Ambulance workers in England have begun a fresh strike in the long-running dispute over pay and staffing, with no sign of a breakthrough in the increasingly bitter row.
About 15,000 members of Unison in five areas have walked out, with officials warning of escalating action in the coming weeks unless the deadlock is broken.
Unison is balloting another 10,000 of its ambulance members in England for industrial action, so any further strikes could be the biggest yet for the union.
The strike involves ambulance workers across five services in England – London, Yorkshire, the South West, North East and North West.
Speaking on Thursday on the eve of the strike head of health Sara Gorton said there was a "gap" between what Prime Minister Rishi Sunak and other ministers were saying in public about having "constructive talks" with unions, compared with what was actually happening.
She said she believed the Government was now "sitting it out" and waiting for the next pay round rather than trying to negotiate a deal to resolve the current dispute.
Any recommendation from the NHS Pay Review Body about next year’s pay is not expected for months, she said.
Union officials think the Government believes support for the strikes will fall, but they say the opposite is happening.
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Ms Gorton said an increased pay offer to health and teaching unions in Wales shows what can be achieved through proper negotiations.
University lecturers will be on strike again on Friday in a separate dispute over pay, pensions and conditions, while physiotherapists in England walked out on Thursday.
4,500 members of the Chartered Society of Physiotherapy (CSP) went on strike yesterday after accusing the government "intransigent" in discussions about pay.
Strikes in Wales and Scotland were suspended after the local governments improved their offers.