The government has been accused of using "bully-boy tactics" on health workers after warning that a pay offer could be staged or even cut if it is not accepted.
More than a million employees received a letter from the NHS chief executive David Nicholson saying the government reserved the right to stage or reduce a pay award if a three year deal worth 8% is turned down.
The Royal College of Midwives said the government is circumventing a pay review body, which had only recommended a one year deal.
Dame Karlene Davis, general secretary of the RCM said: "This is a bully-boy tactic to force midwives and the other unions to submit to a pay deal that will see earnings fall even further behind the real cost of living. This is not a slap in the face to midwives, it is putting a gun to their heads.
"There is a chronic and worsening shortage of midwives, and the proposed deal will do nothing to help change this. We need to give people an incentive to join the profession, not one to stop them entering it."
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