Health Secretary Steve Barclay has mounted an extraordinary attack on striking health staff by accusing them of making "a conscious choice to inflict harm on patients".
The top Tory, who has been accused of using bully boy tactics, said that contingency plans would not cover all 999 calls during today's mass walkout by ambulance staff.
He added: "Ambulance unions have made a conscious choice to inflict harm on patients."
Union leaders insist that cover is in place for the most serious calls through a series of local agreements.
Unison's Christina McAnea said she was "shocked" by his inflammatory language, while GMB's Rachel Harrison branded his remarks "really insulting" to hard-working staff.
The Government has continued to resist pleas for pay talks, despite the heads of the Royal College of Nursing and ambulance unions saying they would call off walkouts if ministers got round the table.
The Health Secretary argues that pay hikes had been decided by the independent pay review body - despite the fact that ministers can overrule it.
And he insisted that the fault for the walkouts lies with unions.
Here are just some of the times the top Tory has tried to put the blame on workers.
Top Tory makes inflammatory claim that unions made 'conscious choice' to harm patients
Mr Barclay stoked fury by writing a bullish piece in the Telegraph today where he put the blame for strikes squarely on unions.
“We now know that the NHS contingency plans will not cover all 999 calls. Ambulance unions have made a conscious choice to inflict harm on patients,” he said.
He added: "The British people would not forgive if politicians like me spent every single winter frozen in negotiations with trade unions, rather than getting on and solving the very real challenges we face as a country.
"It is a dangerous trap we have been determined to avoid."
Rachel Harrison, GMB National Secretary, said: “Ambulance workers are seething at such a crude, insulting attempt to divert attention from the government’s continued chaos in the NHS.
“The public know it’s not ambulance workers who have presided over a decade of failure."
She said paramedics and other ambulance staff were already leaving picket lines to assist on emergency calls.
... and then he doubled down
Mr Barclay later refused to take back the comments he made in the Daily Telegraph on putting patients at risk.
Sky News presenter Kamali Melbourne asked him: "That's not conciliatory language, that's not going to bring the two sides together, that only going to harden the side against you, isn't it?"
"Well, it's just a reflection on the fact that trade unions have chosen this time for the strike," Mr Barclay replied.
He claimed unions 'refused' to work with Government on national contingency plans
The Health Secretary said Unite, Unison and GMB unions had "refused" to work with the Government at the national level to set out plans for dealing with the strikes.
He told BBC Breakfast that unions would only agree local arrangements for life-threatening and emergency calls, which had led to "further uncertainty".
Mr Barclay said trade unions "haven't been willing to work with us to agree national exemptions in terms of covering all of the category 1, category 2, life-threatening and emergency calls."
But Unison boss Christina McAnea said: I'm utterly shocked by the SoS's [Secretary of State's] comments in the media.
"He's never specifically asked UNISON for a national contingency agreement.
"In our meeting yesterday, he acknowledged that NHS staff - our local unions - have negotiated detailed, appropriate plans for their areas.
"These accusations from the SoS are a distraction from the government’s own failings and their refusal to constructively resolve this dispute."
Unite general secretary Sharon Graham said lcategory 1 incidents will be responded to immediately and category 2 incidents would be triaged for those that are life-threatening.
She said blame for the strike "lies squarely at the floor of the Government", adding: "I've never seen such an abdication of leadership like it in 25 years of negotiating."
He said pay hikes would 'divert money' from patient services
Asked about repeated pleas for pay talks to avert strikes, Mr Barclay told Sky News: "We have a process in terms of pay, an independent process, and we've accepted the recommendations of that in full."
He added: "We're investing in the NHS, we're investing in social care, and I don't want to divert money from those essential services focused on patients to overturn what has been an independent process which has looked at what is affordable to the economy, what is affordable to your viewers at a time of cost-of-living pressure, but also recognising the system is under very severe pressure and we need to get that extra investment into the NHS and into social care."
He tried to shift responsibility to pay review bodies
The Government has repeatedly tried to use the recommendations of the independent NHS pay review body as a cover for refusal to hike wages.
The body recommended that the majority of NHS staff on "Agenda for Change" contracts were handed a £1,400 uplift in pay earlier this year.
But it made its decision before inflation spiralled to double digits - and it's advice is non-binding on the Government.
The Health Secretary finally admitted that ministers have ignored recommendations before but claimed he would have been criticised if he'd overruled it.
"When we haven't accepted in full the recommendations of the independent pay review body programmes such as yourselves have been the first to criticise us," Mr Barclay told BBC Radio 4's Today programme.
"When we don't accept in full the recommendations, we're criticised for doing so, on this occasion we have accepted them in full," he said.
