After rejecting a “best and final” pay offer, Scottish nurses, paramedics, porters, cleaners, midwives, and a range of NHS staff are threatening a wave of strikes early in the new year.
Both the Royal College of Nurses and the Royal College of Midwives declared on Wednesday that their members had overwhelmingly rejected the offer and that they were debating when to go on a national strike.
Their votes came after GMB last week rejected a similar proposal. It should be noted, however, that unions Unite and Unison accepted the offer, the following are the results from the major unions.
- Unite voted accept by 64%
- Unison voted accept by 57%
- GMB voted reject by 66%
- RCM voted reject by 65%
- RCN voted reject by 82%
Commenting on the result, Julie Lamberth, RCN Scotland Board Chair, said:
“It was the right thing to ask our members whether to accept or reject this offer. It directly affects their lives and each eligible member needed to be given the chance to have their say. And the result could not be clearer – we have forcefully rejected what the Scottish government said is its ‘best and final’ offer. Make no mistake – we do not want to go on strike.
Years of being undervalued and understaffed have left us feeling we have no alternative because enough is enough. The ball is in the Scottish Government’s court if strike action is going to be avoided. Members can be reassured that planning for strike action will be thorough. The safety of patients and of our members are paramount and we will be working hard to ensure that while any strike action is disruptive, it does not put patients or our members at risk.”
What was the offer?
The offer would have seen NHS workers given an average 7.5% pay uplift for 2022-23, equating in pay rises ranging from £2,205 to £2,751, depending on pay band. Previously the Scottish Government had put forward an across-the-board £2,205 pay increase for all Agenda for Change staff. The new deal would see an improved pay increase of between £2,450 and 2,751 for nurses between Band 5 and Band 8A.
This represents an increase of 11.3% for the lowest-paid workers, such as porters and cleaners.
Additionally, report the Nursing Times, the offer includes a commitment to reduce the working week from 37.5 hours to 36 hours with no loss of pay.
Humza Yousaf, the Scottish health secretary, confirmed he would start fresh talks with the unions, adding:
“While I am naturally disappointed the Royal College of Midwives and the Royal College of Nursing have rejected this offer, I respect the voice of their membership. We have engaged tirelessly with trade union representatives over recent weeks and months, leaving no stone unturned to reach a record pay offer which responds to the key concerns of staff across the service.
We are making this offer at a time of extraordinary financial challenges to the Scottish government to get money into the pockets of hard-working staff and to avoid industrial action in what is already going to be an incredibly challenging winter. Constructive engagement is crucial; those unions who have rejected our pay offer have all said they want to avoid industrial action. We must collectively work toward avoiding strikes taking place this winter at a time of already significant pressure for our NHS.”
What does this mean?
The Scottish government, which had promoted this pay offer as the best and highest in the UK, now faces a serious setback in averting strike action as a result of the significant majority of RCM and RCN members rejecting the offer.
However, given that some other unions, like Unison and Unite, who also represent a portion of the nursing workforce, have accepted the offer, the situation here in Scotland is complicated, to say the least. Others have also declined the offer, including GMB, the union primarily represents ambulance staff, porters, cleaners and many other support staff groups.
It is difficult to envision where upcoming negotiations could lead, but there is a willingness on all sides to sit down at the table and see if anything new can be accomplished.

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