AS AMBULANCE care assistants organised into the GMB union embark on an escalating programme of strike action against Epsom and St Helier NHS, it is timely to highlight the history and the very poor treatment of these workers. 

Back in 2018 these ambulance staff had no union strength as the union had very few members. Visits to the ambulance base led to aggressive confrontations with some bullying, petty-minded managers who were supported by the senior managers.

In spite of the challenges, a persistent and consistent GMB union organising drive over a number of years alongside the bravery and determination of newly appointed GMB representatives has led to a high union density amongst this workforce. The workforce has come a long way, so this strike is about more than pay, it’s about the right to keep hard-won trade union density in this workplace.

Ambulance care assistants play a vital role in transporting patients to life-saving treatments in hospitals up and down the country. These workers are professional dedicated personnel who go over and above in their job because they feel a deep sense of duty and responsibility for the patients in their care. They provide physical and psychological support to the patients as well as a transportation service. 

Cuts and privatisations mean that all ambulance care assistants right across the country are suffering a deterioration in pay, terms and conditions as they get moved to and from the NHS with the result that the NHS employers are now adopting the same poor employment practices as some of the anti-union private contractors.

The Epsom and St Helier strikers are still not benefiting from NHS contracts because they were outsourced in the past. Instead management decided to make savings and tag their pay to the London Living Wage so they didn’t have to pay full sick pay, extra holidays and other entitlements that are more favourable on the NHS Agenda for Change (AFC) contract. 

It is now the case that Epsom and St Helier NHS is not even sticking to the lower level of contractual commitment for the London Living Wage as they are refusing to pay back pay from October 2023 which is over £1,000 per employee. They are instead offering a Covid payment which the rest of the NHS staff received months ago, in addition to the national salary increase. This is the equivalent of giving with one hand while taking away with the other. 

The ambulance care assistants have had enough and they are determined to use their union strength to fight for their rights.

The health and safety of the staff and the patients who use non-emergency ambulance transport has deteriorated as cutbacks take effect and as experienced staff get utterly demoralised by the way they are treated and they leave the services for good. 

Many of the ambulance care assistants work long hours because the pay is very low, so they book overtime to make ends meet. During the pandemic these workers were particularly vulnerable to contracting infection as they were carrying unwell hospital patients to and from care homes and residential properties with inadequate personal protective equipment and poor air flow and protection systems within the confined environment of the ambulances. 

To add insult to injury, the Epsom and St Helier patient transport crews were accused of stealing personal protective equipment when little to none was provided to begin with.

Crews suffer musculoskeletal injuries as there is pressure to transport patients quickly when the correct equipment like wheelchairs and stretchers may not be readily available. 

It is also possible that patients who are more immobile and require two crew members to support may be misallocated to one ambulance care assistant who then has to struggle to get the patient up or down stairs or into the back of a vehicle. The lack of adequate sick pay means that workers are forced to come into work sick and injured. 

Lack of appropriate welfare facilities can also become an issue particularly when they are on longer-haul journeys with patients. There are scant facilities for hygiene purposes, toileting or heating and consuming food. Low pay means these workers simply can’t afford the expensive hot food served in outsourced hospital canteens.

Enforced overtime occurs as jobs get allocated that take the workers beyond their finish time which affects their work-life balance and their need for adequate rest between shift times.

There is a lack of investment in ambulance stock and the improper management of vehicles. It is not uncommon for crews to be pressurised to take out vehicles that are not road worthy. There are concerning reports of MOTs running out, vehicles not having lights or suitable restraints for passengers and crews are pushed to use the vehicles anyway by bullying managers.

Epsom and St Helier ambulance care assistants have taken their first day of strike action, the turnout was high and the mood was electric. The solidarity and support from patients and the public is also high because increasingly there is a growing recognition that the pay and conditions of NHS staff are intrinsically linked to quality of patient care. These workers are standing up for themselves and the patients and growing in confidence as they do so. 

Further strike action is set for the May bank holiday and once again we call for widespread solidarity from all across the labour and trade union movement. 

The Epsom and St Helier ambulance care assistant strike is also exposing the misuse of public money allocated to the NHS.  

Unaccountable managers are booking expensive third party providers like HATS Group and others private taxis in their effort to break the strike. They also want to break the union and the determination of the staff to stand up for themselves. The amounts that are being spent to break the strike are likely to dwarf the one-off payment owed to these staff.

The GMB ambulance staff have embarked on strike action in a serious way with a determination to win and in doing so they are setting an example for all ambulance care assistants across the country. The attacks on the quality of NHS services, jobs, pay and conditions and trade union rights aren’t going away, so there is little choice but to get organised and fight back. 

On May Day 2024 we hope that the fighting spirit shown by the Epsom and St Helier ambulance strikers gives renewed hope and inspiration to all workers who find themselves at the sharp end of cuts, privatisation and anti-trade union attacks.

Helen O’Connor is a trade union organiser and former nurse. Follow her on Twitter @HelenNhs.