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| NHS staff strike in dispute over pay | |
| (35 minutes later) | |
| A four-hour NHS strike, involving nurses, midwives and ambulance staff in England, has come to an end. | A four-hour NHS strike, involving nurses, midwives and ambulance staff in England, has come to an end. |
| Workers from seven trade unions took part from 07:00 to 11:00 BST in a dispute over pay. | |
| Services have been disrupted, although emergency care was kept running - as was agreed by unions and NHS bosses ahead of the walkout. | Services have been disrupted, although emergency care was kept running - as was agreed by unions and NHS bosses ahead of the walkout. |
| Staff in Northern Ireland are taking action from 11:00 to 15:00 BST, but only two unions are involved there. | Staff in Northern Ireland are taking action from 11:00 to 15:00 BST, but only two unions are involved there. |
| The walkout will be followed by four-days of work-to-rule from Tuesday. | |
| It is not yet clear just how much disruption has been caused so far. | |
| In advance of the walkout, unions and managers had met to ensure essential services were maintained. | In advance of the walkout, unions and managers had met to ensure essential services were maintained. |
| Military personnel and police were also put on stand-by to help ambulance services if needed. | Military personnel and police were also put on stand-by to help ambulance services if needed. |
| As the morning progressed, reports emerged of ambulance services developing backlogs - although bosses said the life-threatening cases were being prioritised. | As the morning progressed, reports emerged of ambulance services developing backlogs - although bosses said the life-threatening cases were being prioritised. |
| Meanwhile, hospital staff were seen leaving the picket lines to deal with patients in some places. | Meanwhile, hospital staff were seen leaving the picket lines to deal with patients in some places. |
| Union leaders had always said their members will be providing "life and limb" cover during the strike. | Union leaders had always said their members will be providing "life and limb" cover during the strike. |
| The expectation was that 999 calls would be answered and A&E units would remain open and that seems to have been the case, according to early reports. | The expectation was that 999 calls would be answered and A&E units would remain open and that seems to have been the case, according to early reports. |
| However, hospital outpatient appointments, community clinics and some routine operations seem to have been affected. | However, hospital outpatient appointments, community clinics and some routine operations seem to have been affected. |
| The Royal College of Midwives, which is taking action for the first time in its history, said in advance services for women giving birth were going to be unaffected. Instead, its members targeted antenatal and postnatal care. | The Royal College of Midwives, which is taking action for the first time in its history, said in advance services for women giving birth were going to be unaffected. Instead, its members targeted antenatal and postnatal care. |
| Doctors and dentists were not involved. | Doctors and dentists were not involved. |
| Pay dispute | Pay dispute |
| Unison said the action - the first strike by NHS staff over pay in more than 30 years - would send a "clear message" to the government. | Unison said the action - the first strike by NHS staff over pay in more than 30 years - would send a "clear message" to the government. |
| As well as the RCM, there were another five unions involved in the strike in England - Unison, Unite, GMB, UCATT and the British Association of Occupational Therapists. Between them they have over 400,000 members, including porters, cleaners and administration staff. | As well as the RCM, there were another five unions involved in the strike in England - Unison, Unite, GMB, UCATT and the British Association of Occupational Therapists. Between them they have over 400,000 members, including porters, cleaners and administration staff. |
| In Northern Ireland, members of Unite and the GMB are involved. | In Northern Ireland, members of Unite and the GMB are involved. |
| 'Fairer deal' | 'Fairer deal' |
| Ministers in England have awarded NHS staff a 1% increase, but only for those without automatic progression-in-the-job rises. | Ministers in England have awarded NHS staff a 1% increase, but only for those without automatic progression-in-the-job rises. |
| These, designed to reward professional development, are given to about half of staff, and are worth 3% a year on average. | These, designed to reward professional development, are given to about half of staff, and are worth 3% a year on average. |
| An independent pay review board had said the 1% increase should be across the board. | An independent pay review board had said the 1% increase should be across the board. |
| It was implemented in full in Scotland. Northern Ireland has yet to make a decision on pay, while Wales did the same as England but did give extra to the lowest paid. Some unions are balloting their Welsh members about action there. | It was implemented in full in Scotland. Northern Ireland has yet to make a decision on pay, while Wales did the same as England but did give extra to the lowest paid. Some unions are balloting their Welsh members about action there. |
| From the picket line: Dominic Hughes, BBC News | From the picket line: Dominic Hughes, BBC News |
| A boisterous, noisy picket outside the Edwardian facade of the old Manchester Royal Infirmary has been made up of nursing assistants, porters, paramedics and for the first time in their history midwives. | A boisterous, noisy picket outside the Edwardian facade of the old Manchester Royal Infirmary has been made up of nursing assistants, porters, paramedics and for the first time in their history midwives. |
| Plenty of cars are tooting their support as they pass on Manchester's busy Oxford Road. | Plenty of cars are tooting their support as they pass on Manchester's busy Oxford Road. |
| Inside the hospital some services will be affected, and a number of midwives have already left the picket to go to staff a ward that was short on numbers. | Inside the hospital some services will be affected, and a number of midwives have already left the picket to go to staff a ward that was short on numbers. |
| So this is a symbolic strike but one that displays the real anger of health workers over pay. | So this is a symbolic strike but one that displays the real anger of health workers over pay. |
| Health Secretary Jeremy Hunt said that hospitals would be forced to lay off staff if the recommended pay award was met in full. | Health Secretary Jeremy Hunt said that hospitals would be forced to lay off staff if the recommended pay award was met in full. |
| "We have had very clear analysis that if we did that, hospital chief executives would lay off around 4,000 nurses this year and around 10,000 nurses next year," he said. | "We have had very clear analysis that if we did that, hospital chief executives would lay off around 4,000 nurses this year and around 10,000 nurses next year," he said. |
| "The NHS has just come through a terrible tragedy with Mid Staffordshire when we discovered the most appalling care happening there and indeed some other hospitals as well. | "The NHS has just come through a terrible tragedy with Mid Staffordshire when we discovered the most appalling care happening there and indeed some other hospitals as well. |
| "We have turned the corner on that by recruiting in hospital wards around 5,000 extra nurses in the last year alone. We don't want to turn the clock back on that." | "We have turned the corner on that by recruiting in hospital wards around 5,000 extra nurses in the last year alone. We don't want to turn the clock back on that." |
| Christina McAnea, head of health at Unison, said the offer in England was a "disgrace". | Christina McAnea, head of health at Unison, said the offer in England was a "disgrace". |
| "The fact that so many unions representing a range of NHS workers are taking action or preparing to join future actions should send a clear message to the government," she said. | "The fact that so many unions representing a range of NHS workers are taking action or preparing to join future actions should send a clear message to the government," she said. |
| "The NHS relies on the good will of its workers, but we know that a demotivated workforce is bad for patients. The government needs to start negotiating with us and reconsider their pay policy." | "The NHS relies on the good will of its workers, but we know that a demotivated workforce is bad for patients. The government needs to start negotiating with us and reconsider their pay policy." |
| RCM chief executive Cathy Warwick added: "At a time when MPs are set for a 10% pay hike, we're told that midwives don't deserve even a below-inflation 1% rise. And politicians wonder why the public does not afford them more respect. | RCM chief executive Cathy Warwick added: "At a time when MPs are set for a 10% pay hike, we're told that midwives don't deserve even a below-inflation 1% rise. And politicians wonder why the public does not afford them more respect. |
| "It feels to a great many people, including midwives, that there is one rule for them and another rule for everybody else." | "It feels to a great many people, including midwives, that there is one rule for them and another rule for everybody else." |