Ambulance workers in Bolton walked out in a desperate bid to bring about change.
They manned a picket line outside Royal Bolton Hospital as part of a national walkout.
Motorists and passers-by showed their support by sounding their horns.
Paramedics, call handlers, drivers and technicians from the Unison and GMB unions are taking part.
Workers with North West Ambulance Service held signs demanding better pay and conditions for workers and improved patient care through what they call a ‘failing system.’
Up to 25,000 ambulance workers across England and Wales have gone on strike in a dispute with the Government over pay.
Paramedics, call handlers, drivers and technicians from the Unison and GMB unions are taking part in staggered strikes across a 24-hour period.
NWAS Unison Bolton branch secretary Jeff Gorman said: “Not one of our ambulance members want to strike.
“Our members are fed up as the system has failed.
“Patients are dialling 999 and are having to wait hours at a time for the ambulance to arrive.
“The crew on that ambulance arrive to find a very upset family who are worried about their relative.
“The crew then take the patient to hospital where they join another queue of ambulances where once again, they have to wait for hours to transfer their patient into A&E, this is before any strike action, it happens everyday.
“While they are sat in that queue, they are unable to respond to 999 calls. It is unacceptable.”
Workers at the picket line in Bolton were still answering category two calls for major emergencies and sending out crews.
But pay is also a factor in the ongoing strike dispute as workers say they have had a pay freeze for over 10 years.
Jeff added: “All that we are asking for is for the Government to meaningfully sit down with the unions and negotiate a reasonable offer.
“We are also fed up with the MP's telling blatant lies. We have ensured that there is life and limb cover in place and that means anyone having a heart attack or stroke will always get response.
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“They go on about the ambulance unions refusing to agree a national position.
“We cannot do that as many ambulance Trusts differ in the makeup of their workforce. eg. LAS does not have a Patient Transport Service or an Urgent Care Service whereas NWAS do. “
In the North West, the ambulance service is urging the public to keep ambulances for people with life-threatening injuries and illnesses.
The next walk-out is planned for Monday, January 23.
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