Ambulance workers across England and Wales have staged their second national walkout against the imposition of a derisory 4 percent pay rise by the Conservative government. This forms part of the pay settlement for National Health Service (NHS) workers and amounts to a 10 percent cut when compared with inflation.

The previous stoppage on December 21 involved ambulance workers who are members of the GMB, Unison and Unite trade unions. The latest one day action on Wednesday was held by the GMB and Unison. It involved up to 25,000 ambulance workers, including drivers, paramedics, call handlers and technicians across all areas of England and Wales except for the Eastern region and Isle of Wight. The action by the GMB covered 9 regions and Unison 5 regions, including London. According to the Guardian 10,000 members of the GMB were out and 15,000 from Unison.

The Sunak government again deployed armed forces personnel to drive ambulances. Their role is negligible from the standpoint of providing cover and is aimed at intimidation and normalising a state clampdown.

The strike is the first by NHS workers since the government brought forward its Strikes (Minimum Service Levels) Bill. Nurses are scheduled to stage follow-up action on their last month with a two-day strike next week on January 18-19. The Chartered Society of Physiotherapy (CSP) reported that 4,200 of its members are to strike at 30 NHS Trusts across England over pay and retention on January 26 and February 9.

Ambulance workers have been targeted along with firefighters and rail workers in the first tranche of the draconian anti-strike legislation to be rolled out across six sectors, including health service.

In a sickening attempt to justify measures that strip workers of their essential rights, Business Secretary Grant Shapps told parliament Tuesday the legislation was to “ensure the safety of the British public.” He singled out the ambulance strike, referring to the “patchy service” during the industrial action.

The last strike did not result in a single death as derogations in the strike action were agreed beforehand, ensuring “life and limb” coverage for Category 1 life-threatening calls. This continues to be the case.

In comparison, the Tory government is responsible for the ongoing destruction of the NHS posing a daily threat to life for those requiring emergency treatment. The health service has been through chronic underfunding and privatisation. Added to this is the criminal mishandling of the pandemic, with increased admissions as a result of the unrestrained spread of the Covid-19 adding to the acute shortage of hospital beds, compounded by delays in discharge due to the gutting of social care.

The president of the Royal College of Emergency Medicine, Dr. Adrian Boyle, stated that up 500 people a week could be dying as a result of delays in emergency treatment.

The trade unions continue to suppress strike action by NHS workers with the potential to draw behind it the entire working class.

On the picket lines this month and last, ambulance workers speaking to the World Socialist Web Site expressed their support for co-ordinated action in the face of the GMB, Unison and Unite ensuring strikes took place at different times even within the same ambulance service.

The union apparatus continues to block collective action. The GMB to date has yet to confirm any further strike dates but it has been reported a meeting will take place on Monday, with a further six strike days under consideration. Unison has scheduled further action for January 23, which will coincide with action by Unite in four regions in England and Wales. Unite has called an additional stoppage earlier on January 19 in Wales alone.

As for an inflation-matching pay settlement, none of the unions have spelt out a demand. But they have already shown their hand by blocking strike action in Scotland. Unison and Unite pushed through a revised below-inflation deal with the Scottish National Party/Scottish Greens administration, worth on average 7.5 percent. This was presented as a model to end the action in the rest of the UK.

The shameful deal was rejected by members of the Royal College of Midwives (RCM) and Royal College of Nursing (RCN) by majorities of 65 percent and 82 percent. This occurred on the first day of strike action by ambulance workers on December 21.

The GMB has ignored the rejection of the revised offer by ambulance workers and other NHS staff in Scotland. SNP Health Secretary Humza Yousaf has stated it will be implemented regardless, citing its acceptance by Unison and Unite. The RCN has not called out Scottish nurses in next week’s action. RCN leader Pat Cullen has recently stated the union would “meet the government halfway” and settle for 10 percent—a betrayal of the nurses’ mandate of RPI inflation plus 5 percent (19 percent).

Even after the Sunak government brought forward its strike-busting bill, representatives of the GMB, Unison, Unite and other union heads shuffled into talks with ministers on Monday. As the WSWS reported, their attendance exposed their treacherous intentions, with the government making clear it would move pay talks on to 2023-4, with the de facto pay cuts for last year kept in place. Under pressure from the rank-and-file, 14 health unions representing over a million NHS workers in England are now refusing to participate in the NHS pay review body scheduled for April regarding this year’s claim.  

In the hands of the union apparatus, there will be no fight for a cost-of-living pay increase and no defence of the NHS.  Labour leader Keir Starmer spoke in parliament yesterday calling on the government to negotiate with the unions rather than pursue the draconian measures. This is based on his recognising the role of his allies in the union bureaucracy in enforcing further pay cuts on health workers in Scotland and sitting on broader strike action by the million-strong workforce in the NHS. The fear is the dictatorial measures will unleash an escalation in the class struggle that would break free of the grip of the trade union and Labour Party bureaucracy.

Starmer has dismissed the above-inflation pay demand of nurses as “unaffordable.” Shadow Health Minister Wes Streeting has called for greater use of the private sector, promising further “reform” of the NHS. Labour shares criminal responsibility for the “living with Covid” policy embraced by the Tory government which has claimed another 60,000 lives in the UK since Boris Johnson declared the pandemic over.

As a staunch supporter of NATO and its war against Russia, Labour has no reservations over spending public money when it comes to pouring arms into the conflict.

A joint industrial and political offensive must be waged against a political set-up which excludes the interests of the working class. Rank-and-file committees should be established to unify all health workers.   

The entry of NHS workers into a mounting strike wave is part of an unfolding global movement of health workers, who bear the brunt of a pandemic now in its fourth year, government austerity, and the demands of private health companies. This has seen a growth in strike action including in Germany, France, New Zealand, Australia, Argentina, Sri Lanka, Canada and the United States.

Health professionals committed to treating the sick and vulnerable in society are in direct conflict with the prioritisation of profit above social need and public health under capitalism. The International Workers Alliance for Rank-and-File Committees is being built to inform, guide and unify these struggles. We urge nurses, ambulance staff and all NHS workers to read its programme and discuss how this fight can be taken forward.