Health chiefs have warned they cannot guarantee patient safety when ambulance workers launch strike action on Wednesday, as Rishi Sunak refused to reopen this year’s NHS pay deal.
Health secretary Steve Barclay met ambulance unions on Tuesday to discuss cover for 999 calls during the strike in England and Wales, but the talks broke down with warnings that people could die as a result of the pay dispute.
“There will be delays, there will be a significant impact and lives could be lost,” said one ally of Barclay. “The unions have to take responsibility for that. It’s their strike.”
Christina McAnea, general secretary of the Unison union, responded by saying: “It’s ministers putting people’s lives at risk by refusing to negotiate with unions. Without a proper pay rise, escalation of action looks likely in the new year.”
Sir Stephen Powis, NHS England national medical director, said people could help avoid straining emergency services “by taking sensible steps to keep themselves and others safe”, including by “drinking responsibly”.
Will Quince, a health minister, urged the public to avoid “any risky activity” during the ambulance strike.
The industrial action by about 10,000 ambulance workers in England and Wales poses the biggest challenge yet for the prime minister as workers in the public and private sectors respond to the cost of living crisis by demanding higher pay.
The government is deploying 600 military personnel to drive ambulances during the strike organised by the Unison, Unite and GMB unions.
In a letter to Sunak, the NHS Confederation and NHS Providers, which represent health organisations across the UK, warned of “deep worry among NHS leaders about the level of harm and risk that could occur to patients tomorrow and beyond” during the industrial action.
Matthew Taylor, chief executive of the NHS Confederation, insisted it was not something NHS leaders would say lightly, “but some now tell us that they cannot guarantee patient safety tomorrow”.
The NHS Confederation and NHS Providers urged Sunak to open negotiations on pay with unions to end the industrial action.
But Sunak told MPs that any discussion on pay should be in the context of next year’s settlement, which applies from April 2023, adding he was wedded to the current independent review body process.
In July, the government accepted recommendations from the NHS review body for most health staff in England to receive a flat-rate pay increase of £1,400, backdated to April. This represents an increase of about 4 per cent in the average basic pay of NHS workers.
The Royal College of Nursing, which organised a second strike by nurses in England, Wales and Northern Ireland on Tuesday following industrial action last week, is demanding a pay increase of 19 per cent. Ambulance unions want a pay rise matching inflation.
“Our door is always open to talk to everybody and we will be constructive about how we approach these things in future,” said Sunak, adding that pay restraint was needed to tame high inflation.
Onay Kasab, the Unite national lead officer who attended the meeting with Barclay, said the health secretary had refused to discuss pay.
Rachel Harrison, GMB’s national secretary, defended the timing of ambulance worker walkouts, saying staff were experiencing “stress, burnout, exhaustion”.
Cover for 999 calls on Wednesday is due to be relatively uniform across regions, with most ambulance services planning to respond to life-threatening “category one” call-outs and the most serious “category two” emergencies following agreements reached with unions.
In England’s north-west and the north-east, for example, category two call-outs where an ambulance will be sent include childbirth complications, cardiac-related chest pain and paediatric emergencies.
However, underlining the difficult backdrop to Wednesday’s strike, five ambulance trusts around the country — in London, the south-east coast, the east, Yorkshire and north-east — declared “business continuity” or “critical” incidents: a status invoked when services are at risk of being overwhelmed.
Meanwhile Pat Cullen, RCN general secretary, warned that the clock was running down for Sunak to avoid further action by nurses.
“There are two days for us to meet and begin to turn this around by Christmas,” she said. “By Friday, we will be announcing the dates and hospitals for a strike next month.”
Sir Geoffrey Clifton-Brown became the latest Tory MP to urge a compromise. He said ministers “parroting” lines about sticking to the recommendations of pay review bodies was “unrealistic”.
While Sunak has taken a tough line, public opinion appears to support striking NHS workers. About two-thirds of people polled by YouGov said they backed industrial action by nurses and ambulance workers.