Nurses' strikes: Tensions boil over between government and Royal College of Nursing

The deterioration in relations between the government and the Royal College of Nursing (RCN) has been rapid and stark.

Not long ago, ministers were praising the way the RCN handled strikes, contrasting them favourably with the likes of Unison and the GMB union, who represented ambulance workers.

The RCN general secretary, Pat Cullen, was highlighted as the reasonable one, who negotiated strike emergency cover at a national level.

She was the first to enter talks, and then recommended the government's pay offer to her members.

But on Thursday, outside the High Court in London, Ms Cullen was almost emotional with anger as she told me she felt she had woken up in a "nightmare".

Ms Cullen said nurses would not forgive the government for dragging them into court - a case in which they successfully argued that the final day of a 48-hour strike starting this weekend is unlawful.

Not surprisingly, the government paints a very different picture of how this has unfolded.

Health Secretary Steve Barclay says the action was requested by NHS Employers, and necessary because individual nurses will not have legal protection if they strike on Tuesday.

They say the RCN should have withdrawn from the case days ago, especially given that in the end they didn't actually attend the court session, but simply submitted a witness statement from Ms Cullen.

In truth, the RCN had given up the legal arguments on Thursday morning - effectively accepting that a six-month mandate does run out on Monday night.

But they still wanted to make the moral argument, with the optics of a protest outside the High Court.

They argued that there had been an overwhelming mandate of their members for a strike, and that no single NHS employer had challenged the decision to stretch into Tuesday.

So where does this all leave them?

On one hand, it is possible this case will have galvanised nurses, feeding their anger at the government ahead of a fresh ballot starting next month, which could pave the way for strikes until Christmas.

On the other hand, the RCN has set itself an even higher bar in this next vote, which will be done in one block, nationally, rather than employer by employer.

The union needs 50% of its 280,000 members to vote in the next round, and for half of them to back further strikes.

Moreover, one by one, other health unions are backing the government's pay offer.

First the biggest, Unison, then Midwives and Physios.

Next, we can expect Unite to join RCN in a likely rejection. But I've long thought there is a good chance the GMB union will vote to accept the pay offer.

If they do, then by the end of Friday the government will have enough union votes to get a majority on what is known as the NHS staff council on Tuesday.

With that, sources say the money will be paid, including to nurses.

That won't stop their ballot, but it may make members feel differently when it comes to the vote.

Which way this all goes is really critical for Rishi Sunak, because he is desperate to stabilise things and be a prime minister who can fix problems at a time when voters keep telling pollsters, focus groups and politicians on doorsteps, that nothing works.

If Mr Sunak can't stop nurses from staging walkouts, then it is going to be very hard to persuade folk that the NHS is on the up.

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