The Government is facing the threat of renewed strike action over its controversial pension reforms after the country's biggest trade union said fresh action is a "real possibility".
Unite said it planned to ballot its 100,000 members in the NHS with a recommendation that they reject the proposals, complaining there had been no substantive changes from what was on the table last year.
Up to two million public sector workers staged a one-day strike in November in protest at the pension changes and, although some progress has been made, the dispute remains unresolved.
Unite said if there is no significant movement by the time of the Government's "self-imposed" deadline of February 20, it will press ahead with a ballot.
General secretary Len McCluskey said: "There have been no substantive changes from what was on the table before Christmas. Our hard-working members will still be expected to pay more, work longer and get less when they retire.
"Our members are deeply unhappy at the Government's stance and we will be holding a consultative ballot to reaffirm our members' position - the prospect of further strike action will be very real, unless ministers move on their hardline position."
Unite said it had continuing concerns over the high proportion of NHS staff who will see their pension contributions jump from the current 6.5% to 9.3% by 2014/15 and the linking of the NHS retirement age to the state pension age, warning that paramedics and nurses could be doing heavy lifting into their late 60s.
Meanwhile, the Government has announced that a heads of agreement had been established on a new pension scheme for firefighters.
Communities and Local Government Minister Bob Neill said there had been constructive discussions with firefighters' unions on the new scheme, which will include average member contributions of 13.2% from April 2015.
A spokesman for the Fire Brigades Union said: "We have been in detailed talks for many months. The union's national executive is currently meeting to consider the proposals."
