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um Secretary of State strikes across the NHS are self-evidently one of the major challenges facing the service at this time what is your plan to end them are engaging with the trade unions I think if you look at the last meeting weve had the uh the chair of the NHS staff Council as Sarah Gordon said that our discussion had been constructive and thats very much the tenure in which we are engaging with Trade union colleagues we recognize that the NHS has been under huge pressure through the pandemic and also the pressures that many others in society face from the cost of living also apply to those working within the NHS so we recognize both in terms of the demand from covid the demand we saw over Christmas in terms of the issued spike in flu over a hundred times the number of people in hospital with flu compared to the same time last year very sudden spike in terms of a Sevenfold increase in the space of a month going into December on top of a high ongoing level of covid that the syste