Unison members raised two defiant fingers and voted to strike at the turn of the millennium during their annual health conference last week.
Health secretary Frank Dobson promised to go to a local hospital on 31 December and 'stay there' - provided, that is, he declines his official invitation to attend the party at the Millennium Dome.
But he was booed and hissed and jeered by delegates to Unison's annual health conference when he confirmed that there would be no national millennium pay bonus for NHS staff.
NHS Executive human resources director Hugh Taylor admitted that it would be no consolation to health workers, but he, too, would be working on 1 January and, by implication, for no extra pay.
The reaction to his statement was more muted, but delegates were simply keeping their powder dry.
Against the advice of their leadership, they voted by a margin of three to one to strike over the two days of the millennium weekend.
This raised two defiant fingers at the notion of 'public service' advanced in Mr Taylor's health service circular telling senior managers that there would be no national millennium pay deal.
Unison members were particularly angry at the circular's advice that staff should be provided with transport and 'decent hot food'.
That was the 'final insult' for Myfanwy Manning of the south west regional committee, who proposed the strike call in an emergency motion otherwise acceptable to the Unison national executive.
'I have never seen anything like this in my life,' she told the conference. 'I am used to reading health service circulars. Most are incomprehensible, even more extremely boring, but none as provocative or insulting as this.'
It formalised the 'exploitation' practised by successive governments against health workers, who were 'expected to accept a bus ride and a plate of pie and chips - what an insult'.
The vote for industrial action was the second taken by the conference, and poses a headache for the union.
It is due to meet the General Whitley Council on Monday to hear the formal response to its claim, on behalf of all NHS staff except doctors, for a£500 millennium eve bonus and£250 for working the first shift on 1 January.
But, because strike action must be taken within 28 days of an affirmative ballot, the union cannot ballot members until November.
Deputy head of health Paul Marks asked: 'What are we supposed to do about this between May and November?'
It was clear that Unison delegates didn't care.
Throughout their three days in Brighton, they demonstrated a deep sense of disillusionment with what many regarded as 'their' government and what it is doing.
Mr Dobson was asked: 'How can you talk about fairness, but deliver inequity?' by one of many delegates angered by the 2.8 per cent offer to 200,000 non-review body staff while nurses received 4.7 per cent.
Newcastle nurse Yunus Bakhsh asked him directly: 'Why am I worth more than an ancillary?'
They were not reassured by Mr Dobson's insistence that differential awards to nurses had been made because they were recommended by the pay review body, or by his statement that there would be negotiations on the 'above- inflation' 2.8 per cent offer to other staff.
The delegates rejected that as 'derisory' and voted to ballot on industrial action if the offer is not increased to match the nurses' 4.7 per cent.
The conference also passed an emergency motion expressing 'extreme anger' at the government's proposals for a new pay system, and calling for a nationally agreed structure for pay and conditions for all NHS staff.
The resumed talks on the new pay system have established that the key parts of the proposals - the government's proposed three pay spines for doctors, nurses and midwives, and all other staff - are open to negotiation.
Mr Marks, who is leading for Unison in the talks, thinks this makes it possible to consider the link between the three to ensure that they do not produce unequal awards for different groups.
But there is clearly a long way to go if the Unison leadership is to carry its members with it in working together on the government's NHS agenda. Head of health Bob Abberley, having already endorsed Mr Taylor as 'someone we can do business with and someone who actually thinks trade unions are a good thing', felt obliged to go further.
He told delegates: 'Those of us who operate at a national level can see a huge change in the way industrial relations are carried out. It hasn't yet got down to where you are.'
It was a reasonable stab at defining the mood, which in other places has been described as 'post-euphoria, pre-delivery' as people discover that the world does not change overnight just because a government does.
It was expressed by Sophie Taylor of Unison's black members' council. She applauded Hugh Taylor's determination to deal with the issue of institutional racism, a point both he and Mr Dobson emphasised in their speeches.
'But what I would like to know is when it will get to the ground floor where I work?'
Mr Taylor acknowledged the force of her question when he said there was clear evidence of institutional racism in the NHS, where 7 to 8 per cent of staff were from black and ethnic minority communities, but only 0.6 of ambulance staff and less than 1 per cent of nurse directors were black.
He promised that where people did not respond to the government's initiatives on race issues, it would be made clear they 'are not living up to the standards we require'.
Mr Taylor also pleased delegates by acknowledging that the impact of the private finance initiative on staff 'can be damaging and difficult' if not managed effectively.
'I don't see any reason why employers to whom staff are transferred should not be expected and required by the NHS to have the same standard of employment practices as we require of the best NHS employers,' he said.
He had already told the conference that he was 'dead serious' about taking the new human resources agenda forward because what counted was what worked.
'Unless we improve the quality of working life for the staff in the NHS, we will not succeed in our wider aims of improving the quality of health services for the people of this country,' he said.