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Members of the Royal College of Nursing are to go on strike again after they voted against the latest government pay offer.

The result comes despite a recommendation from union leaders that they accept it and means there will be a round-the-clock 48-hour strike – without exemptions – from 8pm on 30 April to 8pm on 2 May.

The result comes despite Unison members voting in favour of the pay deal, on the grounds it was the “best that could be achieved through negotiation”.

For the first time, the Royal College of Nursing (RCN) strike will involve staff working in emergency departments, intensive care units, cancer care and other services that were previously exempt from industrial action.

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%.

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.

Final day of walkout by doctors and updates on nurses – politics latest

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In a letter to Health Secretary Steve Barclay, Ms Cullen said what nurses had been offered was “simply not enough”.

“Since our talks in February, we have seen the pressures on the NHS continue to increase,” she said.

“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.

Instead, there is the likelihood of further strikes over the summer months after teachers also voted to reject the government’s offer and junior doctors continue to strike in an increasingly bitter struggle over pay.

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”.

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.”

Read more:
‘The system is broken’: On the A&E frontline during the strikes
Strike organiser on holiday as junior doctors stage 96-hour walkout

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.

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Mum of emaciated baby in Gaza says ‘I lost my husband… I don’t want to lose her’

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Mum of emaciated baby in Gaza says 'I lost my husband... I don't want to lose her'

In mid-May, the World Health Organisation assessed that there were “nearly half a million people in a catastrophic situation of hunger, acute malnutrition, starvation, illness and death”.

“This is one of the world’s worst hunger crises, unfolding in real time,” its report concluded.

Warning: This article contains images of an emaciated child which some readers may find distressing

Israel‘s decision this week to reverse the siege and allow “a basic level of aid” into Gaza should help ease the immediate crisis.

But the number of aid trucks getting in, so far fewer than 100 per day, is considered dramatically too few by aid organisations working in Gaza, and the United Nations accuses Israel of continuing to block vital items.

Israel-Gaza latest: Gaza enduring ‘atrocious death and destruction’, UN boss warns

“Strict quotas are being imposed on the goods we distribute, along with unnecessary delay procedures,” said UN secretary general Antonio Guterres in New York on Friday.

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“Essentials, including fuel, shelter, cooking gas and water purification supplies, are prohibited. Nothing has reached the besieged north.”

Nineteen of Gaza’s hospitals remain operational, all of them are overwhelmed with the number of patients and a lack of supplies.

Baby Aya at the Rantisi hospital in northern Gaza
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Baby Aya at Rantisi hospital in northern Gaza is dangerously thin

“Today, we receive between 300 to 500 cases daily, with approximately 10% requiring admission. This volume of inpatient cases far exceeds the capacity of Rantisi hospital, as the facility is not equipped to accommodate such large numbers,” Jall al Barawi, a doctor at the hospital, told us.

At least 94% of the hospitals have sustained some damage, some considerable, according to the UN.

Jall al Barawi, a doctor at Rantisi hospital
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Jall al Barawi, a doctor at Rantisi hospital

Paramedic crews are close to running out of fuel to drive ambulances.

The lack of food, after an 11-week blockade, has left thousands malnourished and increasingly vulnerable to surviving injuries or recovering from other conditions.

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Children are the worst affected.

Our team in Gaza filmed with baby Aya at the Rantisi hospital in northern Gaza. She is now three months old and dangerously thin.

Her skin stretches over her cheekbones and eye sockets on her gaunt, pale face. Her nappy is too big for her emaciated little body.

Aya's nappy is too big for her emaciated little body.
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Aya’s nappy is too big for her emaciated little body.

Lethal spiral

Her mother Sundush, who is only 19 herself, cannot get enough food to produce breastmilk. Baby formula is scarce.

Aya, like so many other young children, cannot get the vital nutrition she needs to grow and develop.

It’s a lethal spiral.

This is what Aya looked like shortly after she was born
Image:
This is what Aya looked like shortly after she was born

“My daughter was born at a normal weight, 3.5kg,” Sundush tells us.

“But as the war went on, her weight dropped significantly. I would breastfeed her, she’d get diarrhoea. I tried formula – same result. With the borders closed and no food coming in, I can’t eat enough to give her the nutrients she needs.”

“I brought her to the hospital for treatment, but the care she needs isn’t available.

“The doctor said her condition is very serious. I really don’t want to lose her, because I lost my husband and she’s all I have left of him. I don’t want to lose her.”

Read more:
British doctor in Gaza describes horror
Shouts of ‘genocide’ in Commons

Aya and her mother Sundush
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Aya and her mother Sundush

Some of the aid entering Gaza now is being looted. It is hard to know whether that is by Hamas or desperate civilians. Maybe a combination of the two.

The lack of aid creates an atmosphere of desperation, which eventually leads to a breakdown in security as everyone fights to secure food for themselves and their families.

Only by alleviating the desperation can the security situation improve, and the risk of famine abate.

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Police launch ‘major operation’ after 12 people injured in knife attack at Hamburg train station

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Police launch 'major operation' after 12 people injured in knife attack at Hamburg train station

Twelve people are reported to have been injured after a knife attack at Hamburg’s central train station.

A “major operation” has been launched and a suspect was arrested, police said in a post on X.

The identity of the suspect has not been revealed.

Reports in Germany said the suspected attacker was a woman.

The fire service said six of the injured were in a life-threatening condition, three others were seriously hurt, and another three sustained minor injuries, news agency dpa reported.

Bild newspaper said the motive for the attack was so far unknown.

Hamburg is Germany’s second biggest city, with the train station being a hub for local, regional and long-distance trains.

More on Germany

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Israeli embassy shooting suspect ‘fired repeatedly after victims hit the ground’

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Israeli embassy shooting suspect 'fired repeatedly after victims hit the ground'

The man suspected of shooting dead two Israeli embassy workers in Washington DC leaned over and fired at them repeatedly after they fell to the ground, the FBI has said.

Elias Rodriguez, 31, has been charged with murdering Sarah Milgrim and her boyfriend Yaron Lischinsky, after they left an event at the Capital Jewish Museum on Wednesday night.

Israeli PM attacks Starmer – latest updates

Footage has showed Rodriguez, from Chicago, chanting “free, free Palestine” as he was arrested.

It later emerged Mr Lischinsky had bought a ring and planned to propose to Ms Milgrim.

Authorities are investigating the killings as both a hate crime against the Jewish community and terrorism.

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Shootings suspect shouts ‘free Palestine!’

‘I did it for Gaza’

It comes as the FBI has said in a charging document on Thursday that surveillance footage shows how Ms Milgrim and Mr Lischinsky died.

Rodriguez is allegedly seen passing the couple after they left the museum before shooting them in the back.

The FBI says the footage then shows him leaning over the couple and firing at them several more times after they fell to the ground.

The video then shows Ms Milgrim attempting to crawl away before “(Rodriguez) followed behind her and fired again”, the charging document says.

The suspected gunman is then accused of reloading his weapon and firing at Ms Milgrim as she sat up.

According to the charging document, Rodriguez then jogged to the museum and once inside asked to speak to a police officer before stating that he “did it” and that he was unarmed.

He is then said to have told police: “I did it for Palestine, I did it for Gaza, I am unarmed.”

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DC shooting: Father pays tribute to ‘perfect’ daughter

Suspect ‘expressed admiration’ for fatal protest

The court document also states that 21 expended 9mm bullet cases were found at the scene and the gun was slide-locked – meaning it was empty of ammunition.

An empty gun magazine was also recovered from the scene.

The FBI says it has obtained travel records which show Rodriguez flew from Chicago’s O’Hare International Airport to the Reagan National in Washington DC on Tuesday with the gun in his checked baggage.

Rodriguez had bought the weapon in the state of Illinois on 6 March 2020, according to the charging document.

The FBI has said that while Rodriguez was in custody he “expressed admiration” for a US Air Force member who set himself on fire in front of the Israeli embassy in Washington DC on 25 February 2024.

Aaron Bushnell died in the apparent act of protest against the war in Gaza.

Rodriguez also told police he bought a ticket to the museum around three hours before the event that was attended by Ms Milgrim and Mr Lischinsky.

Read more:
Why Trump will worry about attacker being glorified

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Starmer ‘on wrong side of history’

During a brief court appearance at the E. Barrett Prettyman Federal Courthouse in Washington DC today, Rodriguez was charged with two counts of first degree murder and with the murder of foreign officials.

He has also been charged with causing the death of a person through the use of a firearm and discharge of a firearm during a crime of violence.

Rodriguez was told he could face life in prison or the death penalty if he is found guilty.

He remained calm throughout the hearing, paying attention to the proceedings throughout and confirmed that he is asking the court to appoint an attorney on his behalf.

He will next appear at a federal court in Washington DC on 18 June.

Murdered couple ‘were perfect for each other’

Meanwhile, Ms Milgrim’s father, Robert, says he feared his daughter might be in danger when he saw news alerts of a fatal shooting in Washington DC.

Ms Milgrim’s mother Nancy opened a phone locator app and saw Ms Milgrim was at the Capital Jewish Museum.

“Shortly after that, the Israeli ambassador called us on my wife’s phone,” Mr Milgrim told Sky News’ partner network NBC News, fighting back tears.

He added that it was the ambassador who told them Mr Lischinksy had bought a ring and was planning to propose to Ms Milgrim.

“They were perfect for each other, he said.

Mr Milgrim continued: “They just brought us joy, and her memory, which is a blessing, will continue to bring us joy – but it’s not the same as her not being here.”

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