The health secretary claims the disparate level of emergency cover during recent ambulance strikes could not be “relied upon to ensure patient and public safety”.

In a letter to the GMB union, seen by Sky News, ahead of further strikes this month, Steve Barclay accepted all areas that staged walkouts ensured the most serious 999 calls were still answered.

But he said the lack of cover for category two calls – which includes strokes and chest pain – in some areas were “material to the risk to life of the strike action”.

Mr Barclay criticised the “volatile” assurances given to him about cover by trade unions, claiming the “scope and extent of arrangements [was] being disputed right up to wire”.

While he believed in the right to strike and that “a certain amount of disruption is inherent” during walkouts, he said that “during recent action I have not been reassured that the current system of voluntary arrangements can be relied upon to ensure patient and public safety”.

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