union chief has urged the Government to “make us an offer” on pay in a bid to avert strike action by ambulance workers on Wednesday.
During questioning by MPs on the Commons Health Committee, ambulance leaders warned the service is already struggling under huge pressure and cannot hit response times, with paramedics stuck for hours outside hospitals waiting to hand over patients.
Health Secretary Steve Barclay is meeting unions on Tuesday afternoon to discuss preparations for Wednesday’s strike but it is understood he will not discuss pay.
The Prime Minister Rishi Sunak’s official spokesman said: “He’s hoping for a constructive discussion ahead of these planned ambulance strikes.
“He’s concerned that some union officials still haven’t confirmed what they will cover with regards to emergency calls with their talks with trusts so far.
“We are conscious that the contingency plans we have can only do so much, so he will continue to urge them to honour their commitment to provide responses to life-threatening emergency calls.”
Our members will be the ones to decide on any pay offer that’s made and if no pay offer is forthcoming, we will continue to have that conversation next year as we head towards the next round of pay discussions as well
Rachel Harrison, a national secretary at the GMB trade union, told MPs that unless the Health Secretary is willing to talk about pay, ambulance strikes will go ahead.
She said: “Unless the Secretary of State is willing to talk to us about pay today, those strikes are set to go ahead.
“Make us an offer on pay we can take back to our members.”
Asked what will happen if the Government does not move on pay, she said: “Our members will be the ones that will decide… We will continue to say to the Government, ‘our door is open to talk about pay’.
“Our members will be the ones to decide on any pay offer that’s made and if no pay offer is forthcoming, we will continue to have that conversation next year as we head towards the next round of pay discussions as well.”
Regarding Wednesday’s strike, she said “life and limb” cover will be provided.
Ambulance responses are split into categories, with category 1 being the most life-threatening such as cardiac arrest, while category 2 covers conditions like stroke, heart attack and sepsis.
Regarding exemptions for other categories, she said: “Most agreements have now been signed off and we’re doing our role in communicating to our members what they are and encouraging them to adhere to the exemptions that have been put in place.”
Ms Harrison said that cover will vary by service, but she added: “We will do everything within our power to ensure that communities are safe during this action. The Government has to play their part, they have to come to the table and talk to us.”
Conservative MP Lucy Allan told the committee 44,000 hours had been lost in a single month at West Midlands Ambulance Service, while ambulances waited outside hospitals to hand over patients to A&E.
Dr John Martin, president at College of Paramedics, said hospital handovers were “top of the list” of issues.
Citing NHS England data published in December, he said: “There was 4,232 hours lost in one day outside of hospital. That equates to 176 ambulances.
“That is our members who are really struggling because they can spend the whole of their shift outside a hospital waiting to hand over a patient.
“Everybody is frustrated, including ED (emergency) doctors.
“The frustration is they are worn out, they are tired, they want to get back to being good paramedics.”
I think the important bit to note though is that the Category 1 calls – the ones that come in at the time that look like they’re life and limb – they will get a response and the unions are working very hard on how that will occur
Earlier, Dr Martin said that, over the last five years, demand for ambulances had gone up 18% in England, with a sharp rise for category 1 calls, which include cardiac arrest and respiratory distress.
“I looked back over the last five years nationally in England, it’s gone up by 18%.
“But more importantly it’s gone up much more significantly in the higher acute categories, so what we call category 1 is way, way higher than it was previously, above 50% increase over the last five-year-period. So we’re seeing a sicker population who are calling us more often.”
He suggested patients in category 2 can wait so long for care that they are upgraded to a category 1 incident.
He said: “I don’t think safety is black and white. It’s not one or the other. Right now today we’re seeing long delays for patients. There are lots of patients waiting at the moment for an ambulance response.
“On Wednesday, even with the derogations, that’s likely to be worse. But with this life and limb cover, paramedics up and down the country will absolutely want to keep patients safe.
“I think the important bit to note though is that the Category 1 calls – the ones that come in at the time that look like they’re life and limb – they will get a response and the unions are working very hard on how that will occur.
“It’s the group in category 2 and below who maybe don’t start off as life or limb, and this is what we’re seeing today and (likely on Wednesday), who will deteriorate over time and eventually they will become a life or limb emergency and obviously at that point they do fall into (Category 1).”
He added: “That’s happening today right now before we even get to industrial action on Wednesday.”
Daren Mochrie, chairman at Association of Ambulance Chief Executives, said he did not think the situation would improve in the coming months.
Quizzed by Conservative MP Lucy Allan, he told her: “I cannot see how in the next few weeks and months ahead the situation will improve.”
He added that retention of staff is a problem partly due to higher salaries outside the service.
Elsewhere, Professor Julian Redhead, national clinical director for urgent and emergency care at NHS England, told MPs that ambulance services on Wednesday would be focused on the most serious cases.
“I think what we’ve done is to concentrate with our unions to make sure that we have the services available for those sickest and most vulnerable patients to have the response that they require.
“And those in general will be in category 1 and category 2 call out categories.
“There are others where there may be elderly patients who are on the on the floor for some time as well who also may need care.”
Asked by MPs if public safety will be affected by the strike, he said: “I think that we’re doing everything we can to maintain patient safety.”