NHS Scotland strike action is back on the table, as the Royal Colleges representing midwifery and nursing staff follow GMB Scotland in rejecting the Scottish government’s latest pay offer.

Cabinet Secretary for Health and Social Care, Humza Yousaf says he is committed to continuing ‘constructive’ and ‘positive’ engagement with unions.

Although the latest offer, representing an average uplift of 7.5%, has been accepted by Unite, Unison and CSP unions, GMB Scotland members across NHS Scotland – including ambulance staff -are now joined by midwifery staff in their rejection.

While higher than other offers across the UK and a ‘welcome improvement’ from the previous pay offer, 65% of the Royal College of Midwives (RCM) voted to reject the below-inflation offer.  A total of 82% of Royal College of Nursing (RCN) Scotland members also voted to reject the offer and plan to consider strike action.

Described as a ‘record high pay rise’ by the Scottish government, worth an additional £515m, nurses and midwives were set to receive between £2,205 to £2,751 more per year. The RCM says that while presenting an improvement for early career midwives and maternity support workers (MSWs), the offer does little to improve the take-home pay of the majority of RCM Scotland members.

RCM Director for Scotland Jaki Lambert said:

“Our members have spoken loud and clear – the latest pay offer by the Scottish government is simply not good enough. It goes nowhere near addressing the rising cost of living and would see many midwives actually worse off in real terms.

“While we acknowledge that the Scottish government has listened to some of the concerns regarding career opportunities and development, it has failed to meet our members’ needs on pay. If the Scottish government is as committed to NHS staff as they say they are, they need to offer a much better deal. Warm words are great, but they won’t heat their houses or put food on the table.”

RCM members in Scotland voted previously for industrial action in the absence of an acceptable pay offer and its board will now meet to decide on the next steps following this rejection – including planning for industrial action.

Mr Yousaf said the offer comes at a time of “extraordinary” financial challenges to the Scottish government:

“We have engaged tirelessly with trade union representatives over recent weeks, leaving no stone unturned to reach an offer which responds to the key concerns of staff across the service.

“We have made the best offer possible to get money into the pockets of hard-working staff and to avoid industrial action, in what is already going to be an incredibly challenging winter. If the offer is agreed this pay uplift will also be backdated to April.”

RCN Scotland’s Board Chair, Julie Lamberth said this directly affects members’ lives and it was essential that their voices were heard. She added:

“And the result could not be clearer – we have forcefully rejected what the Scottish government said is its ‘best and final’ offer.”

Workforce crisis

The offer comes with measures that the government says will promote staff and patient safety, support long-term sustainability, and recognise the breadth of skills and experience across Scotland’s NHS. It is 0.5% more than the previous pay offer, which both RCM and RCN unions explained was a “real terms pay cut” and did not address the workforce crisis.

In May, RCM Scotland reported 7 in 10 midwifery staff surveyed were thinking of quitting due to the pressures of the workforce crisis, with staffing levels reported as ‘unsafe’.

By June, the Royal College of Nursing (RCN) Scotland highlighted that staff and patients are suffering and urged action to increase staffing and support nurses as 9 in 10 reported staffing levels on their last shift could not meet the needs of patients.

In a pre-recorded message to Scotland’s Policy Conference on the health and care workforce crisis this September, Mr Yousaf said “work is well underway to provide a healthy labour supply” and committed to addressing patient backlogs. However, representatives of staff across the sector remained concerned and urged the government to review its workforce model.

Jaki Lambert explained RCM’s rejection of the latest pay offer, citing continual staffing challenges:

“Our maternity services are continuing to face staffing challenges. In many places it’s only the goodwill and commitment of midwives and their colleagues that keep these services going. Those same midwives and MSWs often find themselves working 12-hour shifts with no breaks, and even staying beyond those long shifts, just because there’s no-one to relieve them.

“They do it because they care, and because it’s what women and families need – and we know those same women and families really value them for it.”

Ms Lambert added that RCM Scotland have written to the Cabinet Secretary to “get back around the table” for discussions, saying that it is not too late to avoid strike action.

RCM Scotland is part of the Scottish Terms and Conditions Committee (STAC), which will meet tomorrow to share the outcomes of their consultations on this offer. Regarding the next steps, Ms Lambert said:

“Our members have been consistent throughout this process – they want a decent deal, and they are prepared to take industrial action to get one. No midwife wants to do this, and it is for the Scottish government to make sure that they do not feel that they are left with no other option.”

RCN Scotland’s members share this feeling, said Chair Julie Lamberth:

“Make no mistake - we do not want to go on strike. Years of being undervalued and understaffed have left us feeling we have been left with no option because enough is enough. The ball is in Scottish government’s court if strike action is going to be avoided.”

Humza Yousaf has said that while disappointed in this outcome, he respepcts the voices of RCN and RCM's members and is committed to meaningful engagement. Unions and the Cabinet Secretary are due to meet tomorrow for further discussions – with Mr Yousaf saying the government will leave “no stone unturned” to prevent strikes.

Read more: RCN: Staff need to see light at the end of the tunnel; Staff shortage concerns in latest MWC reviews; Latest pay offer for NHS “deeply insulting”

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