UNISON, the largest health union, is to propose a ballot on "action short of a strike" to nursing and professional staff at its health sector conference in Brighton later this month.
This would be the first nationally-coordinated action over pay since 1988, and marks a sea-change in the stance of UNISON leaders as they recognise the mood of members after branches were asked to report back.
Health workers across England and Wales have been seething with anger over the recent announcement that the feeble 2.5% pay award recommended by the NHS Pay Review Bodies covering nurses and health professionals is not to be paid in full, but staged -to reduce its value to just 1.9% over the year.
With inflation running at over 4.6%, and the cost of professional registration of nurses and health professionals set to leap by a massive 75%, this level of increase amounts to a substantial pay cut in real terms.
To make matters worse, support staff working in nonclinical sections have so far been made no offer at all: pay talks are not even due to start until the end of April, a whole month into the new pay year.
The staging is a direct result of Gordon Brown's insistence on capping public sector pay increases below 2% - while handing out lavish tax cuts to the rich and to big business, and shovelling billions in to the budget for replacing Trident missiles, as well as the ruinously expensive and inoperable NHS computer system that has already swallowed £12.4 billion.
But while Brown forces nurses in England to eke out an existence on a below-inflation pay rise, nurses in his own Scottish constituency will at least get the whole of their 2.5% award paid in full at once - thanks to a decision of the Scottish Parliament.
This policy is one of relatively few populist gestures from a Labour administration that seems to recognise it is on its last legs and needing to rebuild some of its traditional support: they may have left it too late to do so with any credibility.
But at least the MSPs did better than the Welsh Assembly, which was urged by
eno owpay scanda It's almost 20 years since the unions last considered national industrial action over pay unions and employers to take a similar stand in advance of the Assembly elections in May, but dithered and failed to do so.
It was clear in the run-up to UNISON's health conference that anything short of a call to action - which could yet be
Speeches from UNISON national officers are larded with dire warnings of how much worse things might be under the Tories if David Cameron is allowed to creep back in.
Having been forced to agree