Ambulance strikes pose ‘big risks’ to public, warns Oliver Dowden

The public faces “big risks” from ambulance strikes next week, Oliver Dowden warned as hospitals were ordered to empty as many beds as possible.

Mr Dowden, the Cabinet Office minister tasked with contingency planning for the strikes, said it was impossible to “mitigate away” the dangers ahead despite the Government’s best efforts.

In an interview with The Telegraph, as paramedics and ambulance crews prepare for the first national strike in 30 years, he urged union leaders to “think carefully” and call off Wednesday’s action.

“The Government is not going to be able to mitigate away all of the impact of these strikes, and particularly with something like the ambulance strike we cannot remove those risks,” he said.

“Those are big risks that people face, and I would urge union leaders to think carefully about that and urge them to come to discussions and call off the strikes.”

Mr Dowden described the dangers ahead as “significant”.

On Friday night, hospitals were ordered to send home as many patients as possible in an attempt to prevent A&E units from becoming overwhelmed as ambulance workers strike.

Health chiefs have instructed all trusts to take extraordinary measures so those ambulance crews working on Wednesday can drop off patients far more quickly than normal.

The instructions from NHS England make it plain that hospitals will have to take “risk-based decisions” to speed up the turnaround, using makeshift wards and emergency beds, so crews that are working can get back on the road.

Hospitals may need to cancel appointments in order to get more senior doctors into A&E departments to speed up the number of patients getting in and out of hospital, the instructions say.

While cancelling appointments and operations should be seen as “a last resort”, even urgent cancer tests and treatment may need to be put on hold if other options are exhausted, a letter from Prof Sir Stephen Powis, the national medical director, says.

Health leaders have warned that Wednesday’s strikes – which will follow a second day of action by nurses – are of a “completely different order of magnitude of risk” to the NHS industrial action seen so far.

On Friday night it emerged that just 10,000 nurses took part in Thursday’s strike action in England, despite claims by the Royal College of Nursing that up to 100,000 would take to picket lines.

The NHS England figures suggest support for the campaign for a 19 per cent pay rise may be waning, ahead of a second day of strike action planned for Tuesday and the threat of further strikes in January.

The figures show that around 16,000 patients in England saw operations and appointments cancelled as a result of the first day of strike action.

Concern is mounting about the risks to patients during the ambulance strikes, taking place on Dec 21 and 28, which involve the GMB, Unison and Unite unions.

Unions and ambulance trusts across the country are locked in talks, with no national agreement about which 999 patients can expect to receive a response.

So far, only one local agreement says all emergency cases will be covered. Other areas say heart attacks and stroke victims may only receive a response if cases are deemed “time-critical”, while pensioners who fall may have to wait four hours to get a response.

Steve Barclay, the Health Secretary, is understood to be growing increasingly frustrated with union leaders, who have been accused of “playing games” over strike day coverage as public anxiety grows.

A source close to Mr Barclay said: “They are keeping us in the dark about what level of 999 calls they will respond to. That is utterly irresponsible and makes it very difficult to prepare plans, including deployments of military drivers.

“As things stand, union refusal to cooperate will lead to many people in severe pain being left to fend for themselves. Accident victims whose injuries are not immediately life-threatening but who need time-critical treatment will be put in danger.

“If they are intent on striking, unions need to be reasonable and help us keep the public as safe as possible during industrial action.”

Pat Cullen, general secretary of the Royal College of Nursing, has criticised Mr Barclay’s “confrontational” approach to talks with union officials. In an interview with The Times, she also urged Rishi Sunak to wade in and “get a grip” of the impasse “before it engulfs the NHS”.

On Friday Wes Streeting, the shadow health secretary, said: “I’m even more worried about the ambulance than about the nurses' strike. I think there is an even greater risk to patients.

“The Government should seize the agenda and use the precious little time that is available to get the unions around the table and see if we can get those strikes called off before they happen.”

Matthew Taylor, the chief executive of the NHS Confederation, which represents hospitals, urged ministers to enter pay talks with unions, calling on unions to do more to ensure the public is kept safe if the strikes on Dec 21 and 28 go ahead.

“Health leaders continue to urge the Government to enter into meaningful negotiations with trade unions, and for trade unions to ensure that their commitment to protect life and limb is credible and deliverable in the face of the extreme pressures facing all parts of the health service as winter pressures pile up,” he said.

Saffron Cordery, the NHS Providers interim chief executive, said: “With local discussions between trade unions and ambulance trust leaders over which services will be exempt from strike action likely to go down to the wire, widespread disruption across different ambulance services now looks inevitable.

“Trust and system leaders are being asked by NHS England to focus on reducing handover delays and maximising capacity in urgent and emergency care.

“But given that the scale of operational pressures on providers now includes very high bed occupancy levels, rising flu admissions, ongoing Covid pressures, record staff absences and increasing A&E attendances, this will be incredibly difficult to implement.

“And while no trust leader wants to reschedule or cancel planned operations and procedures, we have seen from this week’s nurses' strike that this may need to happen to ensure patient safety is maintained and that staff can be redeployed across emergency and critical services.”