A quarter of a century on, things are much more severe. The waiting list back then was below 1m; today it tops 7m (see chart). One of the unions to reject the government’s deal is the Royal College of Nursing (RCN), the main nurses’ union, which in its 106-year-old history had never gone on strike until last year. On May 1st its members concluded a 28-hour walk-out which affected half of English hospitals, mental-health and community services, and obliged nurses to leave the bedsides of their cancer patients. (It would have lasted 48 hours, save for a court ruling that the union’s strike mandate had expired.)

The RCN has vowed to escalate the strikes if it secures the backing of its 280,000 members in a new ballot. Last time around votes were held on an NHS-trust-by-trust basis. This time, strikes would hit the entirety of the NHS, and if there were no resolution with the government, could last until next winter.

RCN members may yet vote against further action. But their union is not the only one mulling more strikes. On May 2nd junior doctors from the British Medical Association (BMA) were due to meet Steve Barclay, the health secretary, to put to him their own demands for a 35% pay rise to compensate for years of falling real wages. The talks follow the longest-ever strike by junior doctors last month. At the same time, the two other principal BMA occupations, consultants and general practitioners, are also threatening their own industrial action. “The current government has turned a lot of professionals into strikers,” says Dave Lyddon of Keele University.

For the NHS the events of the past few months will have long-lasting consequences. The Department of Health and Social Care has announced that some of the pay deal will be paid for through the “reprioritisation” of existing funds, as well as some additional government funding. That may mean less wriggle room for squeezed trusts, who are already struggling to balance their budgets.