Early on an April morning outside of Queen Elizabeth Hospital in Woolwich, south London, a manager walked up to Gary Palmer. ‘My job today is to stop people like you getting out and about around here,’ he told him. Palmer, a longstanding organiser for the GMB union, shot back. ‘My job today is to ignore you and make sure that people get fed.’

The manager was employed by the subcontracting giant ISS, who ‘provide’ at least 100 ‘solutions’ — company parlance for supplying casual labour — to scores of NHS hospitals, including at Queen Elizabeth. Palmer was distributing food parcels to his union’s members employed by ISS. ‘Let’s look at the scale of things,’ Palmer told the manager. ‘We can do this amicably and very quickly, because I don’t want to disrupt hospital services. I don’t want patients suffering. But I am going to get our people fed, and if I’m going to have to come in here to do it, I will.’

Eventually the manager backed down and the union set up their foodbank. As workers trickled out of the hospital to collect their parcels from other GMB activists, the stories began flowing in about management intimidation. African and Caribbean workers collected several parcels for their colleagues inside, who were intimidated by the sight of a particularly disliked manager observing every individual who collected food from the union.

The incident is indicative of the woeful relationship ISS maintains with its workers. Over the years, it has faced widespread criticism for refusing to pay its staff the London Living Wage of £10.55 an hour. Their workers do not receive immediate sick pay — something that has raised questions from NHS officials. Their concern is that impoverished workers will be forced to return to work while still unwell and contaminate patients. Allegations from staff of late payment of wages are also widespread.

However, the final straw was the company’s decision to move employee pay from weekly to fortnightly. Justified as a ‘pay harmonisation scheme’, the change meant that workers had their wages withheld from the end of April until around 16 May. The management made sure they were immune from this shift, but refused to concede the GMB’s demand of paying the workers in advance.

The move incensed the workforce. ‘If I stole that amount of money’, one worker told Tribune, ‘I’d be in Belmarsh.’ One woman said: ‘My friend called me and told me that her wages just had not arrived. She had no idea about the pay harmonisation. She didn’t believe it. Her road tax is £140. Her council tax is £150. Her money is just not there. What on earth can she do?’

The situation has led to stormy consultation meetings on hospital grounds. During one particularly explosive encounter at Queen Elizabeth, a porter stood up and told ISS representatives that ‘pay harmonisation’ meant that he hadn’t eaten in three days, choosing instead to feed his 2-year-old son for whom he is the sole provider. Workers also say the decision has had a catastrophic effect on their mental health, with one cleaner being diagnosed with depression due to the stress.

One porter, speaking anonymously to Tribune, said that the relationship between management and the workforce is one of ‘take, take, take’. ‘I don’t know what goes on in people’s private lives,’ he said. ‘But people are struggling. Someone back here was crying their eyes out just then. They can’t afford to join the union. They worked it out and they couldn’t afford £2 a week. People are living hand-to-mouth, week-by-week. They want to join the union, but they can’t afford to risk that investment.’

To many, it seems as if threatening strike action may be the only way for ISS to listen. ‘Even just the fear of being balloted would make them sit up, I think’, one cleaner said. ‘We need something to make them back down and ease up.’

Another porter agreed. ‘We just need to go out. Until we’re out, they’re just going to keep on the bullying. They’re making up all the rules of the game to suit themselves, changing the goal posts against us all the time. We’re just fighting a losing battle at the moment. Hitting back will turn everything back around.’

Union figures on the ground are sympathetic to balloting, but insist that further work to build a bigger union membership must be done before making the move. Whatever ends up happening, more and more WhatsApp groups of discontented agency hospital workers are springing up across London. The people who provide the arterial services to the capital city’s health services are increasingly exhausted and fed up with the Dickensian lives they are being forced to lead.

The union has every intention of encouraging them to fight. ‘The agencies don’t want these people to be treated like people’, GMB Regional Organiser Helen O’Connor said. ‘But believe me, the union will force them to do what’s right in the end.’