"None of us want to be here," declares Steve McDonnell as he holds aloft a placard outside Manchester Central Ambulance Station.
"People are struggling. I have a family at home and I'm using food banks."
It is just four days until Christmas, but despite of his bushy white beard and Santa hat, Steve is not feeling full of festive cheer.
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That is because he is one of tens of thousands of workers to have walked out across the country today in the biggest ambulance strike in 30 years. Member of three unions - GMB, Unite and Unison - voted to strike amid a row with the government over pay.
As Steve and his colleagues formed a lively picket line in Plymouth Grove - a stone's throw from Manchester Royal Infirmary - this afternoon, passing motorists honked their horns in a show of solidarity.
For Steve, who works as an emergency medical technician for North West Ambulance Service (NWAS), the decision to strike was a difficult one.
"I can't afford to strike but it's the principle," he explained.
"We are being shunned constantly. Morale is at rock bottom and it's been left and left and left."
Steve, who lives in Moss Side, says the 'increasing pressures' of the job, including lengthy times at hospitals, have taken their toll on he and his colleagues.
"It's the frustration of not being able to get to people quickly enough," he added. "This is the best job in the world.
"We do it because we care, not for the money. It's just frustrating that the government don't want to listen.
"We know we are in a crisis but they need to sit down and work with the unions because the NHS is the pride of the UK. It doesn't matter if you have one pence or £50,0000, we are there for people."
Ann Sumner, a paramedic of 38 years, was another of those who took to the streets this afternoon.
"It's about time the government realised how much hard work the ambulance service staff actually do," she said.
"It's about giving everyone a fair pay rise and supporting the public because the staff are dwindling. They're moving on to other jobs that are more well paid than we are.
"We're losing an awful amount of staff and the public are being put at risk because we have not had a decent pay rise for a number of years now.
"All we're asking is to be recognised for the amount of work we do, especially through Covid when everyone went above and beyond. The government thanked us then. Why can't they thank us now and give us a decent pay rise and support the staff?
"We take a patient in and it's gridlock now because there is not enough staff in A&E. The patients then can't be moved to a ward, patients then can't be discharged because the health service is dwindling fast. It's about time the government realised that."
Other long-serving paramedics like Alan Roberts fear for the future of the NHS as a whole.
He said the ambulance service had been 'hemorrhaging staff' in recent years - a situation he hopes will be resolved if the government agrees to increase its pay offer.
"We have got to have some means of retaining staff," said Alan. "It's becoming increasingly difficult when people realise the work is not what they thought.
"It's too difficult to do the job well due to a lack of resources.
"I love the NHS. Until a few years ago I thought it was the finest thing going. In reality, it's being dismantled.
"I can't believe the government's approach is not to hold any discussions with unions or even their members. I think they are quite willing to sacrifice the NHS, which is why we are here today."
Strikes were also held outside several other ambulance stations across Greater Manchester throughout Wednesday.
Pete Moore was one of those on who stood outside Bury Ambulance Station. As well as maintaining and repairing ambulance vehicles for NWAS, he also works as a driving instructor and regularly works 60 hours a week.
"Most of us have second jobs," he said. "We've not had a proper pay rise in over ten years. I'm struggling to pay my bills."
Meanwhile, Tony Dunn, an advanced emergency medical technician and convenor for the GMB union, said the ambulance service was at 'breaking point'.
"Day to day we are seeing delays on ambulances of 12 hours plus for patients who are on the floor - and it's just not acceptable anymore," he said from a picket line in Whitefield.
"Our members have spoken and said they are not prepared to take the abuse that we are getting from members of the public - we are the first person they see after that call was made some 12 hours later."
"I was at one a few weeks ago where the call was made at 2pm in the afternoon and the ambulance crew turned up at 4am in the morning - so you see the complexities of what we are dealing with."
Mr Dunn said there were 'vast amounts of vacancies within the trust that aren't being filled anymore because of the pay differential'. "The trust are doing their best to address this but it needs finding from central Government. And central Government at this moment are just not entertaining of any negotiations regarding this.
"The pay issue is secondary to me - it's the conditions that my members are working under."
Sara Gorton, head of health at Unison, said ambulance staff were striking ‘as a last resort’, adding that the ongoing dispute with the government was 'entirely avoidable’.
“It should be a matter of national shame that it takes paramedics and call takers stepping away from jobs they love to focus attention on what is a national scandal,” she added.
Despite the walkout, Ms Gorton said several workers had been forced to leave picket lines around Greater Manchester to attend to serious incidents, which she said highlighted how 'overstretched' the ambulance service is.
Amid the strike action, hundreds of armed forces staff were brought in to help ambulance trusts across the UK, although they have only a limited role.
North West Ambulance Service confirmed 89 members of military personnel were supporting the trust across the region. The figure has not been broken down for the Greater Manchester region specifically.
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