All of this comes as a 96-hour walkout staged by junior doctors comes to an end this morning.
Senior officials within the Royal College of Nursing (RCN) have suggested that they may consider coordinating future industrial action with junior doctors in an attempt to increase pressure on the government.
For the first time, the RCN’s strike will involve staff working in emergency departments, intensive care units, cancer care and other services that were previously exempt from strikes
More than six in 10 of eligible members took part in the ballot, with 54% voting to reject the government’s offer and 46% voting for it. Turnout was 61%.
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RCN General Secretary Pat Cullen said she had written to the government to notify it of “imminent” strike action, as well as a new ballot and a request for a fresh round of talks.
In a letter to Health Secretary Steve Barclay, Ms Cullen said what nurses had been offered was “simply not enough”.
She said: “Since our talks in February, we have seen the pressures on the NHS continue to increase.
“Until there is a significantly improved offer, we are forced back to the picket line.
“After a historic vote to strike, our members expect a historic pay award.”
The development will come as a blow to the government, which hoped a settlement with nurses would pave the way for breakthroughs in other sectors gripped by industrial action.
However, the government will be buoyed by the “decisive” Unison result, in which three-quarters of 288,000 NHS workers across England voted to accept the offer.
Unison’s head of health, Sara Gorton said that while health workers “would have wanted more … this was the best that could be achieved through negotiation”.
The health unions are lodged in their own dangerous game of divide and rule
It’s not a good news, bad news type of situation – it’s a mess. By rejecting the government’s pay offer, nurses from the RCN are now in conflict with their health worker colleagues from Unison who have overwhelmingly decided to accept it.
At the start of the process the unions warned that the government was playing a dangerous game of divide and rule. Now they have managed to do it to themselves.
Other health unions including the GMB, Unite and those representing physios and dieticians are consulting their members. They have until the 28 April.
Until then we are in limbo. In early May all the unions will go back to the government with their decision. Unison has said it will ask the government to impose its pay deal on their members.
But the RCN has already announced further strike dates and will ballot its members for more action over the last six months of the year.
It raises the prospect of nurses and junior doctors standing together on picket lines for the first time. That is a situation that will fill NHS Trust leaders with dread.
The outcome will not be known until at least May. It means more uncertainty for long suffering patients.
Under the deal, Unison health workers will receive an additional one-off payment for the year 2022/23, along with a 5% pay rise for 2023/24 – 10.4% for the lowest paid.
Unison, GMB and Unite the Union all also represent nurses in some capacity, as well as paramedics, 999 call handlers, midwives, security guards and cleaners.
According to the RCN, if the majority of members across all unions vote to accept the deal, then the government could still implement it.
A Unison source told Sky News they will be pushing for the government to implement the pay offer their members voted for, even though RCN members have rejected it and other unions may do as well.
A government spokesperson said: “It is hugely disappointing that the Royal College of Nursing membership has rejected the pay deal recommended by their leadership.
“Following constructive discussions, all parties agreed this was a fair and generous offer which is demonstrated by Unison, representing the largest share of the NHS workforce, choosing to accept it.
“The fact that the Royal College of Nursing has announced an escalation in strike action with no derogations, based on a vote from the minority of the nursing workforce, will be hugely concerning for patients.”
The pay deal rejected by RCN members would have seen nurses awarded a one-off payment of 2% of their salary, plus a COVID recovery bonus of 4% for the current financial year and 5% for the year after.
Mr Barclay previously explained that, under the offer, a newly qualified nurse would have received more than £1,800 this year on top of a pay rise of more than £1,300 next year.
NHS Providers Director of Communications Adam Brimelow said the RCN vote was a “setback” and was “extremely worrying”.
“Trust leaders understand the frustration of nurses, junior doctors and other staff who have seen their pay fall behind inflation year after year.
“It’s really important that the unions and government find a way through this to prevent more strikes and let the NHS focus on its big challenges, including cutting waiting lists and transforming services, instead of having to resort to ‘all hands on deck’ just to get through the day.”
The nurses’ dispute is separate from the junior doctors row. Ministers have repeatedly insisted they will not enter into talks with the British Medical Association (BMA) until the union drops its demand for a 35% pay rise for junior doctors.
The joy that filled the final weeks of Diogo Jota’s life makes his death even more devastating to comprehend for his family and millions of fans worldwide.
The most illustrious title of his career was won in May, when he paraded through Liverpool with his teammates and the Premier League trophy.
More success came with Portugal as he won the Nations League for a second time alongside Cristiano Ronaldo in June.
And then came the bliss at marrying his childhood love Rute Cardoso, watched by their three children.
Just yesterday Jota posted a video from the ceremony on social media alongside the message “a day we will never forget”.
The happiest of days was remembered before the tragedy that killed Jota and his brother Andre Felipe in northwest Spain.
Image: Diogo Jota and wife Rute. Pic: rutecfcardoso14/Instagram
Brothers – whose careers both developed at their hometown club, Porto – so tragically dying together.
“Football has lost two great men,” Porto president Andre Villas-Boas said, as fans descended on the club’s stadium to mourn.
At Anfield, Liverpool fans are grieving the versatile forward who was so often in the shadow of Mohamed Salah, as he was under Ronaldo at Portugal.
But he knew how to sacrifice stardom to contribute to the squad.
Image: Diogo Jota holds the Premier League trophy with Wataru Endo and teammates. PIc: Reuters
The last of his 65 Liverpool goals was the winner in the Merseyside derby against neighbours Everton in April – helping the club become the record 20-time champions of England.
A Premier League winners’ medal joining those from the FA Cup and League Cup, won by the 28-year-old after he joined the Reds in 2020.
It was Wolverhampton Wanderers who gave Jota a platform to shine in England after he joined from Atletico Madrid.
Promotion was gained to the Premier League in 2018, and they more than just avoided relegation, but secured back-to-back top-seven finishes.
Jota was a reason why.
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Fans react to Jota death
He was also why Wolves could embark on such a memorable European campaign, and scored two hat-tricks in the run-up to the Europa League quarter-finals in 2020.
“The memories he created will never be forgotten,” Wolves said.
For the football world, the loss of such a talent so young will be hard to comprehend.
And so many are reflecting on the fragility of life as football grieves from Liverpool to Portugal – and beyond.
The father of a grooming victim who was raped by more than 60 men has said she still lives with the “trauma every single day”.
Marlon West, 51, said Scarlett, now 20, was an academic student at a school in Greater Manchester.
She was happy with a good friendship group and enjoyed riding her horse, Jasper.
But her life changed after she was attacked by a gang at a bus station – they started bullying her and she decided it was better to become their friends.
An older female member then started grooming her for rape gangs made up of Muslim men, her father told Sky News.
Image: Scarlett before she was groomed
Mr West said six men were involved in grooming her from the age of 14 but she was raped by more than 60 before the abuse finally stopped shortly before she turned 18.
By then, she was too terrified to leave home.
“Scarlett isn’t a survivor and a lot of these other girls aren’t survivors,” he said. “The reason being is they’re still living with the trauma every day.”
Mr West, an advanced nurse practitioner for mental health services at the NHS, said his daughter was thrown out of school aged 14 and would go missing for weeks at a time.
On one occasion, he tracked her down to a property in Derbyshire, but when he eventually persuaded police to attend, he was told Scarlett was “safe” with the woman who groomed her and “her friends”.
Image: Scarlett enjoyed riding her horse
Mr West said he was “absolutely furious” when police and social services dismissed the abuse as “a lifestyle choice” and was so desperate he put Scarlett into care when she was 15.
“I couldn’t keep her safe,” he said. “It’s the hardest decision of my life.”
But within a week of her returning home, when she had to leave the care system after turning 16, she was going missing again.
Mr West said the female groomer had stayed in contact with Scarlett and “was literally waiting for her” when she came home.
She was then trafficked all over the country, including Bradford, Birmingham and London.
Image: Marlon West and his daughter Scarlett
Mr West said he had to “scream” at police to track her down before they raided a property in Rochdale where she was found along with heroin and crack cocaine.
Scarlett was arrested and released on bail, but wasn’t charged because she was on a Home Office database as being at risk of trafficking, he said.
“Even though that [arrest] was inappropriate, that stopped it because she was terrified of going out of the house, which she still is now to a certain extent.”
Mr West believes the abuse also came to an end because she was getting older and her abusers were no longer interested.
“This is not just about child sexual exploitation but also criminal exploitation – she was doing county lines, she was picking up firearms for them,” he said.
Image: Scarlett and her dad Marlon
Mr West said any child can be at risk of grooming.
“They’re stereotyping a lot of these survivors, that they’re coming from broken homes, or they’re in care,” he said.
“A groomer doesn’t stand outside a school gate and think, ‘I’m not grooming her because her dad’s a doctor or her dad’s a GP’ – they don’t care. Once they target, that’s it.”
Mr West was speaking as a report by police watchdogs revealed Greater Manchester Police has live grooming investigations involving 714 victims and survivors.
The force said it has 1,099 lines of enquiry relating to potential suspects but only 269 who are confirmed.
“I think there’s more – a lot of survivors haven’t come forward. One, because they’re probably still being groomed and secondly because they’re terrified of GMP and how they’ve been treated in the past,” he said.
“It’s higher than it’s ever been. Services such as police and social services are terrified of political correctness.
“The groomers know they can get away with it because there aren’t many arrests and so it’s increased.”
GMP Chief Constable Sir Stephen Watson promised to go after child rapists and paedophiles “relentlessly” after the publication of the report, which was largely positive about the force’s turnaround in tackling the gangs.
But Mr West believes they are “still failing”, although he welcomed the investigation opened into his daughter’s case.
He said he is “hopeful” the national inquiry into grooming gangs by the government last month “will expose a lot of the cover-ups and give accountability” but is worried about the involvement of services such as councils and police forces because of a lack of trust.
A GMP spokesperson said: “We have met with Scarlett and her father and we’re conducting an extensive investigation into their allegations.
“While we understand the impact of their experiences cannot be undone, we aim to ensure that the experience of the GMP of today would be much improved from that of previous years.”
A Tameside Council spokesperson previously said they were legally unable to comment on Scarlett’s case.
But they said: “Where any concerns or issues are raised we work closely with individuals, families and our partners to provide support and resolve, as appropriate.
“Where individuals aren’t satisfied with the services received, we do have a statutory complaints procedure and individuals can ultimately take their complaint to the Local Government & Social Care Ombudsman.”
You’re probably tired by now of hearing all about “black holes”.
It’s one of those phrases trotted out by journalists in an effort to make economic policy sound a little more interesting. And in some senses it’s a massively misleading image.
After all, when people talk about fiscal holes, what they’re really talking about is something rather prosaic: the amount of money it would take for the chancellor not to break her fiscal rules.
Those fiscal rules are not god-given, after all. They were confected by the chancellor herself. Missing them will not really result in Britain sliding into infinite nothingness. Even so, whatever you choose to call the dilemma she’s faced with right now, it’s certainly quite a big deal.
Image: Rachel Reeves speaks at the NHS’s 77th birthday
And understanding this helps provide a little context for the extraordinary events of the past few days, with markets sliding in the wake of Ms Reeves’ teary appearance at Prime Minister’s Questions.
Following that moment, the yield on UK government debt – the rate of interest we’re being charged by international investors – suddenly leapt higher. Granted, the jump was nothing like what we saw in the wake of Liz Truss’s mini-budget. And those yields dropped down after the prime minister backed the chancellor.
UK’s a global outlier
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Even so, they underline one very important bit of context. The UK has become something of an outlier in global debt markets. For years, the yield on our benchmark government bonds was more or less middle of the industrialised-world pack. But since 2022’s drama, it has hovered unnervingly high, above every other G7 nation.
That speaks to a broader issue. Britain might not have the biggest deficit in the G7, or for that matter, the highest national debt. Others (most notably France, and to some extent, too, the US) face even more desperate fiscal dilemmas in the coming years. But markets do still seem nervous about Britain.
Perhaps that’s because of what they (and we) all endured in 2022 – when British gilt markets stepped briefly over the precipice, causing malfunctions all around the financial system (most notably in obscure parts of the pensions investment sector). But it also owes something to the fact that the chancellor’s own fiscal plans are sailing worryingly close to the wind.
Reeves made fiscal rules matter
The main piece of evidence here is the amount of leeway she has left herself against her fiscal rules. As I said at the start, there’s nothing gospel about these rules. But having created them and banged on about them for a long time, even those of us who are a little sceptical about fiscal rules would concede that breaking them is, as they say, not a good look.
Back in spring, the Office for Budget Responsibility thought the chancellor had about £9.9bn in leeway against these rules. But since then, she has u-turned on both the cuts in winter fuel payments and on personal independence payments. That reduces the £9.9bn down to barely more than £3bn.
But the real issue isn’t just these U-turns. It’s something else. The stronger the economy is, the more tax revenues come in and the more her potential headroom against the fiscal rules would be. By the same token, if the economy grows less rapidly than the OBR expected, that would mean less tax revenues and an even bigger deficit.
And if you compare the OBR’s latest forecasts with the current average of forecasts among independent forecasters, or for that matter, the Bank of England, they do look decidedly optimistic. If the OBR is right and everyone else is wrong, then the chancellor “only” has to fill in the hole left by those U-turns. But if the OBR is wrong and everyone else is right, things get considerably more grisly.
Even a small downgrade in the OBR’s expectations for productivity growth – say a 0.1 percentage point drop – would obliterate the remaining headroom and leave the chancellor with a £6bn shortfall against her rule. Anything more than that (and bear in mind, most economists think the OBR is out by more than that) and she could be £10bn or more underwater.
Now, there are plenty of very reasonable points one could make about how silly this all is. It’s silly that so many people treat fiscal rules as tablets of stone. It’s silly that government tax policy from one year to the next seems to hinge on how right or wrong the OBR’s economic forecasts are.
Yet all this stuff, silly as it might all seem, is taken quite seriously by markets right now. They look at the UK, see an outlier, and tend to focus more than usual on black holes. So I’m afraid we’re going to be talking about “black holes” for quite some time to come.