Hundreds of thousands of NHS workers including midwives, nurses, radiographers, cleaners and psychiatric staff are staging a fresh protest over a pay dispute with government.
Members of 11 unions walked out for four hours from 7am in England and 8am in Northern Ireland in protest at the coalition's controversial decision not to accept a recommended 1per cent wage rise for all NHS employees.
More than 400,000 workers will join the strike, including 300,000 in Unison, which will be followed by a work to rule for the rest of the week.
Unison leader Dave Prentis said the strike, the second in a month, should "sound alarm bells ringing" in Westminster because of the anger of such dedicated workers.
Unions have struck deals with the administrations in Scotland and Wales, increasing their anger at Health Secretary Jeremy Hunt, who they accuse of refusing to discuss the long-running row.
The minister has erected a “Berlin wall of intransigence”, the unions said.
Mr Prentis said: “The fact almost all health unions are taking part in the industrial action should ring alarm bells in Whitehall.
“The anger is spreading and so is the public support for health workers’ cause. The strength of feeling is far from fading and the dispute far from going away.
“If the Secretary of State seriously thinks staff are the NHS’s best asset then he needs to treat them fairly.
“The Government and NHS employers need to engage in meaningful talks about how to resolve this dispute. We are prepared to keep up the pressure through the winter and up until the general election.”
By the end of the next financial year, health workers will have had their pay capped for six years, said the TUC.
Show of support
General Secretary Frances O’Grady will join Mr Prentis on a picket line at the London Ambulance Service headquarters in Waterloo as a show of support for health workers taking part in the pay protest.
She said: “Health workers care passionately about their patients and the quality of service they provide, and so are always reluctant to take action.
“But the Government’s refusal to accept the recommendations of NHS independent pay review body — even though it only called for an affordable, below-inflation pay rise — leaves health workers feeling that they have no other option.
“It’s not too late for the Government to change course and award health workers the pay rise the public knows they deserve.”
Cathy Warwick, chief executive of the Royal College of Midwives, said: "I was overwhelmed by the response of our members to the previous industrial action and I urge them to respond equally next week.
“I am also very heartened to see that public support for a 1% award for NHS staff has remained high since that industrial action, so we know the public are behind us.
“This is not about our members demanding huge banker-sized bonuses or asking for the similarly large bonuses and pay increases given to many senior managers in the NHS.
“It is about our members having to fight just to get the very modest 1% pay award recommended by the NHS Pay Review Body.
GMB national officer Rehana Azam said: “We regret having to inconvenience NHS users again, but the intransigence of the Government and employers leaves us no choice.
“We are open to talks but the Health Secretary still refuses to meet the unions. This is not the way to go about dispute resolution.”
A Department of Health spokesman said: "NHS staff are our greatest asset and we want to make the current pay system fairer.
“We have taken tough decisions to increase the NHS budget but we can’t afford a consolidated pay rise in addition to increments without risking 10,000 frontline jobs.”
An NHS England spokeswoman said: “NHS organisations have tried and tested plans to deal with a range of disruptions including industrial action.
“We are working with the NHS to ensure there are robust plans for November 24 that protect the safety, welfare and service provided to patients.”
PA