NHS workers gave Tory Health Secretary Jeremy Hunt a blunt ultimatum yesterday — heed our message or we strike again.

Thousands of staff from cleaners and porters to midwives, ambulance crews and nurses stepped out into the crisp winter sunshine to show their backing for the fight against a pay freeze.

This week they will continue industrial action through a work to rule.

GMB union national officer Rehana Azam said yesterday’s four-hour walkout had been “rock solid” and added that public support was growing on a tide of opposition to Tory health policies.

She warned Mr Hunt: “If the Health Secretary refuses to negotiate we will have no alternative but to work alongside all health unions to announce a rolling programme of strike action.”

That prospect of negotiations looked increasingly unlikely yesterday as Mr Hunt’s Department of Health maintained a barrage of propaganda aimed at undermining NHS workers’ case.

A spokesman claimed that trade unions were defending an “unfair” system which sees pay increase with length of service separately from the annual pay round.

Mr Hunt has made no secret of his plan to axe incremental rises based on workers’ experience, telling MPs last year that NHS staff faced a three-year pay freeze unless they accepted his ultimatum.

But campaigners yesterday highlighted the reality behind the current system, which means that a newly trained nurse starts on £21,478 before earning a maximum of £27,901 after eight years in the job.

The current dispute centres on a freeze of all bands, although those on the top rate have been granted a 1 per cent one-off payout.

So far Mr Hunt has refused to budge.

Unison general secretary Dave Prentis said: “All we’re asking for is fair pay.

“It is irresponsible of the government to not even try to resolve this dispute.”

Unite head of health Rachael Maskell added: “Our members are working harder and getting poorer.

“We are urging the Health Secretary to value the vital work of NHS workers who would rather be caring for patients than fighting their own poverty.

“With the Welsh government reaching a pay settlement last week, there can now be no excuses for Hunt’s continued refusal to get around the negotiating table.”