Revealed: cabinet split over NHS pay disputes piles pressure on Sunak

Health secretary Steve Barclay urges unions to lobby PM over improved pay offer for striking nurses and ambulance workers

The health and social care secretary Steve Barclay has privately urged trade unions to help him make the case to the Treasury and No 10 for extra money for nurses, ambulance workers and other NHS staff in an extraordinary twist to the escalating crisis over health service strikes, the Observer can reveal.

A serious cabinet split has opened up, with Barclay now wanting more money for all NHS staff except doctors – while Rishi Sunak and Jeremy Hunt, the chancellor, are refusing to budge from their insistence that no more can be offered.

Barclay’s call for the unions to help him present a convincing case to Sunak and Hunt was made at a meeting between the unions and ministers last Monday.

Sara Gorton, head of health at Unison, who chairs the 14-strong NHS group of unions, and who was present, told the Observer: “On Monday he talked about asking us to help make the case to the Treasury for the investment needed.”

Gorton said that after weeks of stonewalling Barclay’s tone was “very different” in the meeting and that he was willing to talk about more pay, including for this year.

But just as surprising to union leaders was that Barclay requested help from the unions to make an argument to Hunt and Sunak that more money would help stop the rapid exodus of NHS staff to other jobs, and increase efficiency. “He asked for our assistance in making the case about how improving pay and investing in the workforce could lead to greater efficiencies and productivity.”

Gorton, who has been involved in every pay round on behalf of Unison members in the NHS for the past 20 years, explained that in order to reach deals with Conservative governments she had found that ministers needed to be able to convince the Treasury that any extra money spent would lead to savings in the medium and longer term. “All of the agreements I have been involved with in the past have involved a certain amount of showing the benefits of investing,” she said.

Sara Gorton, Unison head of health, outside King’s College Hospital in London on Friday.
Sara Gorton, Unison head of health, outside King’s College Hospital in London on Friday. Photograph: Sophia Evans/The Observer

“He [Barclay] offered to be the advocate for health workers inside the cabinet. My interpretation of what he said was that he was prepared to make the case for us for investment in pay.”

Gorton has written to Barclay this weekend asking him to organise a meeting with the prime minister, the chancellor and Unison’s general secretary Christina McAnea. The aim, she said, would be to secure extra funding for an improved settlement for NHS staff from outside existing budgets.

Gorton’s account was confirmed last night by senior Whitehall officials who had been briefed on the meeting, as well as several other sources from the health unions.

One Whitehall official briefed on the discussions said: “Everything Sara Gorton has said in public has turned out to be fair and accurate and this is a true reflection of what was said in the meeting.”

Downing Street said No 10 and the Treasury continued to hold the view that ministers would not move beyond the pay review body recommendations, although a spokesman said Barclay had made clear that his “door was open” for more talks. No 10 said it would respond to the letter from Gorton.

The Observer understands that while Barclay has stuck doggedly to the official government line for months, he made the case inside government for higher pay for NHS staff early on in the dispute, only to be told by the Treasury that making an exception for NHS workers would lead to rash of other unaffordable claims across the public sector.

Barclay is now understood to be concerned that the NHS’s capacity crisis, and lengthening waiting times for ambulances, could lead to the collapse of the service and more staff quitting.

With the unions feeling increasingly confident that they are winning the argument, the Royal College of Nursing said last night that it would pull double the number of nurses out on strike in February compared with previous strikes before Christmas, and involve more hospitals.

The latest Opinium poll for the Observer shows that public support for nurses and ambulance staff remains solid, with many more voters blaming the government for the crisis than the unions. Some 57% of voters supported nurses striking, compared with 31% who opposed the action. Striking ambulance staff were backed by 52%, against 35% who opposed them taking action.

Ambulance staff on the picket lines in Keighley, West Yorkshire, on the second day of walkouts last week.
Ambulance staff on the picket lines in Keighley, West Yorkshire, on the second day of walkouts last week. Photograph: Christopher Thomond/The Guardian

Adam Drummond of Opinium said: “The government will be disappointed if it was hoping the public would blame striking nurses and ambulance workers for the situation in the NHS. Although support for strikes in general has fallen slightly since before Christmas, the public are still overwhelmingly supportive.”

Despite Sunak’s attempts to make political capital from the crisis by claiming Labour is in the pockets of the striking unions, Keir Starmer’s party has increased its lead over the Tories in the Christmas period. Labour is on 45% (+1) compared with the Conservatives, who are unchanged on 29% since three weeks ago.

The nurses’ strike will continue this week with staff at more than 70 NHS trusts in England that were not part of December’s first wave of industrial action walking out on Wednesday and Thursday. The RCN will announce new strike dates for the start of February in the 48 hours before its second strike this week.

Nurses’ leaders said that if progress was not made in negotiations by the end of January, the strikes in February would include all eligible members in England for the first time. Pat Cullen, general secretary of the RCN, said: “The public supports nurses because of just how much nurses give to the public. Rishi Sunak’s intransigence is baffling, reckless and politically ill-considered.”


Toby Helm Political editor

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