Thousands of ambulance workers in England and Wales begin strike as public warned to avoid ‘risky activities’ – live

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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.

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 maybe 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 follow the government’s priorities.

Specifically, Barclay has ordered 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 require 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 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.