Ambulance staff across West Yorkshire have voted to take industrial action from Christmas Eve.
Some patients in the Bradford district needing non-emergency transport to hospital for operations or appointments, or being transferred between hospitals, face having to organise lifts or take taxis.
And West Yorkshire ambulance staff's work to rule and overtime ban raises the real prospect of industrial action by both ambulance and fire crews at the same time in late January.
Today Unison and T&G staff promised that the action would not hit 999 calls, but from 4pm next Tuesday the unions' 780 staff will refuse overtime, take their meal breaks at the station instead of on the road and turn off radios which monitor their performance.
Brian Wheeler, Unison spokesman, said the action had been taken after six months of talks.
"Members have reluctantly voted for industrial action to progress their case as a last resort.
"Emergency 999 calls will, of course, be responded to, there is no question of that. But the rest of the service will be stretched and inconvenience non-emergency services, such as hospital transfers."
Unions want a five per cent pay increase, a three-hour reduction in weekly hours, better overtime and double pay on bank holidays. They maintain that pay and conditions are not good enough to retain staff, so overtime is commonplace.
In November, last-minute talks averted a threatened overtime ban.
A spokesman for Bradford Royal Infirmary and St Luke's Hospital said contingency plans were in place for patients.
He said: "Our number one priority is to minimise the impact this may have on our patients.
"We worked constructively with WYMAS a few weeks ago when there was a threat of industrial action to develop a number of contingency measures which included patients making their own way to hospital appointments. Public response was positive."
Ambulance workers at Bradford Royal Infirmary last night said they felt they had no option but to work to rule.
One male technician, who would not be named, said: "This is the only way of attracting the attention of management. We work really hard and it is not reflected in our pay.
"Half my shifts run into overtime and I lose a quarter of my meal breaks. We need more crews and proper wages to attract more staff."
A female colleague agreed. She said: "We never know if we will get off on time or not and we work a 42-hour week as it is."
The festive period is traditionally a quieter time for hospitals, with few non-urgent operations or out-patient appointments.
Trevor Molton, West Yorkshire Metropolitan Ambulance Service chief executive, was disappointed that "practical solutions" to reduce pressure on staff had been rejected.
He said: "Demand for ambulance services is increasing and funding has not been available to allow us to increase resources. This has led to intense pressure on already hard-working staff.
"The package, which we put to our unions, included measures designed to alleviate these burdens. The action which they propose will serve only to increase the pressure faced by all our staff and will jeopardise the service which we offer to the public."
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