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Nurses will continue to strike in January if the government does not negotiate with them on pay, union leader Pat Cullen has told Sky News.

Ms Cullen, of the Royal College of Nursing (RCN), said it was “absolutely not true” that pay is a “tiny element” in the dispute as she hit out at “disparaging” remarks made by health minister Maria Caulfield.

She told The Take with Sophy Ridge: “Nurses are on the breadline, they can’t afford to pay their bills, some of them can’t even afford to travel to work for goodness sake. And yet you have a minister sitting here saying that it’s about all of the other things and not about pay. That is absolutely not true.”

Ms Caulfield, who is also a nurse, told Sophy Ridge that while pay is “obviously a concern” this was only a “tiny” reason for the strike action, which she claimed was more about working conditions.

But Ms Cullen said that while there are working conditions that need to be addressed, there are 50,000 nursing vacancies across the NHS and “pay is fundamental if we are going to try and keep the nurses we have and get more in”.

Nurses are set to strike for the first time in a century on Thursday in bid to secure above-inflation pay rises, after talks to avert the action ended in a deadlock on Monday.

Stephen Barclay, the health secretary, is refusing to negotiate with unions on pay because the government has accepted recommendations made by the NHS Pay Review Body (PRB) to give below inflation pay rises of around 4%.

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Moments before Ms Cullen came on air, the GMB union – which represents tens of thousands of health workers who are also due to strike – announced it was pulling out of the process used by the government to set NHS pay.

‘Trust lost in pay review process’

The NHS Pay Review Body is an advisory public body which takes evidence from government and unions before recommending a pay increase.

The government say it is “independent”, but the GMB disputes this and is suspending its participation until “substantial reforms are made”.

That means the union, which represents thousands of ambulance workers, paramedics, nurses and cleaners working in the NHS, will refuse to provide evidence to the board during next year’s pay negotiations.

“The credibility of the Pay Review Bodies is under greater strain than at any point in their 50-year history. Our members want to participate in a meaningful process, but the trust has been lost,” the union said.

The union said the PRB is not independent because ministers and government:

• Set the Review Bodies’ annual remits including the financial limits within which they are expected to work
• Appoint the Pay Review Body’s members – a process unions have no role in
• Provide the PRB’s secretariat

More strikes in 2023

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Because of the PRB recommendations, nurses with the RCN have been offered a pay rise of at least £1,400.

But the union says this is not enough to make up for a decade of real-terms pay cuts, and they are asking for a pay rise of 5% above RPI inflation, so 19.2%.

The government has said that figure is “unaffordable” and Ms Cullen would not say what offer the RCN would accept if ministers were willing to negotiate.

“I am not going to negotiate on the airwaves and I don’t think any minister should reduce our profession to having to do that,” she told Sophy Ridge.

While nurses in England, Wales and Northern Ireland will strike tomorrow, the RCN has paused industrial action in Scotland to consider a revised pay offer of 7.5%, after First Minister Nicola Sturgeon agreed to negotiations.

Ms Cullen said more strikes were likely in January if the government sticks by its refusal to come to the table on pay.

“The ball is in their court quite frankly, there will be a second strike day on the 20 December.

“Unless we have talks and negotiate on behalf of my members – then I am afraid to say that’s a very strong possibility. We will be starting to look at when those dates will be. I am afraid they will continue into January.”

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Patient support divided on eve of nurses’ strike

Both sides in this dispute have had weeks to try and reach a settlement. But on the eve of the nurses strike their union the RCN and the Government have not moved any closer to resolution. The reverse in fact.

Steven Barclay, the Health Secretary says his door is always open. Pat Cullen, the RCN’s General Secretary said she walked through it and back out again when she realised there was talk about patient safety but none about a pay settlement.

Patient safety is now becoming a central theme and both sides are warning of a risk.

Steven Barclay says the industrial action could put patients at jeopardy so he is urging all patients to continue to seek emergency treatment if they feel they need it.

The nurses continue to argue patient safety is already being compromised in understaffed hospitals.

The nurses and the government know long term widespread patient support is crucial. So far, anecdotally at least, it seems to be fairly divided.

There is sympathy for the nurses but also, while so many people are struggling with the cost of living crisis, there is also an understanding of the Government’s economic case against an above inflation pay rise.

Because of the advance warnings NHS leaders have been able to manage attendance numbers by not booking in routine appointments on the strike dates. This will help hospitals on restricted staff rotas to manage patient flows.

But there will be disruption. That is the whole point of the industrial action.

Patient discharge is one of the biggest issues facing the NHS right now. There are too many patients in hospital who do not need to be there but have to stay because there is no social care prison for them.

So when the nurses who manage hospital beds, virtual wards and are in other capacity roles are absent because they are on strike that pressure will build even more.

Ambulances will keep bringing patients to hospital even on strike days. The challenge of finding beds for them all will become greater. The pressure on all sides , inside the NHS and in government will continue to build.

On the eve of the strike, Mr Barclay repeated his insistence that increasing the nurses’ pay offer would mean taking money from frontline services.

He added: “Our nurses are incredibly dedicated to their job and it is deeply regrettable some union members are going ahead with strike action.

“My number one priority is to keep patients safe – I’ve been working across government and with medics outside the public sector to ensure safe staffing levels – but I do remain concerned about the risk that strikes pose to patients.

“Nevertheless, the NHS is open and patients should continue to seek urgent medical care – and attend appointments, unless they’ve been contacted by the NHS.”

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Why hastily declared ceasefires tend to be fragile

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Why hastily declared ceasefires tend to be fragile

Ceasefires that are suddenly declared tend to be pretty fragile.

Stable ceasefires usually require a lot of preparation so that everyone on both sides knows what is supposed to happen, and – more importantly – when.

And they normally agree on how it will be monitored so one side cannot seize a quick advantage by breaking it suddenly.

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An ambulance burned by Israeli attacks stands on a street, amid the Iran-Israel conflict, in Tehran, Iran, June 23, 2025. Majid Asgaripour/W
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An Israeli attack in Tehran, Iran, ahead of the ceasefire. Pic: Majid Asgaripour/WANA via Reuters

Without such preparations, and sometimes even with them, ceasefires will tend to be breached – perhaps by accident, perhaps because one side does not exercise full control over its own forces, perhaps as a result of false alarms, or even because a third party – a guerrilla group or a militia, say – choose that moment to launch an attack of their own.

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Timeline of Israel-Iran conflict so far

The important question is whether a ceasefire breach is just random and unfortunate, or else deliberate and systemic – where someone is actively trying to break it.

Either way, ceasefires have to be politically reinforced all the time if they are to hold.

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All sides may need to rededicate themselves to it at regular intervals, mainly because, as genuine enemies, they won’t trust each other and will remain naturally suspicious at every twitch and utterance from the other side.

This is where an external power like the United States plays a critical part.

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If enemies like Israel and Iran naturally distrust each other and need little incentive to “hit back” in some way at every provocation, it will take US pressure to make them abide by a ceasefire that may be breaking down.

Appeals to good nature are hardly relevant in this respect. An external arbiter has to make the continuance of a ceasefire a matter of hard national interest to both sides.

And that often requires as much bullying as persuasion. It may be true that “blessed are the peacemakers”.

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Five key takeaways from Volodymyr Zelenskyy’s interview with Sky News

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Five key takeaways from Volodymyr Zelenskyy's interview with Sky News

Volodymyr Zelenskyy has given a wide-ranging interview to Sky News in which he was asked about the prospect of Russia attacking NATO, whether he would cede land as part of a peace deal and how to force Vladimir Putin to the negotiating table.

The Ukrainian president spoke to chief presenter Mark Austin.

Here are the five key takeaways from their discussion.

NATO ‘at risk of attack’

Mr Zelenskyy said plans for NATO members to increase defence spending to 5% of GDP by 2035 are “very slow” and warned Russia could attack a NATO country within five years to test the alliance.

“We believe that, starting from 2030, Putin can have significantly greater capabilities,” he said. “Today, Ukraine is holding him up, he has no time to drill the army.”

But while Mr Zelenskyy conceded his ambition to join NATO “isn’t possible now”, he asserted long term “NATO needs Ukrainians”.

US support ‘may be reduced’

Asked about his views on the Israel-Iran conflict, and the impact of a wider Middle East war on Ukraine, Mr Zelenskyy accepted the “political focus is changing”.

“This means that aid from partners, above all from the United States, may be reduced,” he said.

“He [Putin] will increase strikes against us to use this opportunity, to use the fact that America’s focus is changing over to the Middle East.”

On the subject of Mr Putin’s close relationship with Iran, which has supplied Russia with attack drones, Mr Zelenskyy said: “The Russians will feel the advantage on the battlefield and it will be difficult for us.”

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Ukrainian president Volodymyr Zelenskyy speaking to Mark Austin
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Ukraine’s president Volodymyr Zelenskyy speaking to Mark Austin

Trump and Putin ‘will never be friends’

Mr Zelenskyy was sceptical about Mr Putin’s relationship with Donald Trump.

“I truly don’t know what relationship Trump has with Putin… but I am confident that President Trump understands that Ukrainians are allies to America, and the real existential enemy of America is Russia.

“They may be short-term partners, but they will never be friends.”

On his relationship with Mr Trump, Mr Zelenskyy was asked about whether he felt bullied by the US president during their spat in the Oval Office.

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“I believe I conducted myself honestly. I really wanted America to be a strong partner… and to be honest, I was counting on that,” he said.

In a sign of potential frustration, the Ukrainian president added: “Indeed, there were things that don’t bring us closer to ending the war. There were some media… standing around us… talking about some small things like my suit. It’s not the main thing.”

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Putin and peace talks

Mr Zelenskyy was clear he supported both a ceasefire and peace talks, adding that he would enter negotiations to understand “if real compromises are possible and if there is a real way to end the war”.

But he avoided directly saying whether he would be willing to surrender four annexed regions of Ukraine, as part of any peace deal.

“I don’t believe that he [Putin] is interested in these four regions. He wants to occupy Ukraine. Putin wants more,” he said.

“Putin is counting on a slow occupation of Ukraine, the reduction in European support and America standing back from this war completely… plus the removal of sanctions.

“But I think the strategy should be as follows: Pressure on Putin with political sanctions, with long-range weapons… to force him to the negotiating table.”

Russia ‘using UK tech for missiles’

On Monday, Mr Zelenskyy met Sir Keir Starmer and agreed to share battlefield technology, boosting Ukraine’s drone production, which Mr Zelenskyy described as a “strong step forward”.

But he also spoke about the failure to limit Russia’s access to crucial technology being used in military hardware.

He said “components for missiles and drones” from countries “including the UK” were being used by Russian companies who were not subject to sanctions.

“It is vitally important for us, and we’re handing these lists [of Russian companies] over to our partners and asking them to apply sanctions. Otherwise, the Russians will have missiles,” he added.

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At least 25 people killed after Israeli forces open fire near aid trucks in Gaza, witnesses say

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At least 25 people killed after Israeli forces open fire near aid trucks in Gaza, witnesses say

At least 25 people have been killed after Israeli forces opened fire towards people waiting for aid trucks in Gaza, according to witnesses and hospitals.

The Awda hospital in the Nuseirat refugee camp, which received the victims, said the Palestinians were waiting for the trucks on a road south of Wadi Gaza.

Witnesses told the Associated Press (AP) news agency Israeli forces opened fire as people were advancing to be close to the approaching trucks.

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Israeli ambassador challenged on Gaza deaths

The Awda hospital said another 146 Palestinians were wounded. Among them were 62 in a critical condition, who were transferred to other hospitals in central Gaza, it added.

In the central town of Deir al-Balah, the Al Aqsa Martyrs hospital said it received the bodies of six people who were killed in the same incident.

“It was a massacre,” one witness, Ahmed Halawa, said.

He said tanks and drones fired at people, “even as we were fleeing – many people were either martyred or wounded”.

Another witness, Hossam Abu Shahada, said drones were flying over the area, watching the crowds. Then there was gunfire from tanks and drones, leaving a “chaotic and bloody” scene as people attempted to escape.

He said he saw at least three people lying on the ground motionless and many others wounded as he fled.

The Israeli military did not immediately comment on the reports.

Philippe Lazzarini, the head of the UN’s Palestinian refugee agency, described the aid delivery mechanism in Gaza as “an abomination that humiliates and degrades desperate people”.

He added: “It is a death trap, costing more lives than it saves.”

A spokesperson for the UN’s Human Rights Office said: “The weaponisation of food for civilians, in addition to restricting or preventing their access to life-sustaining services, constitutes a war crime and, under certain circumstances, may constitute elements of other crimes under international law.”

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Around 56,000 Palestinians have been killed during the Israel-Hamas war in Gaza, according to the territory’s Hamas-run health ministry. The ministry says more than half of the dead were women and children, but does not distinguish between civilians and militants in its count.

The war began after Hamas attacked Israel on 7 October 2023, when militants stormed across the border and killed around 1,200 people, mostly civilians, and took another 251 hostages. Most of the hostages have been released in ceasefire agreements.

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