The below-inflation pay deal between Britain’s main health unions and the Conservative government has provoked anger among National Health Service (NHS) workers. It is likely the deal will be rejected by nurses in balloting that closes Friday April 14, with members of Unison, Unite and other health unions voting on the same deal in separate ballots.

The Royal College of Nursing (RCN) leadership led by General Secretary Pat Cullen is resorting to threats and intimidation in a bid to force through a “yes” vote. Its strong-arm tactics culminated in threats to call police against organisers of a petition calling for an Extraordinary General Meeting to move a no-confidence vote in Cullen and the National Executive which endorsed the below-inflation pay deal, along with the union’s negotiating committee.

While the petition and RCN threats to call police were reported prominently in the Guardian, Times and nursing publications, Britain’s Socialist Workers Party buried news of both. Its only mention is at the end of an April 4 article on the junior doctors’ strike headlined, “Junior doctors battle for better with four-day strike”.

The SWP’s correspondent writes, “Disgracefully the RCN has asked the police to investigate a petition to hold a vote of no-confidence in its leadership. It has also reported the behaviour of other members to social media platforms and the nursing regulator.” These two sentences are the sole reference to what is a significant development in the class struggle, following the first national nurses’ strike in NHS history.

Despite the article stub’s headline, “Nurses must organise a revolt: campaign and vote to reject shoddy deals”, the SWP advances no strategy for a nurses’ revolt, instead encouraging the illusion that a majority “no” vote will be enough to defeat the RCN leadership’s rotten deal with Health Secretary Steve Barclay and the Tory government.

The SWP’s article concludes, “Activists need to carry on fighting for no votes until the very last moment. The best way to create an atmosphere of struggle in the workplace is to join the junior doctors on their picket lines. The best way to fight is to stand together.” Their headline article declares,“Health workers in the NHS must keep fighting for better despite all of the attacks from the Tories and the media”.

Such empty tub-thumping serves to divert workers from the necessary political struggle they face against the unions’ collusion with the government. Junior doctors face the same issues as nurses, with the British Medical Association (BMA) already signalling its willingness to negotiate based on a retreat from the junior doctors’ pay claim. The Tories’ pay-cutting agenda is reliant on the health unions’ role in dividing and suppressing unified action by hundreds of thousands of NHS nurses, doctors and allied health staff.

The SWP’s muted response to the no-confidence petition is more striking as one of its leading members, Karen Reissmann, is a national executive member of Unison, Britain’s largest health union. Reissmann came to national prominence recently after she was fined £10,000 by Greater Manchester Police for organising a socially-distanced protest during COVID against low pay for nurses. A campaign in her defence won huge public support with police forced to withdraw the fine. She would be in an ideal position to promote the RCN petition and to advocate for similar action in Unison, including an Extraordinary General Meeting to mobilise the membership against the union’s betrayal and a vote-of-no-confidence in executive members who endorsed the Conservative government’s offer.

Like the RCN leadership, Unison’s National Executive is recommending a real-terms pay cut, based on a one-off lumpsum payment of 8.2 percent for the lowest paid and around 6 percent for nurses, midwives and other colleagues (in band 5) for 2022-23, and a 5 percent consolidated rise next year (less than half the rate of inflation). This would mark 13 years of below-inflation pay awards for NHS staff.

Unison’s leadership is also browbeating workers to accept the deal. Sara Gorton, Unison head of health, issued a statement on March 27, warning members, “A vote to reject would likely see the one-off payment disappear and leave NHS staff waiting for the uncertain outcome of the pay review body. The government has told the review body it could only afford 3.5%, so that’s a risk.”

Reissmann is not the only SWP member on Unison’s NEC. Others include Liz Wheatley, Helen Davies, Julia Mwaluke, Caroline Johnson and Sandy Nicoll. None have any intention of mounting a campaign to remove the right-wing leadership and place the rank-and-file in charge. This would mean mobilising health workers on a socialist anti-austerity platform, including the fight for an inflation-busting pay rise in direct opposition to the union bureaucracy. The efforts of the SWP’s members in Unison are instead focussed firmly on elections to the union’s national executive which begin Monday.

The SWP pays lip service to “rank-and-file” action, but its efforts are directed in practice toward the union bureaucracy or supposed “left-wing groupings” within it. A March 16 article in the Socialist Worker headlined “Why health workers should reject the new NHS pay deal”, declares, “A left wing grouping on the Unison union’s health executive is urging workers to reject an inadequate deal”.

What does this “left-wing grouping”, which includes the SWP, advocate?

The SWP promotes a March 17 statement by Time For Real Change (TFRC), which is the dominant faction in Unison’s national executive, as offering a road to defeat Unison’s sell-out pay deal. TFRC won a majority of positions in elections to the national executive in 2021, with a slate backed by the SWP that included Reissmann, Wheatley, Davies, Mwaluke, Johnson and Nicoll, and members of the Labour Party, Socialist Party and other pseudo-left groupings. It won 40 out of 68 seats on the executive council.

Yet the outcome of this “left-wing” victory and TFRC’s pledge “for a members’ union” has been a rout of members’ interests. A vote in favour of recommending the government’s below-inflation pay offer was taken by Unison’s health Service Group Executive (SGE) on March 16 where supporters of General Secretary Christina McAnea, aligned with Labour leader Sir Keir Starmer, reportedly retain a majority. Yet TFRC members merely called for a “no” vote to fight for “something better”. What this should comprise remains unstated, with the TFRC refusing to advance any concrete proposals for a pay rise or other demands to address the crisis facing NHS staff.

The “left wing grouping” hailed by the SWP has no genuine independence from, or strategy to oppose, McAnea’s leadership. Indeed, its March 17 statement goes so far as to describe the first element of the Tory’s pay deal with health unions “a big improvement” on its original offer, before noting lamely that “we could have done so much better”.

Wedded to the bureaucracy

The SWP claims, “Union leaders shied away from using their strongest tactic [i.e., rejecting the deal and continuing the strike], fearing that it might drive away public support.” On the contrary, they feared a direct challenge to the Tory government would unleash an avalanche of support from doctors, nurses and other health workers which they would be unable to contain.

Their “left-wing” opponents in the TFRC are just as fearful that any open challenge to the bureaucracy’s grip would encourage a rank-and-file rebellion. If the SWP and its members are downplaying the RCN no-confidence petition, this is not an accidental oversight. They instinctively oppose any initiative that threatens the grip of the bureaucracy, of which they are a part.

In responding to the eruption of rank-and-file opposition within the RCN, the Socialist Equality Party and NHS FightBack welcomed the no-confidence petition launched by RCN members and has sought to promote it among health workers, while pointing to the fundamental political tasks it poses before the working class. In its statement of March 17, “UK National Health Service workers must organise to defeat the Tory-union sellout deal!”, NHS FightBack wrote, “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.”

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It continued, “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.”

NHS FightBack urged, “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.”

The statement called for the formation of rank-and-file committees in all hospitals and workplaces, explaining, “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 sell-outs and for workers’ basic interests.”

The diametrically opposed responses of the SWP and the SEP and NHS FightBack speaks to the unbridgeable chasm dividing socialist internationalism from the nationalist politics of the pseudo-left. Bound to the trade union apparatus and the capitalist nation state by countless threads, the pseudo-left is hostile to any independent action by the working class that challenges the grip of the bureaucracy.

Forming rank-and-file committees would allow health workers to break down the divisions erected by the health unions between nurses, doctors and allied health staff, and enable NHS workers to reach out and coordinate action with workers in struggle across the UK and Europe, including France where strikes and protests have rocked the government of Emmanuel Macron, opening up the possibility for a European-wide and global counter-offensive by the working class against austerity, war and the endless looting by the capitalist oligarchy.

Contact and join NHS FightBack today. NHS FightBack Facebook here and Twitter here.