TODAY sees the biggest NHS strike in history as striking nurses are joined by paramedics, ambulance workers and call handlers organised in the Unite and GMB unions.

Ambulances queued up outside hospitals unable to hand over emergency patients have left the country in no doubt about the scale of the NHS crisis.

Last week Rishi Sunak was forced to announce £1 billion in funding for thousands of extra beds and hundreds more ambulances.

But that hasn’t appeased a furious workforce, GMB general secretary Gary Smith tells the Morning Star.

“The crisis in the NHS is about a lack of investment in the health service and its workers.

“Average pay has fallen by 17 per cent over the last decade. We’ve got a massive problem in recruitment and retention. There are 130,000-plus vacancies — the problem in the NHS is a workforce problem.”

Smith isn’t convinced the government even wants to solve the problem: “I think there is something very cynical afoot — there plan is to get the NHS to such a point of crisis that it becomes a backdoor route to privatisation.”

He pours scorn on Tory claims that there isn’t the money for a proper NHS pay rise: “They have blown billions on the mismanagement of the economy under Kwarteng and Truss.

“They can always find money for bonuses for the City of London. And is it any wonder we’ve got a problem in terms of investment in the NHS when the Chancellor of the Exchequer couldn’t get his own taxes right?

“Solving this is about money. It’s about investment in infrastructure and investment in people. It’s about raising wages. And if the government thinks it can deliver reform to the health service when it’s in the biggest conflict with the NHS workforce in history that’s pie in the sky stuff.”

Public opinion is firmly ranged on the side of NHS workers. “The Tories are not going to win against health service workers. People in this country remember who they depended on going through the depths of the pandemic. The Tories were partying while people were putting their lives on the line.”

Though politicians try to sell the need for wider-ranging NHS reform, Smith believes the NHS’s broader problems are also connected to pay.

“You cannot resolve the crisis in the NHS without resolving the crisis in the care sector — a sector which was in crisis even before the Tories turned care homes into morgues during the pandemic through hospital discharges.

“The fundamental problem is wages. Care workers doing highly skilled, specialised jobs for pennies above the minimum wage. You have to see health and social care together.”

The health service is just one sector now rocked by strikes which are spreading across public services and private workplaces. We haven’t seen such worker militancy in years. How come?

“This is a grassroots revolt. In workplaces a thousand fires have been lit across the country. Ordinary people are just fed up of watching their wages falling over a long time.

“They’ve had enough and they want a fairer share.”

Smith does believe union leaders are changing their approach — like some others, he argues that his union had become “obsessed with Westminster politics” and is now getting back to the workplace.

But the militancy does not come from union leaders. “This mood is at the grassroots.

“And what’s changed since the pandemic is that people really understand who brings value to society in terms of delivering services, goods and products. It is the gig economy workers. It is the care workers, the health workers, the refuse workers.”

The grassroots revolt has been spurred by double-digit inflation, and nowhere have prices risen faster than for energy. Britain now has the highest energy prices in the world.

GMB, an energy sector union, does not see eye to eye with most of the left on solutions here. Smith says there has been “political groupthink” in the energy debate.

“There are very distinct class interests at play here and the left has failed to address that. The renewables industry has ripped us off. The winners from renewables thus far have been the City of London, the big developers, foreign-owned multinational companies — and working-class communities have been made poorer.

“The jobs that have been promised have never arrived. They are being created in China, in sovereign oil and gas fund backed yards in the Middle East, in Indonesia… anywhere but the UK.

“And working-class people are paying a subsidy on their energy bills to subsidise this scandal. The left has accepted a poll tax on energy bills.

“We need a renewables industry. It should have been paid for by general taxation.”

But his points on jobs are not an argument against renewable energy per se — but about a government approach that outsources it abroad, surely.

Smith agrees, describing the British and Scottish governments as “useless” — he makes an exception for the Welsh government, which he says has tried to address the issue. But he is angry at the left too.

“Where has the critique been of the renewables industry? We have been exporting jobs and importing virtue. We have some of the biggest wind farms in the world. Where is the fabrication?

“My challenge is — we built Aberdeen as a global centre for oil and gas. This was a fishing village in the 1960s… where is the Aberdeen for renewables? Two hundred thousand jobs dependent on North Sea oil and gas. Where is the alternative?”

But countries that have taken a more joined up approach like China have created large, high-tech renewables industries employing large numbers of people.

“The reason China dominates is probably twofold,” Smith argues. “They planned. They invested. They have something like 80,000 engineers working on battery technology. We produce less than 10,000 engineers a year.

“So they had a plan. They have over 70 per cent of the renewables market because of planning.

“But the other truth is that they burn coal to produce the fuel cells for batteries. And the UK cannot compete with cheap, depreciated, Chinese coal-fired power stations.”

Not just China but the rest of the world is more favourable to manufacturing than Britain: “The price of gas is one-fifth in America what it is in the UK.

“If you want to invest in stuff like hydrogen, the German government has given 100 per cent support for projects.”

What can be done? “The state is back in energy in a big way. The debate is what role is the state going to play going forward.

“Labour’s proposal for a Great British Energy company represents a massive opportunity. It’s a huge step forward.”

Critics say Labour’s Great British Energy company is less radical than it sounds: it will not be an energy supplier to households and may not lower prices.

“At least there is a debate about it. What nobody can deny is that the neoliberal model for energy is broken.”

GMB argues for an energy mix to ensure energy security, including nuclear, which many see as dangerous. “If I hear anybody criticising what happens in the nuclear industry it makes me scream. They forget the struggles of nuclear workers in the ’80s to transform that industry and clean it up.”

If lowering prices is one part of the solution to the cost-of-living crisis, Smith is aware the core task of unions remains raising pay.

And GMB organises some of the lowest-paid workers in the country, and has been at the forefront of organising in gig economy employers like Amazon and Uber.

“You cannot talk about low pay without talking about discrimination against women workers. It’s invariably women who are impacted by low pay in the public and private sector. In the public sector we still have massive problems with sex discrimination.

“We’ve got a big campaign in Birmingham on equal pay and I’d love the Morning Star to do more on that.

“We led the Glasgow equal pay struggle, we have just won another £300 million for those women in Glasgow. We have equal pay campaigns in Dundee and Coventry. And in retail we have big equal pay claims against Asda.”

Smith argues that ultimately workers will win on pay not when “politicians come riding in on a white charger” but through unionised workplaces.

But politicians have a role too, surely, and moves like Keir Starmer’s to say frontbenchers should not attend union picket lines must have angered him?

“That was an act of self-harm,” Smith says. “Politicians misjudged the public mood.

“But there will be a choice before us in 12-18 months between Sunak and Starmer in No 10, and who do we want? And I think standing on platforms attacking the Labour leadership in those circumstances is an act of self-harm too.”

Labour might disappoint with its refusal to support the pay demands of workers in the NHS or other fields, I suggest.

“The key thing I want from a Labour government is the right to organise — a level playing field on organising and campaigning.

“If we can’t organise workers to win on pay… collective bargaining is key. We want the right to organise and collectively bargain. The rest is down to us.”