- .400,000 nurses, midwives and others walked out today in row over pay
- .Soldiers and police officers were drafted in to drive ambulances
- .It was the first strike over pay since staff walked out in 1982
- .Unison persuades 9.5% of eligible members to vote for today's walkout
- .Turnout figures increase pressure for urgent reform of union powers
- .Pickets were mounted outside hospitals across the UK from 7am to 11am
- .Seven unions were taking part including Unison, Unite, the Royal College of Midwives, GMB and TUC
- .Health secretary Jeremy Hunt said if pay rise was granted more than 14,000 nurses would be laid off by hospitals as a result
- .He said the pay rise would risk another Mid Staffs scandal
Members of the armed forces today stepped in as more than 400,000 NHS staff staged their first walk out in more than 30 years, mounting picket lines outside hospitals.
But it emerged only a fraction of workers who belong to unions taking part, voted to strike in the row over pay.
Fewer than half those balloted for the controversial health strike voted in favour of the action - the first since 1982 - the Daily Mail revealed.
And Unison, one of the biggest unions, could persuade fewer than one in ten – 9.5 per cent – of eligible members to vote for the controversial walkout.
None of the other six trade organisations involved managed to get a mandate from more than half of those balloted.
Yet 400,000 nurses, midwives, paramedics, specialist health staff and hospital porters and cleaners staged the walk out from 7am for four hours.
The military today stepped in as more than 400,000 NHS staff including nurses, midwives and paramedics walked out for four hours this morning in a row over a one per cent pay rise. Soldiers help ambulance crews with an emergency admission at St Thomas' Hospital in central London (above)
Another colleague helps a paramedic with a stretcher outside the Royal Liverpool Hospital
A member of the Armed Forces is pictured helping an ambulance crew transport a patient at the Royal Liverpool Hospital during today's strike - the first action of its kind by NHS staff since 1982
Laura Mackenzie with her son Gabriel, four months, and Biz Rance and her 11-week-old son Finn, on the picket line outside London's King's College Hospital
Royal College of Midwives' members waves flags calling for action to 'Protect maternity services' outside King's College Hospital in London
A child brandishing a Unison poster calling for 'Fair pay for NHS staff' stands on the picket line outside the Bradford Royal Infirmary (left), while an NHS worker carries the same placard at the Royal Berkshire Hospital
Hundreds of thousands of health workers are set to bring the NHS to a halt today by walking out in a row over pay. Staff protest outside the Royal Berkshire Hospital in Reading this morning
Picket lines were mounted outside hospitals across England, including the Royal Berkshire, this morning from 7am. They are set to stay in place for four hours
Seven unions taking part in the industrial action are calling for a one per cent pay rise for all NHS staff
But fewer than half those balloted for the controversial health strike voted in favour of the action, the Daily Mail can reveal
Members of Unison on the picket line outside London's St Thomas' Hospital in Westminster, just across the River Thames from the Houses of Parliament
They will take other forms of industrial action, in the form of work-to-rule, for the rest of the week, including ensuring staff take their allotted breaks.
The damning turnout figures, which increase pressure for the urgent reform of unions' powers, are published as the NHS faces being brought to a standstill this morning.
Soldiers and police officers were called in to drive ambulances, taking the place of trained staff.
The move sparked a row as unions claimed they had been kept in the dark about the plans.
Jason Killens, London Ambulance director of operations, said: 'We are expecting to be under significant pressure.'
The strike was in protest at the Government's decision not to accept a recommended one per cent pay rise for all NHS staff.
Instead, ministers took the 'divisive' decision to only award a one per cent pay rise for those on the top of their pay band, which unions say has denied it to 60 per cent of NHS workers.
But health secretary Jeremy Hunt said if the pay rise was implemented in addition to an automatic three per cent pay rise for most NHS staff each year, hospitals would be forced to lay off more than 14,000 nurses by next year.
Mr Hunt added that he would not be taking a nine per cent pay rise for MPs, calling the proposed increase wrong'.
Midwives, nurses and other health workers mounted a noisy protest outside St Thomas' hospital opposite Parliament in Westminster.
Most passing cars, buses and lorries tooted in support and patients arriving for appointments said they backed the action.
Midwives shouted: 'Don't push midwives - push fair pay.'
They said they never imagined having to go on strike but were at their wits' end.
Annie Black, who has been a midwife for 12 years, said: 'We haven't had a pay rise for years yet our workload keeps on increasing. It's time the Government took us seriously.
'It's weird being on strike, but we feel that enough is enough.'
For midwives and members of the Royal College of Midwives today's strike was the first in the union's history
They joined nurses, paramedics, hospital porters and cleaners among other staff to protest at the Government's decision
In total six different unions took part in today's walk out and will be taking more industrial action, just short of a strike, for the rest of this week
Ian Evans, a biomedical scientist at the Royal Sussex County Hospital in Brighton, said: 'For the last four years we have had a continuing reduction in pay and our earnings.
'This year we were offered one per cent, well 40 per cent of us were offered one per cent.
'The rest were told, 'well you already get an increment anyway so you don't deserve a pay rise at all'.
'We argue and dispute the point that these incremental steps are the movement towards the correct pay, the genuine pay for the job.
'We do not believe people should be demonised or should suffer financially.
'We believe that everybody should be awarded a pay rise that actually mimics the living wage, which we are not getting.'
Outside the busy maternity unit at Newcastle's Royal Victoria Infirmary, around 40 midwives were on the picket line and cheered every time a driver tooted their horn in support.
Becky Banks, 41, who has been a midwife for 18 years, said the public's support for their strike action had been 'overwhelming'.
She said: 'It is incredibly unusual to be on strike. Strike action is something we are undertaking with a heavy heart because we do not want to jeopardise any care for women and their babies.
'We need to show Jeremy Hunt how angry we are. He has backed us into a corner and left us with no other option.
NHS staff who are members of the Unite and Unison unions stand in protest outside Bradford's Royal Infirmary
The last time NHS staff staged a walk out was more than 30 years ago in 1982
Workers carrying Royal College of Midwives placards strike outside the Luton and Dunstable hospital
'It's absolutely not a life-changing amount of money but it was recommended by the Independent Pay Review Body that we were awarded this one per cent.
'We are wanting what we deserve, we work very long hours. It is a marvellous job and it is an honour to do the job, but we do deserve recognition for that, we still have bills to pay.
'Public support has been overwhelming. We are absolutely buzzing from the support we have had.
'Anybody who comes into contact with midwives knows what an amazing job we do and we work very hard to care for the women we look after, so public support is right behind us.'
Colleague Kate Robison, who joined the NHS in 1972 has only been on strike once before.
The 60-year-old midwife said: 'Jeremy Hunt needs to come on the shop floor and work with some of the midwives and see what we do.
'Come and work a 13 hour shift without a break, and do overtime that is not paid, because that is the reality for many midwives working within the NHS today.
'Clients do back us because they appreciate what our job is.
'We want it recognised that in real terms, our pay is back where we were in 2006.'
Christina McAnea, national officer of Unison, said: 'This is the first time in 32 years that NHS workers take industrial action over pay, and for many, it will be the first time.
'Up and down the country, hundreds of thousands of workers are out fighting for fair pay and for the NHS.'
An ambulance carrying a member of the armed forces, drafted in as part of the Department of Health's contingency plans, drives past a protest at the Royal Liverpool Hospital
Nurses, midwives, paramedics, hospital porters and cleaners on the picket line outside Leeds General Infirmary protesting at the Government's decision not to award a one per cent pay rise to all NHS staff
Mark Boothroyd, a staff nurse at St Thomas', said: 'We have had a pay freeze for four years, so not accepting a recommended one per cent from the pay review body was the last straw.
'There is chronic under staffing and increasing workloads, while the NHS is being privatised.
'At the same time, MPs are being paid a double digit pay rise because David Cameron says he cannot interfere with what is being recommended. It's just not fair.'
Several unions were involved in the action, including the Royal College of Midwives for the first time in its history.
Speaking ahead of the walk out, Jane Cummings, NHS England's chief nursing officer, said: 'We would ask the public to help, for example, by only calling an ambulance if it is a life-threatening situation.
'As ever, the safety and care of patients is our top priority and we have robust plans in place to cope.'
Militant union leaders are furious they have been denied a one per cent salary rise.
But turnout data suggests they have failed to capture the full support of their members.
Conservative MP Dominic Raab, who calculated the figures, said: 'It is totally wrong for militant union leaders to be striking, putting the NHS at risk.
'Everyone in the NHS will be getting a 1 per cent pay rise, and most low and middle income staff substantially more.
'This explains why not one of the striking unions has the support of a majority of its members, with Unison mustering less than 10 per cent support.
NHS workers man a picket line outside University College Hospital in central London this morning
An ambulance passes strikers protesting outside the Royal Liverpool Hospital. It is the first walk out by NHS staff for more than 30 years, the last strike action being taken in 1982
Placards outside the Royal Liverpool Hospital make calls to 'Save our NHS from the enemy within,' bearing pictures of David Cameron, Nick Clegg and George Osborne
Staff have said 'enough is enough' after a six-year pay freeze. But the Government claim meeting the recommended pay deal would force hospitals to lay off nurses
Signs brandished by Unison members outside UCH in central London called for 'Fair Pay for NHS Staff'
'The hardliners need to take a long hard look in the mirror – they are hurting their members, the NHS and the wider public.'
But in contrast, union leaders said there had been 'tremendous support' for the strike across the country.
Len McCluskey, general secretary of Unite, accused the Conservatives of 'lying' over their treatment of the NHS.
He told strikers at St Thomas' Hospital: 'By taking action on such a miserable morning you are sending a strong message that decent men and women in the jewel of our civilisation are not prepared to be treated as second-class citizens any more.
'We also have a message for the Labour Party that if they get elected next year they have to invest in the NHS and the staff.'
Mr Hunt said the Government has been prepared to talk to the unions throughout the row, recognising the invaluable work front line staff do.
He said: 'We will talk to them if they're prepared to look to reform the system of increments, which is unclear and unfair.
'I recognise frontline staff do a magnificent job in the NHS. We have had more than 650 NHS volunteers who are willing to put themselves in harm's way to help tackle the Ebola crisis in West Africa.
Ambulance crews protest outside the Whipps Cross University Hospital in Waltham Forest, London today
Staff from Kings Mill Hospital in Nottinghamshire join thousands of NHS workers taking strike action
Unimpressed: Conservative MP Dominic Raab (above), who calculated the figures, said the 'hardliners need to take a long hard look in the mirror - they are hurting their members, the NHS and the wider public'
'We have magnificent people.
'We're offering them all a one per cent rise. The majority of NHS staff get an automatic three per cent increment but we can't afford to give a one per cent rise to people already getting that.
'We're coming through a very difficult period with the tragedy of Mid-Staffordshire.
'We now have got 5,000 more nurses in just a year. We're recruiting nurses like crazy at the moment and to put that in reverse would not be the right move at the moment.
It would be irresponsible for any health secretary to accept a pay package that means the NHS has to lay off nurses
'The most important thing here is doing the right thing for patients.
'It would be irresponsible for any health secretary to accept a pay package that means the NHS has to lay off nurses.'
Mr Hunt said that hospitals would be forced to lay off staff if the recommended pay award was met in full.
'Nearly 60 per cent of NHS staff get an automatic pay rise through their increments of an average of three per cent.
'We can't afford to offer a one per cent on top of the three per cent,' he told the BBC Radio 4 Today programme.
'We have had very clear analysis that if we did that, hospital chief executives would lay off around 4,000 nurses this year and around 10,000 nurses next year.
'The NHS has just come through a terrible tragedy with Mid Staffs when we discovered the most appalling care happening there and indeed some other hospitals as well.
'We have turned the corner on that by recruiting in hospital wards around 5,000 extra nurses in the last year alone. We don't want to turn the clock back on that.'
Mr Hunt said the majority of NHS staff already get an automatic three per cent pay rise each year, adding the Government cannot afford to give a one per cent rise on top of that. He said the NHS has 'turned a corner' since the Mid Staffs scandal after recruiting 5,000 nurses, adding: 'We don't want to turn the clock back on that'
TUC general secretary Frances O'Grady, who joined a picket line near Euston in London, said: 'NHS staff are always reluctant strikers - there hasn't been a national strike over pay in the health service since 1982 - and they will do everything they can to protect patients in their care. But morale has hit rock-bottom.
'It is no surprise that the NHS is finding it hard to recruit and retain staff as they find themselves squeezed between falling living standards and covering up for NHS cuts.'
Cathy Warwick, chief executive of the RCM, said: 'At a time when MPs are set for a 10 per cent pay hike, we're told that midwives don't deserve even a below-inflation one per cent rise.
'And politicians wonder why the public does not afford them more respect.
'It feels to a great many people, including midwives, that there is one rule for them and another rule for everybody else.
'The independent panel of experts who advise the Government on NHS pay recommended a one per cent pay rise for midwives, nurses, paramedics and other NHS staff.
'Unfortunately, Health Secretary Jeremy Hunt rejected that recommendation, and he and the employers decided that midwives and others won't get a pay rise this year.'
Public sector workers are still earning thousands of pounds a year more than those in the private sector, the Institute for Fiscal Studies reported last week.
The average public-sector pay and pension deal is worth 17 per cent more than the private sector, it found.
The Tories have long promised action to prevent unions holding walkouts without any popular mandate.
But aides say any attempt to change the law in this Parliament would have been thwarted by the Liberal Democrats.
Cabinet Office Minister Francis Maude said the next Tory manifesto would include the requirement for at least half of eligible union members to vote in order for a strike to be lawful.
There would also be a three-month time limit after the ballot for the action to take place and curbs on picketing.
NHS workers strike in 1982, mounting a picket line outside London's Hammersmith Hospital
Millions took part in the three-day action in a dispute over pay. More than 120,000 people took to the streets of London as part of a rally during the strike
Mr Maude said: 'None of the union leaders pushing this irresponsible strike action could persuade a majority of their members even to vote, let alone to support a strike.'
But union leaders object to the proposals. Frances O'Grady, general secretary of the Trades Union Congress, has previously said that any such actions would be 'designed to make legal strikes close to impossible'.
She added: 'Not a single MP would have been elected under these rules.'
Of the seven unions striking today, turnout data has been published for four, none of which managed to persuade a majority of their members to vote for the action.
We are expecting to be under significant pressure
Jason Killens, London Ambulance director of operations
Only 14 per cent of eligible Unison members returned their ballots.
While 68 per cent of those who voted approved industrial action, giving them the legal mandate to strike, only 9.5 per cent of all eligible members actually backed the action.
The Royal College of Midwives had the best result, but even it managed to persuade only 40 per cent of members to vote for the strike.
Three of the other unions taking action today - Unite, the British Association of Occupational Therapists, and the NHS bosses' union Managers in Partnership - refused to publish their turnout data.
The Society and College of Radiographers, which will strike next week, received a mandate from 21.9 per cent of members.
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