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Nurses across Kent are being asked if they want to take strike action in pursuit of higher wages.
The Royal College of Nursing (RCN) has begun balloting its members today
The RCN said nurses pay had fallen by twice as much as those working in the private sector.
The vote could open the door to the first ever UK-wide strike by NHS nursing staff.
The RCN claimed that polling carried out on its behalf by YouGov showed two-thirds of the British public (65%) would support nurses in taking industrial action, but it is still hoping to avoid a strike by recruiting voters in a campaign to make the government rethink its policy on pay.
The college is asking members of the public to co-sign a letter to the Prime Minister from the RCN General Secretary and Chief Executive Pat Cullen which says: "On behalf of the nursing profession, I implore you to see sense. Protect nursing to protect the public.”
In a direct message to nurses set to receive their ballot papers today, Mrs Cullen wrote: "This is a once-in-a-generation chance to improve your pay and combat the staff shortages that put patients at risk.
She said: "Governments have repeatedly neglected the NHS and the value of nursing.
"We can change this if together we say ‘enough is enough.’
The college said record numbers of nurses were leaving the profession because of low pay and high stress levels and patient safety was being put at risk.
The RCN represents 300,000 staff across the UK.
It is the first time in its 106-year history the RCN has balloted members over strike action.
The ballot closes on November 2 and the result will be announced shortly after.
The RCN said statistics showed over the past 10 years nurses’ real-terms earnings had fallen by 6%, compared with an average decline of 3.2% for private sector employees.
A second YouGov poll found three quarters (75%) of respondents thought there were already too few nurses to provide safe care in the NHS.
Jeremy Benton is the RCN council member representing nurses in Kent.
He said: "There is no doubt about the vital role the NHS plays in all our lives. It is hard to imagine life without this bedrock of our nation to care for us when we are at our most vulnerable.
He said: "Nursing staff make up more than half of the NHS workforce, but they've been pushed beyond their limits. Patient care is at risk.
"There are a record number of nursing vacancies and 25,000 nurses left the profession last year alone in the UK. At the end of June, NHS figures show 6,645 nursing vacancies across the South East of England.
"For the first time in our history, Royal College of Nursing members working for the NHS in every part of the UK are considering strike action. Our patients are our priority – and we must advocate for them.
"This year is worse than ever, and the UK government has no plan to improve things.
"Patients deserve better. They deserve safe and effective care. They deserve dignity.
Mr Benton said: "They should not have to fear that when they need them, nursing staff won’t be there.
"Without fair pay, we will never solve the problem of staffing shortages. I will be urging our members to use their voice and vote for change."
The Government has already made its announcement on nurses' pay awards for this year. It is a complicated package that includes a £1,400 uplift for lower paid staff plus enhanced pay points for some grades. Overall it is thought to be worth an average 4% increase.
The RCN wants the Government to pay inflation plus 5% to catch up on previous losses. At the time it formulated its demand that was a pay rise of 12.5%, although actuallly since then inflation has risen still further.
You can sign the RCN petition to the Government here.
The RCN is the largest professional union of nursing staff in the world.
The threat of industrial action by nurses follows a summer of discontent that has already seen strikes by railworkers, bus drivers and postal staff as workers see their wages reduced by inflation running at 10%.