Industrial unrest over pay among NHS support staff who are members of Unison is spreading, while the union is pressing for significant rises of around 10 per cent for nursing staff in the next pay round.
Strikes and an overtime ban are threatened by ancillary staff at the first private finance initiative hospital, Carlisle's Cumberland Infirmary, in a dispute with contractor Interserve FM.
Secretaries at North Glasgow University Hospital trust are set to go on an all-out strike from next Tuesday in an escalation of their 16-month grading dispute, while at Royal Liverpool and Broadgreen University Hospital trust about 100 medical secretaries were this week refusing to answer telephone calls.
A mass meeting of Unison members at Cumberland Infirmary on Monday voted overwhelmingly for industrial action - likely to include an overtime ban and selective strikes by ancillary workers - in support of its demand to end the 'two-tier pay system'. Action could begin next week.
Unison regional officer Peter Doyle said: 'Half the workforce is on NHS rates, while the rest are on Interserve contracts, which pay a slightly higher basic rate but have no shift enhancements.
Interserve workers are now paid less than the lowest workers in the health service for doing the same job.
'So all the commitments the Labour Party gave at its conference over ending two-tier workforces are a pack of lies.'
But Interserve general manager Steve Nightingale said the union had not yet given notice of strike action and negotiations were continuing.
Unison branches at two trusts where PFI deals have also meant ancillary staff transferring to Interserve have pledged support for the Carlisle workers.
Dudley Group of Hospitals and University College London Hospitals Unison branches - which saw lengthy industrial action over the PFI deals - have set up links with the Carlisle branch in order to organise members employed by Interserve across all three trusts.
Meanwhile, the long-running medical secretaries' dispute is gathering momentum after a decision by Unison's industrial action committee to escalate the Glasgow dispute.
The North Glasgow medical secretaries have rejected a Scottish national framework agreement, which would bring a 22 per cent pay rise above inflation over the next three years, and are demanding regrading.
Unison regional officer Joe Lynch said his members were offering emergency cover and the door was 'always open' for talks.
'We do not want to take this action.'
Trust chair Ronnie Cleland said he was 'shocked' by the escalation of the dispute. The trust had sought to minimise disruption to patients throughout the industrial action, but had now decided to 'reduce the number of nonurgent outpatients being seen in those areas being targeted by Unison'.
More than 200 medical secretaries at Lothian University Hospital trust, who have also rejected the national framework deal, have voted for industrial action.
As HSJ went to press, Unison was due to meet trust chief executive Allister Stewart to see if a solution could be found.
Royal Liverpool and Broadgreen University Hospital trust said secretaries had been offered 'a significant improvement in the pay and grading package' and that it was disappointed at 'such irresponsible behaviour'.