The Royal College of Nursing (RCN) has ended industrial action against low pay.

On Tuesday the union announced that it would be calling off all strikes after a ballot registering 84 percent in favour of strike action failed to reach the 50 percent turnout required under law. Just 43.4 percent of RCN members voted. Workers involved in a dispute are required to vote by post every six months to renew a strike mandate.

The result is the latest example of how the union bureaucracy uses Conservative governemnt legislation as a weapon against the working class. The so-called “anti-union” laws are in reality anti-strike laws, which, in the hands of the union bureaucracy, are used to quell rank-and-file resistance.

In the latest vote, the RCN held an aggregated ballot of its entire membership, meaning more than 50 percent of all members nationally had to vote yes to continue industrial action. They union was capitalising on months during which it has worked to demobilise opposition and convince as many nurses as possible that nothing more can be achieved.

At the outset of the dispute, the RCN called its first ballot closing November 2 on a disaggregated basis, meaning that more militant branches could be isolated in the struggle against years of low pay and intolerable working conditions. Nurses at half (176) of England’s NHS hospital trusts ended up not taking part in any of the strikes over the following months having failed to reach the 50 percent threshold.

The RCN had never previously authorised a strike in its entire 106-year history and wanted to prevent or limit any action at all costs. But despite every effort made to sabotage their struggle, from the first walkout last December nurses struck determinedly for eight days—alongside ambulance workers and junior doctors—leading to the cancellation of more than 600,000 operations and procedures in England. Nurses provided emergency care for all who required it, and their strike won almost universal support among workers who also understood that the very future of the National Health Service (NHS) was at stake.

The RCN played a crucial role in preventing unity among the NHS’s million-strong workforce, limiting strikes and making sure there was no coordinated actions with other health workers.

Meanwhile the RCN leadership under General Secretary Pat Cullen was in constant backroom talks with the government and NHS management aimed at reaching a sellout deal. Cullen had initially called for a 19 percent pay rise, but this was junked even before strikes got underway, with the union saying it would accept 10 percent. In February, a national strike was called off by the RCN after the union said it would consider any pay offer made by the government.

Cullen and the other health unions, who also called off action, entered talks which produced the government’s sub-inflation offer consisting of a non-consolidated cash lump sum for 2022/23 and a 5 percent pay award for 2023-24.

The fate of the struggle by NHS workers was anticipated by the sellout of other strikes which began a strike wave last summer, including at BT where the Communication Workers Union negotiated a pittance pay deal and paved the way for the company to announce a 50,000-job redundancy plan. This was followed by the Rail, Maritime and Transport union’s sellout in March of the strike by 20,000 infrastructure, maintenance and signal workers at Network Rail.

In May, the 12 trade union representatives on the NHS Staff Council voted by majority to accept the government’s below inflation offer. Only the RCN and Unite deferred, because RCN members in England had already voted in April to reject the derisory offer, in defiance of a recommendation to accept by Cullen.

After being involved in strikes for five months, with no sign of victory and most of their co-workers no longer even involved in disputes, most nurses were by now convinced that no successful struggle over pay was going to be waged by the RCN.

By the time of the last RCN strike vote, the only other strike planned among NHS workers was that of 50,000 junior doctors next month. Since then, senior hospital consultations have also voted to strike, with two days of action to take place next month—but on separate days to their junior colleagues.

The entire working class will pay an immense price for the betrayals of the health unions. Nurses will be hit with another real terms pay cut, with many more leaving the profession and many who remain ending up as agency staff in the private healthcare sector. This is desired outcome of a Tory government actively seeking the destruction of the NHS.

This takes place after decades of budget cuts and the privatisation of large swathes of the NHS, plus the devastating impact of the pandemic, have already brought it to the point of collapse. This week the King’s Fund published research showing that, as it reaches its 75th anniversary, the NHS produces “below average” health outcomes because it spends a “below average” amount for every person on healthcare. Britain also suffers higher levels of deaths from treatable diseases such as heart attack and stroke than most similar countries, and below-average survival rates for many cancers.

In their role as the junior partner of government, the trade union bureaucracy are able to able to rest on pseudo-left groups including the Socialist Workers Party and Socialist Party, which limit workers to a perspective of placing pressure on union leaders for more effective action. As is clear in the nurses’ struggle, the union bureaucracy responds to pressure by doubling down on their suffocation of the working class.

NHS Workers Say No played the central role in the latest strike in preventing militant workers from carrying out any struggle that could break from the shackles of union officialdom. In an article published after the RCN ended its strikes, the Socialist Worker cited a statement that effectively said, “It’s all over, better luck next time!”

It cited the NHS Workers Say No statement which read, “We will continue to build solidarity across unions and push for a joint pay claim for 2024-5,” concluding with a pathetic appeal, “We urge the unions to coordinate their fight for staff and patients and to fight for a fully funded, publicly owned NHS.”

Little wonder the Socialist Workers Party, whose members make up a significant layer within the national, regional and local union apparatus, insisted, “The NHS Workers Say No group which did such important work must not wither.”

In its February statement “Where next for the UK's National Health Service workers?”, NHS FightBack—a genuine rank and file movement initiated by the Socialist Equality Party—explained the necessity for health workers to adopt a new perspective and programme:

“They must seize control from the trade union apparatus. Rank-and-file committees, democratically elected, must be formed in every workplace, to unify the growing wave of struggles to bring down the Tories. This fight must be waged consciously as part of the growing outbreak of the class struggle in Europe and internationally against the austerity and war policies of the world’s governments, including mass protests and strikes in France and general strikes in Italy, Belgium and Greece. Unifying these struggles is the dedicated task of the International Workers Alliance of Rank-and-File Committees. We urge health workers to contact us and begin this fight.”

Contact NHS FightBack to discuss how to take this work forward. NHS FightBack’s Facebook page is here and Twitter here.