Where next for NHS pay fight after ballot setback?

Unison union activists protest over NHS pay in Manchester in the summer

It’s looking increasingly likely the government will get away with its imposition of a 3 percent “pay rise” in the health service without facing large scale strikes.

Results of a consultative ballot among health workers in the Unison union this week were disappointing.

While more than three quarters of those that voted said they wanted to strike, the turnout was low at just 24 percent.

Before the ballot, Unison leaders said that only a turnout of at least 45 percent would trigger a formal industrial action ballot.

Unison’s results compounded those of the nurses’ RCN union which were reported last week. A smaller majority of RCN voters backed strikes, but also on a low turnout.

So far, only the smaller GMB union has moved to an actual strike ballot.

Leading Unison health activist and nurse Karen Reissmann told Socialist Worker the Unison union’s failure to lead a fight in the past decade lies behind the low voter turnout. “We are paying the price for years of union mis-leadership,” she said.

“In the health service we have faced years of attacks, cuts and privatisation without enough of a collective response.

“The last time the national union seriously mobilised to win a strike vote was in 2011 during the pensions struggle—that’s more than 10 years ago now.

“Then the whole union machine threw everything it had into winning the strike ballot, but everything that has been done since then has been a pale imitation.”

Karen says that long term union inaction has led to demoralisation among activists and frustration among members. “There have been lots of fights at a local level,” she says. “But often these are against attacks that we are all facing, so we should have pulled them all together and turned them into a national fight.

“People join the union for protection, but nationally the union continually punches below its weight.”

Now, the union’s failings are made worse by a growing crisis of morale among NHS workers. Karen pointed to the number of health workers who’ve died during the pandemic, the numbers who are currently off sick, and the psychological trauma it has caused.

“Think of everything we’ve had to do over the last nearly two years, the colleagues we have lost, those we’ve seen suffering, the way Covid has affected our own families.

It’s led to real anger. But there is no outlet for that feeling.

“For the union to bombard members with surveys and consultative ballots makes us look like we aren’t serious. It just doesn’t connect to the anger.

“It certainly doesn’t motivate the union reps to put in the extra work needed to get a vote out. Especially when Unison decided to effectively ask the same question about rejecting the government’s 3 percent offer twice.”

Karen says that many in the union bureaucracy simply don’t believe it can ever meet the 50 percent turnout threshold in the Tories’ anti-union laws.

But, she says, full time officials do feel the pressure of other unions that are fighting and from the unofficial bodies that emerged among health workers in recent times.

“The full timers don’t want the government to simply ignore them. So they go through the motions of making pay demands and threatening action, without delivering the action necessary to win a strike ballot.”

The big question for health union activists is where to go from here. With the pay fight largely over, some will think the question is settled at least until next year’s pay round. But Karen says that there are “tinderbox” conditions in the workplace.

“People are at the end of their tether,” she says. “The government are pushing all sorts of provocations, such as demanding compulsory vaccinations, and any of them could lead to an explosion.

“Our job as union activists is to fan any flicker of resistance. We need to support any small dispute, any mood of anger and drive it towards collective action.

“That’s the only way we can rebuild union organisation at the base. And the only way we can get to a serious fight over pay and the future of the NHS.”