The Government faces a summer of disruption in the health service in the wake of a "landslide" vote for industrial action expected today.
Unison, Britain's largest health union, is set to report a massive majority in favour of sanctions including strikes after consulting its 440,000 NHS members ranging from nurses and administrative staff to cleaners. Some insiders predict a vote of up to 11 to 1 in favour of action.
Having tested the mood of health employees, the 42-strong health group executive at Unison is expected later today to order a full postal ballot on industrial action, possibly including stoppages.
Bob Abberley, the union's head of health, warned Virginia Bottomley, the Health Secretary, that the NHS was "heading for a precipice".
Tomorrow the Royal College of Midwives is due to meet NHS officials, having suspended its ballot on industrial action. The prospects for a settlement look remote, however, because midwives' representatives are seeking a new national pay structure and a general upgrading for their members, while management wants to talk about local negotiations.
Leaders of all unions representing 1.2 million NHS employees have registered their opposition to a pay offer giving a 1 per cent national increase and up to 2 per cent more through negotiations at NHS trust level. Fuelling anger over pay is the Government's insistence on introducing a market system into the NHS.
On Saturday the executive of the Health Visitors' Association voted unanimously to ballot its 16,000 members on disruption short of strikes.
Last Tuesday the annual congress of the Royal College of Nursing voted overwhelmingly to ballot its 300,000 members on a proposal to drop its no-industrial action rule. A government threat to abolish the nurses' pay review body on Wednesday was followed by a vote of no confidence in Gerald Malone, the health minister.