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Prime minister Rishi Sunak said the UK government wanted to have a “constructive dialogue” with unions, as ambulance staff across England and Wales launched industrial action over pay and working conditions.

Workers from the GMB and Unison unions have begun industrial action in 10 out of the 11 ambulance trusts in England and Wales, after an escalation in rhetoric with ministers over the impact of strikes on patient safety.

Rail union leaders warned there had been almost no progress in negotiations to try to stop more strikes on Britain’s railways.

“We are further away than when we started,” Mick Whelan, head of drivers’ union Aslef, told MPs at the House of Commons transport select committee on Wednesday. Mick Lynch, RMT general secretary, said he could not “see a landing zone” in discussions with train companies.

Speaking during prime minister’s questions, Sunak argued that the opposition Labour party and its leader Sir Keir Starmer had no clear policy on industrial action and defended the government’s new anti-strike legislation outlined on Tuesday.

“We’ve always been clear that we want to have constructive dialogue with the unions. That is also why when it comes to the issue of pay we have accepted in full the independent recommendations of pay review bodies,” the prime minister said.

“This is a simple proposition,” he added referring to the bill proposing the minimum service agreements. “No one denies the unions freedom to strike but it is also important to balance that with people’s right to have access to life-saving healthcare.”

Starmer argued that during the 13 years of the last Labour government “there were no national NHS strikes” and accused the government of failing to negotiate on pay.

“If the prime minister had negotiated with the nurses before Christmas, they wouldn’t be on strike,” he said. “So why is he choosing to prolong the misery rather than end these strikes?”

Earlier in the day, Steve Barclay, the health secretary, urged the public to continue to call the 999 in the case of life threatening incidents, but warned there will be “disruption” to NHS services in light of the action.

He also stressed that the government was keen to work with unions on this year’s coming pay review for 2023-24.

However, unions representing health workers confirmed on Wednesday that they will not take part in the pay review body process to set pay for 2023-24, calling instead for direct talks with ministers to resolve the dispute over the current pay deal and to agree next year’s.

“The pay review body process doesn’t fit the current context,” said Sara Gorton, head of health at Unison and chair of a group of 14 NHS unions.

Sharon Graham, general secretary of the union Unite, went further, calling for the NHS pay review body to be abolished because it had been a “total farce” and had served as “a smokescreen which has allowed government to drive the NHS to the point of collapse”.

During the six-month period last year between the deadline for submitting evidence to the pay review bodies and ministers’ accepting their recommendations, inflation had “gone through the roof”, the unions argue.

Train operating companies offered Aslef a two-year 8 per cent pay and reform settlement on Friday, but Whelan said the proposal crossed many of his “red lines”. He added: “I cannot recommend any one element of it, and it may destroy the ability to go back to talks in future.”

The RMT is in a separate dispute with Network Rail, which Lynch said was making “difficult” demands. There are more talks scheduled between unions and industry in the coming days, and railway bosses were less downbeat.

Steve Montgomery, chair of industry body the Rail Delivery Group, conceded there were “challenges” in finding a deal with drivers, but Tim Shoveller, a Network Rail executive, said there was “every chance” of a deal with the RMT.

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