The health unions need to win these ballots and coordinate strike dates to have the biggest impact possible. The strikes need to be solid because to fail here would give a clear signal to the government that we don’t have the will to resist.

Even exhausted as they are, NHS staff have the power to win fair pay, safe staffing levels, and a health service that is fit for the needs of the population. All they have to do is see it and fight for it in the workplace and on the streets.