THE health secretary has told unions that a rejected pay offer remains "the best and final offer" as plans loom for a strike by nurses and midwives.

Humza Yousaf continued to insist yesterday that the half billion pound pay package is all that there on the eve of pre-Christmas negotiations with union leaders to avoid industrial action at a time when NHS Scotland was under "significant pressure".

Members of the Royal College of Nursing and the Royal College of Midwives (RCM) voted “resoundingly” to reject the offer.

Two-thirds (65%) of RCM members and 82% from RCN rejected the offer in ballots.

RCN Scotland said it will continue planning for industrial action and, early in the new year, will announce dates for strikes.

Mr Yousaf said: “While I am naturally disappointed the Royal College of Midwives and the Royal College of Nursing have rejected this offer, I respect the voice of their membership.

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"We have engaged tirelessly with trade union representatives over recent weeks and months, leaving no stone unturned to reach a record pay offer which responds to the key concerns of staff across the service.

"I am committed to meaningful dialogue with our Unions, and I will be meeting with trade unions, including the RCN via the Scottish Terms & Conditions Committee as we seek to avoid industrial action.

“This best and final pay offer underlines our commitment to supporting our fantastic NHS staff."

The deal formed part of the NHS Scotland pay offer which would increase the NHS pay bill in Scotland by £515m and an average of 7.5%.

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Increases would range from 11.24% for the lowest paid to 5.56%. Certain staff would get no more than the original 5% offer.

Members of three major NHS unions in Scotland, Unite, Unison and the Chartered Society of Physiotherapy have already voted to accept an improved pay offer.

But GMB voted to reject the deal.

Julie Lamberth, RCN Scotland board chair, said: “It was the right thing to ask our members whether to accept or reject this offer. It directly affects their lives and each eligible member needed to be given the chance to have their say. And the result could not be clearer – we have forcefully rejected what the Scottish government said is its ‘best and final’ offer.

“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.”

The RCM said the deal offered "welcome improvement" for early career midwives and maternity support workers (MSWs), but did "little" to improve the take-home pay of the majority of RCM members in Scotland.

The RCM, who represent most midwives and maternity support workers in Scotland, had put any plans for industrial action on hold while considering the offer.

In October, maternity support worker (MSW) members of the RCM across Scotland overwhelmingly voted yes on taking industrial action, up to and including strike action, over the "insulting" original Scottish Government pay offer.

Jaki Lambert, RCM director for Scotland, 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.

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“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. We have written to the Cabinet Secretary and said that it’s not too late to avert strike action – we just need to get back around the table.”

The RCM, whose members in Scotland have already voted decisively for industrial action in the absence of an acceptable pay offer, said it had put the current offer to its members as it felt it was likely to be the final and best offer this financial year.

The RCM board are now to meet and decide on next steps including taking industrial action.

Commenting on the next steps Jaki added: “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. 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."

The RCM has previously said that if industrial action takes place, NHS employers in Scotland will be given adequate notice of any type of industrial action.

The RCM said it and its workplace representatives will work with maternity service managers to ensure there is cover during any work stoppages across Scotland so that "safe care for mothers and babies is always prioritised".

Mr Yousaf said the offer would see Agenda for Change workers in Scotland receive pay rises ranging from £2,205 to £2,751, an average uplift of 7.5%, and up to an 11% increase for the lowest paid.

A newly qualified nurse and midwife would see a pay rise of 8.7%, and experienced nurses and midwives and would get uplifts of between £2,450 and £2,550."

“We are making this offer at a time of extraordinary financial challenges to the Scottish Government 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," he said.

“Constructive engagement is crucial, those unions who have rejected our pay offer have all said they want to avoid industrial action, we must collectively work toward avoiding strikes taking place this Winter at a time of already significant pressure for our NHS.”

Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP said that Mr Yousaf should produced a new deal to stop strike action going ahead.

“Scotland’s NHS is on its knees due to the health secretary’s mismanagement, so the last thing it can afford going into the peak winter period is industrial action," he said.

“With a 6,000-plus shortfall in personnel across Scotland, it’s little wonder that nurses feel shattered, over-stretched and taken for granted by the SNP government.

“The conditions nurses are forced to work under are unacceptable. They have made that clear repeatedly but Humza Yousaf doesn’t seem to understand it.

“Resolving this dispute ought to have been the primary focus of ministers in the run-up to Christmas, rather than railroading their controversial GRR Bill through parliament at breakneck speed.”