Barry Mason

Around 450 ambulance workers employed by the Yorkshire Ambulance Service (YAS) National Health Service (NHS) Trust in England held a one-day strike on April 2 in a dispute over staffing changes, de-skilling and trade union recognition. During the strike workers picketed 17 ambulance stations across the county.

The staff began an overtime ban on March 26 in response to YAS management’s plan to replace medical technicians with emergency care assistants (ECAs). Currently an ambulance crew consists of a highly trained paramedic aided by a medical technician. The employees are members of the Unite trade union, which has been derecognised by the Trust. According to Unite, ECAs receive only six weeks training.

The move to downgrade and de-skill 300 emergency staff is part of YAS’s agenda to make tens of millions of pounds in cost savings. This year the trust plans to cut its budget by £10.3 million this year; part of an overall plan to save £46 million over the next five years. This is part of cuts of £20 billion (almost 20 percent) in “efficiency savings” being imposed throughout the National Health Service.

UNITE represents only around ten percent of YAS staff, with the public sector trade union, Unison, representing the majority.

Unison refused to support the strike and issued advice to its members, effectively endorsing strikebreaking. Legal advice meant that, “Legally our members cannot take part in the action (and not crossing a picket line would be seen as taking action) it would be classed as illegal as we have not held a strike ballot.”

It continued, “We have however got agreement from the trust that staff can work from the picket lines and wherever possible will help us to avoid anyone having to cross them.”

The action of Unison in ensuring the Unite members were isolated is a clear signal to the YAS that it will continue to function as a junior partner in whatever attacks the Trust seeks to impose. In its February 7 statement derecognising Unite, YAS stated, “UNISON is the largest trade union within the Trust and represents the majority of our employees. It is Britain and Europe’s largest public sector union.” It added, “The Trust remains committed to working in partnership with UNISON, which is not affected by the decision to derecognise Unite the Union, and to the principles of effective consultation and negotiation.”

David Whiting the Chief Executive of Yorkshire Ambulance Service NHS Trust, said the decision to derecognise Unite was a “difficult matter.”

As with Unison, Unite has a long record of collaborating with employers in the public and private sectors in order to enforce the diktats of management. This is why Stephen Moir, YAS Trust deputy chief executive was able to say last month, “More recently Unite the Union has advised its members to accept the Trust’s proposals on changes to the A&E [Accident and Emergency] workforce and this is inconsistent with their stated public position to reject the Trust’s plans.”

The role of ECAs is to respond to “emergency calls as part of an accident and emergency crew or at times as first responder.” They were introduced in 2006 under the previous Labour Party government (1997-2010) under the guise of easing the burden on paramedics, by taking patients to hospital and driving ambulances.

Despite the potentially life-threatening conditions they must respond to, ECAs are only trained in basic first aid. Even in 2011, the Daily Telegraph noted that, “trusts are now relying on ECAs, who earn £12,000 less than qualified paramedics, to perform frontline roles as they axe paramedics to cut costs…Six out of 12 ambulance trusts in England now send two ECAs on 999 calls without paramedics…ECAs now account for roughly one in every 10 members of ambulance staff and total more than 2000.”

According to UNITE the downgraded staff will have little or no opportunity for additional training for up to seven years.

Prior to the strike UNITE made clear that it was desperate for a resolution to the dispute. Regional officer Terry Cunliffe said in a March 27 statement that the union would call off the action if negotiations with management could be held. “I would be happy to meet the trust’s (chief officers)…under the auspices of the conciliation service ACAS for meaningful and constructive talks over the holiday (Easter) period”, said Cunliffe. Unable to get agreement to hold talks, Unite reluctantly sanctioned the one day action, the only strike it has called in a dispute going back to the beginning of the year.

Nationally Unite has sought to ensure that any struggle among health workers is kept isolated. It has not lifted a finger to mobilise any of its other members employed in the health service in defence of the Yorkshire ambulance staff. This is despite the union advertising itself as the “the leading trade union in the health sector, with over 100,000 members across all occupations and professional groups”.

The only action being proposed by Unite is for its members to sign an online petition to the Conservative Party Secretary of State for Health, Jeremy Hunt requesting that he “launch an independent inquiry into patient safety from cuts to ambulance services in England” and to write to Members of Parliament.

Bitter experience has demonstrated time and again that NHS workers cannot put their trust in any of the unions or any section of the ruling elite to defend their jobs and livelihoods.

The NHS FightBack campaign, initiated by the Socialist Equality Party urges ambulance workers to form action committees, independent of the unions and Labour Party, in alliance with other health workers and all who rely on the NHS. This is critical not only in order to defend their own pay, terms and conditions but to defend the right to public health provision for all.