Strikes by NHS staff will go ahead this month after a meeting between union bosses and the health secretary broke down.
Steve Barclay failed to avert further walkouts by ambulance workers and auxiliary NHS staff during a short meeting on Monday.
Union leaders reacted in anger over the meeting, which had been seen as a breakthrough in relations after the government initially said it would not talk about pay with unions.
Onay Kasab, Unite’s national lead, said the government “only wanted to talk about productivity” and said there was no detailed discussion on a pay settlement as he confirmed strikes by ambulance workers will go ahead on 23 January.
“Productivity when our members are working 18-hour shifts! Quite how you become more productive, I don’t know,” he said.
“I’m very angry on behalf of our members.”
Mr Kasab added it was “absolutely ludicrous” and “outrageous” the government only wanted to talk about NHS staff being more productive in exchange for a pay rise.
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“It’s an insult,” he said.
The GMB union said no cash offer was made and there was nothing “concrete” offered on pay for the next financial year, which starts in April.
A spokesman confirmed strikes by its members who are ambulance workers will go ahead on Wednesday.
Sara Gorten, head of health at Unison, said strikes by ambulance workers who are members will go ahead on both Wednesday and 23 January.
She said there was no “tangible” offer from the government and Mr Barclay made it “very, very clear” he knows workers want a pay rise for the current year but she is “not sure it goes beyond that”.