Thousands of NHS appointments cancelled as talks fail to avert nursing strike

Ministers admit they cannot eliminate risk to public from wave of industrial action

Thousands of NHS operations and appointments are being cancelled across England, Wales and Northern Ireland, after last-ditch talks failed to avert the first nursing strike in a generation.

Up to 100,000 members of the Royal College of Nursing (RCN) are expected to walk out on Thursday, with just “life and limb” cover available and surgery being limited to cancer patients and emergencies.

Ministers said they were “straining every sinew” to mitigate the impact of industrial action on the public, but Labour accused the government of “spoiling for a fight” with unions, after health secretary Steve Barclay refused to discuss pay in talks with RCN chief executive Pat Cullen.

Ahead of the meeting, Ms Cullen made clear that the RCN was ready to call off a stoppage planned for 21 December if ministers were willing to negotiate on its demand for a pay increase of 5 per cent above inflation.

But emerging after an hour of talks, Ms Cullen said: “I needed to come out of this meeting with something serious to show nurses why they should not strike this week. Regrettably, they are not getting an extra penny. I expressed my deep disappointment at the belligerence – they have closed their books and walked away.”

One NHS trust chief told The Independent that clinics and less urgent operations planned for Thursday have already been postponed, but that more may be cancelled on the day.

“There is a risk of on-the-day cancellations, as we have tried to keep as much cancer work booked in as possible until the last minute,” said the senior NHS manager. “What we don’t yet know is how many nurses will have wanted to register a protest but will be unwilling to walk out due to concerns for patients.”

Senior NHS sources speaking with The Independent have said that services will be “hugely” affected, as “nightmare” negotiations with local RCN reps are leaving hospitals in the dark over what services they can run on the day.

One senior NHS source said the service is likely to have to cancel 4,000 appointments and 300 operations to maintain a “safe” level of care. RCN reps have agreed to maintain an “overnight” level of staffing, which would be lower than the level provided on bank holidays.

The chaos caused by the strikes is likely to affect trusts for a period of time after the nurses return to work, as they will have to reschedule appointments, The Independent was told.

Industrial action in an array of sectors threatens to bring much of Britain to a halt over the coming days, with rail workers from the RMT staging a two-day strike on Tuesday and Wednesday and then another on Friday and Saturday.

Driving examiners in parts of the UK are downing tools for the rest of the week, and postal workers start their latest two-day stoppage on Wednesday, while action is also planned by groups including ambulance workers, civil servants and Border Force officials.

Troops are preparing to man passport booths in airports and drive ambulances to fill the gaps. But Downing Street acknowledged their deployment would not be enough to prevent “significant” disruption to services, with armed forces personnel only being able to operate ambulances on non-urgent journeys as they do not have clearance to drive under blue-light conditions.

Health minister Will Quince told the House of Commons that the government could block-book taxis on the days when ambulance strikes were expected to take place, in order to ferry patients with less serious conditions to hospital.

Pressure on ministers was heightened when the strikes planned by ambulance staff and NHS workers in Scotland were called off after members of two healthcare unions voted to accept an improved offer from the Scottish government. The offer will deliver pay rises of up to £2,751. For the lowest-paid workers, the deal is worth 11.3 per cent, with an average rise of 7.5 per cent.

Mr Barclay insisted he would not budge from the £1,400 rise recommended by the independent pay review body for NHS workers outside Scotland. This is equivalent to an average of 4 or 5 per cent.

Labour’s shadow health secretary Wes Streeting accused Mr Barclay of “spoiling for a fight” and refusing to engage with the healthcare unions, insisting that “a few hours of talks” on pay could still avert this week’s action.

“The power to stop these strikes lies squarely with the government and the secretary of state,” said Mr Streeting. “They want to blame nurses, blame paramedics, blame NHS staff, for challenges in the National Health Service which are the direct fault and responsibility of 12 years of Conservative mismanagement. Frankly, I think it’s disgusting.”

Cabinet Office minister Oliver Dowden urged the unions to step back from strike action to “give families a break” over the festive season.

Mr Dowden chaired a meeting of the government’s Cobra emergencies committee, at which senior military and healthcare figures briefed ministers on efforts being made to limit the impact of walkouts. He said ministers would be “straining every sinew” to minimise risks to the public, but admitted: “We cannot eliminate them.”

Earlier on Monday, Mr Barclay said giving in to pay demands would take money away from efforts to clear the 7 million-strong backlog of patients awaiting treatment.

“I don’t want to be taking money away from clearing the backlog, which is what we would have to do,” he told the BBC. “We’d have to take money away from patients waiting for operations to then fund additional pay.”

A Department of Health and Social Care spokesperson said Mr Barclay said he would continue to engage with the RCN as the government moved into the pay review process for next year and on non-pay related issues.

Meanwhile, the threat of Network Rail strikes affecting planned engineering work over Christmas was confirmed, as RMT members voted by 63.6 per cent to reject the company’s pay offer.