THE brutality of the pandemic alongside the deaths of hundreds of health workers has led to national mobilisations and a new layer of activists coming into the trade unions.

Trade unionism in the NHS has changed as the emphasis shifts towards increased member engagement and activity. A welcome departure from the dry decades of inertia and inactivity imposed by the domination of the partnership working model. Decades when both staff and patients lost so much from cuts and privatisation that went mostly unchallenged.

The wave of national strike action is a reflection of the level of the re-engagement and has been supported by NHS campaigns, patients and the public. This has put enormous pressure on the Tories who have been forced to the table to offer concessions.

Whatever the outcome of the union members pay ballot, one thing is clear, the struggle to protect the NHS for patients and staff alike is far from over and trade unions will continue to play a leading role in the coming battles.

NHS foundation trusts will continue to outsource services and water down  AFC (agenda for change terms and conditions). The cuts and privatisation agenda and the pressure to take out private health insurance will increase.

There is much to protect, even more to win and newly activated union branches and activists can play leading roles in the many disputes that are yet to come. Because workers will always fight when their pay and jobs come under threat, all they need is a lead from their trade unions.

The work necessary to revive trade unionism in the NHS is getting underway and health unions must continue to develop and inspire the next generation of NHS workplace organisers. But we must prioritise moving away from the traditional model of having one overworked rep in each trust to achieving at least one trained rep in every single workplace who are building their branches around them.

Trade union activists and strong branches full of active members are the natural custodians of what is left of the NHS and ambulance trusts.

Now is not the time for any union activist to throw in the towel, embrace the mantra of defeat or to become demoralised. Instead activists can be proud of their achievements so far and keep building up union density in their own workplaces. They can concentrate on leading workplace meetings, communicating important information to members while identifying and sparking campaigns to achieve gains locally and nationally.

The activists, whatever job role or trade union they are in, will be the first to get information on changes, so will be in a prime position to ignite opposition to cuts.

Much can be learnt from the outsourced porters, domestics and hostesses who are slowly but surely getting organised in their hospitals and making demands around their own interests. 

Co-ordinating the efforts of all unions and social movements and pushing for a spirit of co-operation as opposed to competition will be of paramount importance if the working class is to effectively protect the right to free healthcare and the front-line staff who deliver it.

An attitude that prioritises the work of building trade unionism alongside caring for patients will be vital to stop the cuts to services and staffing that will hurt patients.

Professional registrations are also on the line so NHS staff will look to their trade unions for both personal protection and a lead to achieve lasting solutions to the NHS crisis.

Campaigns are likely to increase, not diminish but these will not be won solely in the court of public opinion or by waging wars via social media.

Yes we need press but this can never be a substitute for the hard work of organising workplaces and building up our membership and our activist network.

Unions need their activists and activists need their trade unions in order to deliver successful campaigns that make work better for members.

The fight for the NHS is not over, campaigns will be won by boots on the ground and hundreds of face-to-face conversations in workplaces, the true pillars of organising to win.