Striking hospital staff received a boost with a visit to the picket line by a leading trade union boss.
Dave Prentis, Unison's general secretary, gave his full backing outside Wigan Infirmary to employees protesting about the creation of subsidiary firm WWL Solutions.
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Mr Prentis said the wholly-owned firm, which will employ around 900 estates and facilities staff including porters, cleaners and caterers, was the wrong move for the NHS.
The board of Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust approved WWL Solutions on Wednesday at what was at times an acrimonious meeting.
Mr Prentis said: "I have come up from London to show my solidarity with our members who are being treated very badly by the Trust.
"These are health care workers, part of the health care team, yet they are going to be pushed off into a private company.
"WWL Solutions is not being set up to improve standards but to evade VAT taxation. A public body should not be seeking to do this.
"We have now no alternative but to take major industrial action until we can get the board round the table again, defer the transfer and work something out which will improve services for the communities of Wrightington, Wigan and Leigh.
"It's the 70th anniversary of the NHS and this Trust is going backwards.
"The union is always willing and ready to talk, but the Trust needs to come towards us and stop making threats of moving ahead without discussion."
Also on the picket line to support workers during the first of five days of industrial action were Wigan MP Lisa Nandy and her parliamentary colleague for Makerfield Yvonne Fovargue.
Ms Nandy said: "It's a huge boost to have Dave Prentis here on the picket line. The decision by the Trust was a slap in the face for members of staff, the public and local politicians, all of whom have consistently voiced objections to this plan.
"We will fight on because the public is behind us, the nation is watching us and we will win.
"We are getting a lot of support because a lot of workers in Wigan have been through this process, know the cost of it and don't want to see it happen to anybody else."
Ms Fovargue said: "The decision to set up WWL Solutions is very disappointing and proves the Trust is not listening to its staff who are the bedrock of the NHS.
"I'm absolutely convinced it is the wrong move. The Trust should be talking to the unions and working with them.
"Taking staff out of the NHS is not the answer."