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In one Welsh Ambulance Service depot, all striking members have had to be called away from the picket line on emergency calls, the GMB union’s South West and Wales representative claims.
Nathan Holman tweeted a video of himself alone at Pentwyn service station in Cardiff just before 8am on Wednesday – less than an hour into the day-long walkout.
I’m standing here on the picket line outside Pentwyn ambulance station. Unfortunately, all the members have had to go because, as you can see behind me, there’s only one vehicle left, they’ve all jumped on a vehicle and responded to emergency calls. So, just shows we’re still responding to the public.
Around 1,500 ambulance staff in Wales are expected to take part in Wednesday’s industrial action. Crews are still required to respond to critical 999 calls but, despite this, the service is expected to be “significantly impacted”, according to the Welsh government.
Following a similar line, the leader of the Unite union Sharon Graham tells LBC that, if the government is advising people not to run or play football in case they end up needing an ambulance, that advice should be provided “365 days a year”.
There are 130,000 vacancies in the NHS, there’s 3,000 vacancies within the ambulance service.
It’s like, even in normal play, there (is) strike action happening anyway. We are in a crisis in the NHS. If we do not get around the table and start these negotiations and seriously look at how retain and recruit staff, we have got a very serious situation – not for one day, but for 365 days a year.
Asked whether she would consider coordinated industrial action, possibly with the RMT or other unions, Graham says:
Well, obviously, it depends on whether we have the same members in the same industry. So of course, the point I’m making… these are political disputes, these disputes are industrial disputes about pay, and that’s very important.
The health system is crumbling under the leadership of the Conservatives, with record ambulance delays even before an emblem of its decline, Unison’s general secretary Christina McAnea has said.
Asked on LBC radio how concerned listeners should be if they had a road accident, had a fall on a bike or fell off a ladder, she has said:
They should be as concerned today as they are every other day because those are exactly the kind of instances where it’s almost impossible to get an ambulance to go out because ambulances are so stretched.
McAnea says there are thousands of staff vacancies and “the NHS, the whole system, is basically crumbling under this government”.
She sys she’s “genuinely shocked” by what Barclay has said about her union’s members, adding that it has been “laid out to him in no uncertain terms all the work that has been getting done for the past few weeks to make sure there were safe contingency plans in place”.
McAnea says it is “utter nonsense” and a “complete and utter lie” to suggest unions have made it almost impossible for the government to make contingency plans.
I think they’re covering up for the fact that he waited until the day before the strike to even ask us about contingency planning.
The union chief says it’s “entirely likely” strikes will go into the new year, adding that the government should “come clean” with the workforce that they could not provide a safe and reliable service owing to a lack of staff and poor planning.
About 40 ambulance service staff gathered before dawn to form a picket line outside West Midlands Ambulance Services’ hub in Longford, Coventry. Standing behind a banner reading “Our NHS is under siege”, the workers stressed they were ready to leave the line to respond to emergency callouts when needed.
As passing ambulances sounded their horns in support of the strike action, the Unite union’s representative Steve Thompson said the walkout was about trying to retain and improve services, as well as pay.
This is about telling them that we are not going to allow it (a deterioration in services) to happen. We are not going to roll over. We want the government to actually wake up and realise that this situation is serious. Unfortunately we are where we are because of political will.
The health secretary Steve Barclay is “insulting” ambulance workers, the GMB union’s national secretary Rachel Harrison says.
Barclay has accused trade unions of making a “conscious decision” to “inflict harm” on patients in England and Wales by striking (see: 7.33am). Harrison has told the BBC:
It’s really insulting that the secretary of state has said that. They have not taken the decision to take strike action lightly. They feel they have been forced into this position because year after year the government has failed to listen to them.
Barclay has repeatedly defended his comments this morning.
Asked if there would be harm to patients as a result of the walkout, Harrison said:
The sad reality is that patients are being harmed every single day, and that’s when we’re not on strike. The Association of Ambulance Chief Executives themselves report that the increasing number of handover delays and waiting times is leading to harm to patients and deaths.
So, that’s happening when we’re not on strike. It’s issues like that which have forced our members into this position.
Powis is also warning people not to get “blind drunk” and risk ending up in an overstretched hospital during the ambulance strike.
It’s the season of parties, pre-Christmas, so do enjoy yourself. But, obviously, don’t get so drunk that you end up with an unnecessary visit to A&E. That’s good advice at the best of times and certainly today, when we know that services are stretched.
Certainly, today is not the best of days to end up being in an A&E department if you don’t need to be there. If you’ve got yourself blind drunk that doesn’t sound like fun to me.
The ambulance strikes will create a “very difficult day” for the health service, the national medical director of NHS England warns. Prof Sir Stephen Powis has told BBC Radio 4’s Today programme:
Today is obviously going to be a very difficult day with the health service. But we’ve been working very closely with the unions to ensure that emergency services for life-threatening conditions are maintained, and that will include stroke and heart attacks.
There are increased clinicians in call centres to ensure that the right response goes out to the right incident.
He said strokes fall into the higher end of category two cases, so clinicians will determine what response is needed and he advised people to dial 999 “as usual” if you have a life-threatening condition.
Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, said the emergency system has been under “immense pressure” for the last three years, including “the worst we’ve ever seen it” in the last year when it comes to delays handing over patients to A&E. He has told Times Radio:
Trying to work out the effect of industrial action compared to a system which is already not doing what we want it to do is going to be difficult.
He said A&E departments were expecting people to turn up in different ways during the ambulance strike, adding:
We’re expecting people with strokes and heart attacks to turn up at the front door. Now, because of the delays this has already been happening quite a lot anyway.
It is the best alternative to calling an ambulance – if you think you can get to hospital in a way that appears safe and efficient, with somebody giving you a lift, that might be a more appropriate thing to do.
He added that “hospitals are full to bursting” and some people would be waiting a long time in A&E. The UK had the “least number of beds of almost any European country” and this was coupled with problems discharging people into social care, he said.
Barclay is also doubling-down on offering media pressure as a justification for not overruling the recommendations on NHS pay to offer more. He has told BBC Breakfast the government has accepted the recommendations “in full”, adding:
Indeed, when in the past the government hasn’t always accepted in full the recommendations, on programmes like this, ministers have been criticised for not doing so.
He accepted ministers do not have to accept the recommendations of the pay review bodies. He was told on BBC Radio 4’s Today programme of various examples of the government taking different approaches, including on health pay.
When we don’t accept in full the recommendations we’re criticised for doing so. On this occasion, we have accepted them in full.
Speaking to BBC Radio 4’s Today programme, Barclay is doubling down on his refusal to negotiate on pay and told staff struggling now that they should “look forward” to next year’s pay process.
We’re already three quarters of the way through this year. So, what you’d be saying is, go all the way back retrospectively to April to unpick what has been an independent decision by the pay review body.
But we’re already now under way in terms of next year’s pay review process, the remit letters have gone out.
Obviously that body will then consider the changes in inflation, the other issues that have been raised, all as part of the normal process of looking at next year’s pay, so we should look forward.
Last week, as nurses went on strike, the former chair of the NHS pay review body Jerry Cope said the pay recommendation was out of date. He told BBC Radio 4’s Today programme:
It took place in February and the world was a rather different place in February and therefore I think some of the evidence they considered was probably out of date by the time it was published. Because the process is very slow, the decision is a bit lagged.
Cope also said this factor offered a possible solution to the government.
I think [ministers] should ask the pay review body to reconsider what they did last year, and not reopen last year, because I think it’s too late to do that, but actually say I want you to do a very quick turnaround for this year’s recommendations and I want you to take account on anything you might have missed last time round.
He said that could open the way to a higher offer, in a way that “respects the integrity of the pay review body” – although he also accepted that the pay review might decide not to change its recommendation.
Barclay denies escalating the dispute by accusing unions of making a “conscious choice” to “inflict harm” on patients.
Asked on BBC Breakfast whether his language in the Daily Telegraph was “ramping up this current atmosphere”, he said:
No, it reflects the very different action we’ve seen from these trade unions – the GMB, Unite and Unison – compared to what we saw from the Royal College of Nursing (RCN), where we agreed national exemptions in terms of what would be covered by the RCN, whereas the three unions striking today have refused to work with us on a national level.
On Tuesday, MPs heard that unions and ambulance trusts in most parts of England and Wales have struck deals to ensure “life and limb cover” during the strike. Rachel Harrison, the national secretary of the GMB, told parliament’s health and social care select committee:
Life and limb cover will be provided. The last thing that our members want to do is put patients in harm’s way … The government has to play their part, they have to come to the table and talk to us. Our members want a resolution to this.
The unions point out that Barclay has refused to engage substantively with their concerns, telling them he will not move from the real-terms pay cut he is offering.
And, as NHS bodies call on the government and unions to work constructively towards an agreement in patients’ interests, Barclay is doubling down on the comments he made in the Telegraph (see: 7.33am).
He was asked: “That’s not conciliatory language, that’s not going to bring the two sides together, that only going to harden the side against you, isn’t it?” The health secretary replied:
Well, it’s just a reflection on the fact that trade unions have chosen this time for the strike.
Barclay said recent increases in calls to 111 and 999 as a result of flu, Covid and Strep A meant the system is currently under severe pressure.
Ambulance delays were already at their worst levels on record before the strikes, with paramedics and doctors having to work flat-out just to get patients into hospitals.
Many face long waits to be transferred or being told to make their own way to hospital, with the NHS blaming a lack of capacity caused by difficulties in discharging patients into the community or social care.
In Scotland, the government has already offered 7.5% – a rate that still represents a real-terms pay cut, but that unions have hinted would at least be enough to put to their members.
Asked it he would do similar, Barclay claimed there were “misconceptions” about the deal, telling Sky News its cost is “much more significant” than the nominal 7.5%.
One of the big misconceptions about the deal in Scotland … it wasn’t simply 7.5%. If you add in all the other measures in terms of reducing hours, extra annual leave, changes to the way overtime is addressed, protected learning time, actually the cost of that is much more significant and, as I say, one of the trade unions has rejected that as well.
Barclay has referred to media pressure, when asked why he would not overrule the pay body’s recommendation, as ministers have done in the past. He has told Sky News:
When we have done that, you have been the first – I’m sure – to criticise us for not respecting the independence. The difference here is we have accepted those recommendations in full because we recognise the system coming out of the pandemic has been under pressure.
Steven Morris
In Wales, emergency ambulance crews are responding to red calls (immediately life-threatening) and “selected” amber 1 calls (urgent but not immediately life-threatening) for conditions including chest pains, stroke, gynaecology emergencies and for serious road accidents. Other Amber 1 calls may be responded to after a remote clinical assessment.
A quarter of Welsh ambulance staff are members of the GMB and the trust said it expected the strike to have a “significant impact” on its ability to respond to 999 calls.
The trust is also worried there is a risk individual staff will elect not to respond even to the most serious of calls and there could also be sympathetic action from staff that are not members of the union. The military are not being brought in to drive ambulances in Wales.
The Welsh health minister, Eluned Morgan, called on people to stock up on first aid kit supplies and limit activities that could cause injuries.
Ambulances will only be able to respond to the most urgent calls on strike days. Please don’t add extra pressure on services. It’s important to call 999 if you are in immediate danger, but we must all consider very carefully how we use ambulance services on these [strike] days.
She said everyone could help relieve the pressure by stocking up on prescription medications and over the counter remedies for common ailments to reduce the risk of falling ill on strike days and taking extra care during the cold weather to avoid slips, trips and falls, and accidents on the road.
Asked why he refuses to talk to unions about pay, Barclay claims he does not want to “divert money” from services for patients. Pressed about repeated pleas from union leaders for a conversation to try and resolve the dispute, he tells Sky News:
We have a process in terms of pay, an independent process, and we’ve accepted the recommendations of that in full.
We’re investing in the NHS, we’re investing in social care, and I don’t want to divert money from those essential services focused on patients to overturn what has been an independent process which has looked at what is affordable to the economy, what is affordable to your viewers at a time of cost-of-living pressure, but also recognising the system is under very severe pressure and we need to get that extra investment into the NHS and into social care.
Despite Barclays claim that he is abiding by an independent review process, it’s important to note that some doubt the extent of their independence, noting that their members are appointed by ministers and are told to take account of the government’s priorities.
Specifically, Barclay has asked them to work within the budget that has already been set. And, while there are doubts that public sector pay awards would be inflationary, ministers insist they are and ask the bodies to take that into account.
Moreover, their recommendations are only that – and there is precedent for ministers overruling them when they want to. In 2014, the then health secretary Jeremy Hunt refused to implement the 1% recommended nominal pay rise – itself a real-terms pay cut.
Matthew Taylor, the chief executive of the NHS Confederation, which represents NHS organisations, told BBC Breakfast he wanted to “encourage our colleagues in the ambulance service in the trade unions to work as cooperatively as they can through today’s industrial action to try to minimise patient harm”.
These strikes come on top of the fact that we are already in a very challenging situation.
In most parts of the country the ambulance service is well away from meeting its targets for responses to those kind of category 2 cases – so not absolutely urgently, life threatening, but still very important urgent and critical cases.
So, this strike could not be happening at a worse time because of the pressures the NHS faces.
He urged the government and unions to reach an agreement, saying: “We cannot afford to drift into a winter of industrial action.”
Unions have blamed the need to strike on the government’s refusal to even engage with them on pay, while ministers have insisted they will not budge from their offer of a real-terms pay cut and portrayed the action in response as a choice by the unions.
Some decisions about what will be covered during strikes by ambulance workers will be taken on the day, the health secretary, Steve Barclay, has said, as he acknowledges he has prepared no national contingency plan for the industrial action. He has told Sky News:
The difficulty with putting contingency measures in place is given the uncertainty as to what exactly is and is not being covered, and the fact that those decisions in some cases will be taken on the day.
Thousands of ambulance workers take strike actionThousands of ambulance workers in England and Wales are beginning a 24-hour strike action over real-terms salary cuts, describing last-minute talks with the government as “pointless” because the health secretary, Steve Barclay, refused to even discuss pay.
Nevertheless, Barclay has used an article in this morning’s edition of the Daily Telegraph to place the blame on the trade unions, accusing them of making a “conscious decision” to “inflict harm” on patients.
We now know that the NHS contingency plans will not cover all 999 calls. Ambulance unions have made a conscious choice to inflict harm on patients.
Union leaders insisted there would still be cover for the most serious calls through a series of local agreements during the strike; the first of two planned industrial actions. Unite’s general secretary, Sharon Graham, said claims many serious calls would receive no response were “misleading” and “at worst deliberately scaremongering” by ministers.
Christina McAnea, the Unison general secretary, said that if there were any deaths during the strike it would “absolutely” be the fault of the government. “They have been totally irresponsible,” she told TalkTV. “It’s completely irresponsible of them to refuse to open any kind of discussions or negotiations with us.”
Earlier, the NHS Confederation and NHS Providers, which collectively represent all NHS organisations, wrote to the prime minister warning they were entering “dangerous territory” and urging him to end to the deadlock.
The members of the three trade unions taking action today – Unison, Unite and the GMB – have been offered nominal pay rises of £1,400 each. These are, in effect, pay cuts because the roughly 4% nominal increase for most staff is far below inflation.
In evidence to the Commons health select committee, the GMB’s national secretary, Rachel Harrison, suggested the government upping its offer to 7.5% would be enough for the union to put to its membership to test if it was enough to end the impasse.