Outside Deptford ambulance station in one of south-east London’s grittier districts, striking ambulance workers warmed themselves at a brightly-burning brazier, eternal symbol of winter picket lines.
But if the glowing embers evoked disputes of the past, the strikers insisted their cause could not be more contemporary. They cited the decline of the NHS as a reason for strikes more frequently than concern about their own living standards, even if a demand that pay at least keep pace with rising prices is principal cause of the nationwide action by the Unison, GMB and Unite unions.
“We’re striking because of the crisis in the NHS,” said Tim Fisher, a paramedic and Unison steward. He linked below-inflation salary rises to difficulties in recruiting and retaining staff, with too many people leaving the NHS and others dependent on overtime to make ends meet.
“We’re not trying to be selfish here,” he added, pointing out that the UK spends less on healthcare than many other European countries. “This is an attempt to try and highlight the fact that there is poor pay within the NHS and the consequences that has, and all the consequences of a poorly funded NHS,” he said.
Figures around ambulance callouts reveal a service in crisis. Response times to life-threatening “category one” calls are now 9 minutes 56 seconds on average, compared to the target of 7 minutes, according to data gathered by the Nuffield Trust. For category 2 calls, which can include suspected strokes or heart attacks, the average waiting time is now more than an hour, against the target of 18 minutes. In practice, many wait even longer.
Accusations by health secretary Steve Barclay on Wednesday that the strikers were “consciously” inflicting harm on patients were roundly rejected by the strikers.
It’s “not because we have come out on strike that they are dying,” said Antonia Gosnell, a union representative and paramedic with the London ambulance service for 33 years, on a picket line at London Waterloo. “People’s lives are already being put at risk every day because we don’t have the resources or staff.”
At Deptford, Fisher said if an emergency callout could not be covered a crew would be allocated from the picket line. “We are doing our best to ensure that anyone who is in a life-threatening condition will receive an ambulance,” he added.
His colleague Marie Kerr, aged 59, who two years ago moved into an administrative role at Deptford after 25 years on the road as an ambulance technician, added: “If somebody was to fall over across the road now and couldn’t get up, we would be over there to help them . . . So I think that’s a misconception that the government are trying to put to the public that we are putting people’s lives at risk and we’re definitely, definitely not.”
Speaking on a picket line near Manchester Royal Infirmary, the city’s biggest hospital, Unison’s head of health, Sara Gorton, said that in spite of the strike, paramedics had already dealt with “three or four” callouts from the Manchester base within the first hour or so of the picket starting, under the union’s promise to provide cover for “life and limb” emergencies.
Jeff Gorman, the North West Ambulance Service representative for Unison, which has around 4,000 members, said newly trained paramedics were leaving within a couple of years for higher salaries and less stress elsewhere in the NHS.
“They can get a better-paid job as a paramedic in a doctor’s surgery, not working nights and weekends, rather than deal with all the trauma and abuse you get out on the road as a paramedic,” he said.
Many strikers said these pressures were part of the reason some ambulance staff soon quit the profession.
Strikers felt the public was largely on their side even when they or their relatives had personally felt the impact of an under-resourced service.
In Deptford, Fisher recalled a recent incident when the daughter of an elderly woman suffering from heart failure had called an ambulance at 5pm but he and his crew had been unable to get there until 9.30 the following morning. “She was chronically unwell and had problems with her breathing and her mobility. She’d been bed-bound for 48 hours,” he added.
Despite their late arrival the family had been understanding. “We do have very strong public support,” he said, his words almost drowned out by a cacophony of encouraging honks from passing motorists.
Several of the striking paramedics suggested shortages and underfunding elsewhere in the NHS were putting the ambulance service under strain. Craig, a 30-year-old paramedic who did not wish to give his full name, said he and his colleagues’ “main frustration is the largest proportion of our work isn’t emergency ambulance work and unfortunately that means we are tied up when genuine emergencies come in”.
“There is obviously a strain on GP services and they haven’t got the capacity to do what they are there to do and that results in us picking up their slack,” he said.
On the picket line in Manchester, 60-year-old Alun Roberts, who has been a paramedic in the north-west for 27 years, agreed that strains in primary care had driven pressures on to emergency departments “and they can’t cope — and neither can we”, he added.
The way in which strains in one part of the NHS are reverberating across the entire health service is well understood by family doctors. Dr Zahid Chauhan, a GP in Oldham and clinical lead for Greater Manchester Urgent Primary Care Alliance, said strikes and workforce and system pressures were “all part of the same issue”.
“We need to look at the totality of the issues — and unless we do that, with a long-term plan, it won’t get resolved. You’re looking at a five- to 10-year plan to recover from the current situation and that needs to be communicated to the public,” he added.