Emma Baines

Yesterday was the second day of the nurses’ strike in the UK. Up to 100,000 nurses at almost eighty hospital trusts, health boards and other NHS centres in England, Wales and Northern Ireland were on strike over inadequate pay and appalling working conditions. Many nurses on the picket lines have spoken to reporters about relying on food banks and not being able to pay their energy bills. Some newly qualified nurses are choosing to look for work elsewhere rather than take up the job they’ve trained for because it simply doesn’t pay enough.

On 17 October 2000, four people were killed and 70 injured in the Hatfield rail crash. A high speed train derailed because of metal fatigue in a section of track that had been tagged for replacement months earlier. Railtrack, the company which had managed the permanent way since British Rail was privatised in 1994, never recovered. In 2001 it went bankrupt, more than £3 billion in debt. In October 2002, responsibility for maintaining railway infrastructure was essentially renationalised with the formation of Network Rail.

As well as enough money to build a new hospital every week post-Brexit, the Leave campaign promised to relieve the NHS of the pressure it is put under by 'health tourism' and the arrival in Britain of hundreds of thousands of public-service-hungry migrants each year. It now seems the NHS is as unlikely to benefit from restrictions on EU immigration to Britain as it is to receive an extra £350 million a week. The amount that would be saved by not treating EU migrants would make no dent in the NHS’s financial problems, while a lack of EU workers would mean fewer staff on overworked NHS wards.

In the run up to the EU referendum, the Leave campaign promised that a funding bonanza for the NHS would be one of the many benefits of leaving the EU. Official Leave campaign posters notoriously pledged that £350 million a week would be used to fund the NHS instead of being sent to Brussels. Now it seems that Brexit will deliver the opposite of what was promised: instead of gaining £350 million a week, the NHS will be making a loss of £365 million a week by 2030, according to a new Health Foundation report. And that’s the optimistic outlook, based on an assumption that the UK will be allowed to join the European Economic Area. If it’s excluded from the EEA, the NHS in 2030 may be running a deficit of £540 million a week.

NHS doctors are planning to take industrial action on 21 June over pension reforms that would see them working until they're 68 and paying twice as much in contributions as other public sector staff on a similar pay-grade, for the same eventual pension.

The majority of GPs, consultants, junior doctors, staff, associate specialists and specialty doctors as well as public health and community health doctors who voted in last month’s ballot said they were even prepared to go on strike, but the British Medical Association has ruled that out: ‘doctors will ensure that patient safety is protected’ on the day by continuing to supply urgent and emergency care, only postponing non-urgent cases.

The Health and Social Care Bill has now passed, largely unchanged, through the report stage in the House of Lords, and on Tuesday survived by 314 votes to 260 a Labour motion in the House of Commons to scrap it. Despite widespread opposition from doctors, nurses, other NHS workers and the general public, the NHS 'reforms' that prioritise competition over quality of care look set to be implemented. It’s tempting to point the finger of blame at the Lib Dems.

It’s increasingly hard to find anyone apart from Andrew Lansley and David Cameron who supports the Health and Social Care Bill. Most doctors, nurses and other NHS workers are against it. A Cambridgeshire GP who used to be the vice-chairman of his local CCG and an enthusiastic supporter of the reforms has written in the BMJ that GPs were 'duped' and the bill will 'wreck the NHS'.

Andrew Lansley’s Health and Social Care Bill, due to return to the Lords next month, is looking less and less well. A poll of more than 2500 GPs carried out by the RCGP found that 98 per cent were in favour of rejecting the bill if the other Royal Colleges agreed. When Ed Miliband challenged David Cameron with these figures on Wednesday, the prime minister responded by claiming the reforms were not only supported but being implemented by one Dr Greg Conner, a GP from Miliband's Doncaster constituency. A spokesman for Doncaster Primary Care Trust later told GP newspaper that ‘Dr Conner was no longer chairman of the Doncaster clinical commissiong group and he had in fact left the area.’

The Health and Social Care Bill was passed in the House of Commons yesterday by 316 votes to 251. Before the vote, during Prime Minister’s Questions, David Cameron said: We now see the Royal College of General Practitioners, the Royal College of Physicians and the Royal College of Nursing all supporting our health reforms. He may see it, but that doesn't mean it's true. On Monday, the deputy chairman of the General Practitioners Committee said: The BMA is very clear – the majority of doctors have serious concerns with the Health Bill. We want to improve the NHS, but a wholesale review of the current plan is needed, which is why we are calling for it to be withdrawn.

Doctors are not going to go on strike in protest against the health bill. At the BMA special representative meeting in London on Tuesday, 54 per cent voted against a motion to reject the health bill ‘in its entirety’ in favour of continuing the current policy of ‘critical engagement’ with the government. A vote of no confidence in the health secretary, Andrew Lansley, also failed to pass.