Rishi Sunak said the pay deal sought by the nurses’ union was ‘unaffordable’ but acknowledged people were struggling with the rising cost of living.The Prime Minister told ITV News: ‘We have enormous gratitude for our nurses, and indeed all the other workers in the NHS, for what they do and have done for us over the past couple of years.’But what the unions are asking for is a 17% pay rise, and I think most people watching will understand that that’s unaffordable and the way we deal with these situations, because of course, it’s difficult and of course people are struggling, is that we have an independent body make recommendations to the Government about what a fair settlement is.’Mr Sunak, in Bali for the G20 summit, said the recommendations of the independent body had been accepted, meaning a rise worth about £1,400 for a typical nurse.He added: ‘Ultimately, this money is coming from taxpayers, from everybody watching, and everyone watching will also know that they’re suffering rising bills, they’ll be having those conversations with their own employers about what’s affordable in these difficult circumstances.’That’s why we have an independent process that makes recommendations to the Government. The Government accepted them in full and that’s why it’s right that the Health Secretary is talking to the nurses’ union right now.’The Royal College of Nursing is claiming a pay rise of 5% above the rate of inflation, but other health unions have not put a figure on their demands.Meanwhile, the Health Secretary met union leaders amid warnings of an ‘unprecedented’ winter of strikes in the NHS in growing disputes over pay and staff shortages.Hundreds of thousands of health workers, including nurses, ambulance crews, midwives and paramedics, have either voted for industrial action or are being balloted.Unions have warned that a below inflation pay rise announced by the government in the summer was fuelling a raft of resignations as health workers find better paid and less stressful jobs.Following the meeting on Tuesday, Health Secretary Steve Barclay tweeted: ‘I hosted a roundtable with unions representing a wide range of NHS staff today.’I reiterated my admiration for all healthcare workers and we discussed ways we can work together to make the NHS a better place to work. My door remains open and we will continue to meet.’ It’s not rocket science. Give NHS workers a proper pay rise, that means they don’t have to use food banks or quit the service in drovesGMB national officer Rachel Harrison said: ‘If the Health Secretary wants to stop an unprecedented winter of NHS strikes, he knows what to do.’It’s not rocket science. Give NHS workers a proper pay rise, that means they don’t have to use food banks or quit the service in droves.’By not paying staff properly, ministers are leaving the NHS unable to recruit and retain enough workers, putting patient safety at risk every day. Mr Barclay must listen to the concerns of health workers.’Union leaders said they made it clear that without urgent government action on wages, experienced health workers would continue to quit their jobs, and the NHS would struggle to attract new staff in sufficient numbers.Unison’s head of health and chair of the NHS unions Sara Gorton said: ‘There can be no solution to the damaging workforce crisis unless the government improves NHS pay. Without the staff to provide essential care, patients face excessive and lengthening waits to be seen.’Ministers must give the NHS urgent help and provide the cash for another wage rise. The alternative is multiple disputes in what could be the worst winter on record for the NHS. No one wants that. The government must try harder for all our sakes.’ The government must put forward a better pay deal and one that is not funded from already mercilessly squeezed budgetsColenzo Jarrett-Thorpe, UniteChartered Society of Physiotherapy assistant director Elaine Sparkes said: ‘This is the first time that physiotherapy staff have been balloted over pay. This demonstrates how fearful they are about their ability to continue delivering high quality patient care if the government does not take urgent steps to address the workforce crisis.’Those steps must start with improving pay and putting an urgent retention package in place because we cannot afford to lose more staff if the NHS is to meet its enormous challenges.’Unite national officer for health Colenzo Jarrett-Thorpe said: ‘The government must put forward a better pay deal and one that is not funded from already mercilessly squeezed budgets.’The truth is that NHS workers can’t carry on like this. Waiting lists are lengthening and healthcare staff are leaving in alarming numbers. Unite is determined to win a better deal for our members.’Royal College of Midwives director for employment relations Alice Sorby said: ‘Our members do not take Industrial action lightly. Without urgent action to prevent the exodus of midwives, the staffing crisis in maternity services won’t be solved. There are almost 800 fewer midwives working in England’s NHS than at the last general election. Until the government recognises the need to pay nursing fairly, meetings will be ineffective’Decent pay is absolutely key to retaining staff. We remain ready and willing to talk to the government about ways to retain staff through an urgent retention package. A proper pay award has to be central to this.’RCN director of employment relations and legal services Jo Galbraith-Marten said: ‘We will only make progress through detailed discussions that seriously consider the concerns of nursing staff.’Until the government recognises the need to pay nursing fairly, meetings will be ineffective. No nurse ever wants to strike, but we have been forced into this situation because low pay and workforce shortages are pushing nursing staff out of the profession and making care increasingly unsafe.’Ministers can stop strike action by nursing staff at any point. Our door is always open.’