Patients told to only call 999 if they think they are about to die

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Our Health Editor Laura Donnelly writes that they also raised fears of a “rebound effect” if those in need of help fail to seek it, meaning services could be deluged in the days before Christmas. Christina McAnea, the general secretary of Unison, said it was “absolutely the Government’s” fault and accused them of being “totally irresponsible”.

You should only call 999 if you think you are going to die, an ambulance chief said as tens of thousands of staff walked out. Stephen Segasby, chief operating officer of North East Ambulance Service, wants patients to ask themselves: “Am I going to die? Do I feel like I am going to die?” As a war of words escalated on Wednesday morning between union chiefs and ministers, on the ground Mr Segasby told patients: “Ambulances will still be able to respond during the strike, but this will only be where there is an immediate risk to life.”

Barclay rejects further pay rises

Further pay rises for striking ambulance workers are unaffordable despite unions not demanding a specific figure, the Health Secretary has said. Steve Barclay insisted he did not want to “divert” money from essential services. 

The Unite, Unison and GMB trade unions, which are behind the industrial action, have asked for a pay rise above the 4.75 per cent offered by the Government in line with the independent pay review process. But unlike the Royal College of Nursing (RCN), which wants its own striking NHS staff to receive an inflation-busting 19 per cent increase, these unions have not requested a specific uplift.

No trains until second week of January

In other strike-related news, some commuters may not be able to return to the office until mid-January due to more industrial action on the railways. Passengers were greeted with a sign telling them that there will be no Chiltern Railways services between Amersham and London Marylebone until Jan 8 on Wednesday morning. 

It is thought that hundreds of stations – predominantly on branch lines – will be cut off until the second week of January. Find out which routes are affected by reading our business live blog by Chris Price.

Comment and analysis

World news: China builds on disputed unclaimed land

China is enlarging and building on previously unclaimed land in the disputed Spratly Islands for the first time, Western officials have said. For years, Beijing has been strengthening its presence in the strategic maritime region, militarising disputed reefs, islands and land formations it has long controlled, raising fears it is working to seize control of access to crucial global shipping routes in international waters. But the latest development, reported by Bloomberg, would be the first known instance of China building on territory it did not already occupy. Chinese maritime militias have carried out construction work at four unoccupied features in the Spratly Islands over the past decade, the officials said.

Wednesday interview: ‘Should Rising Damp be edited? No – its intentions were good,’ says Death in Paradise’s Don Warrington

He changed the face of British TV as Philip Smith in the revolutionary sitcom – but the actor’s career has been far from plain sailing

Read the interview

Sport news: Gary Lineker questions SPOTY shortlist

Hours before presenting tonight’s show, Gary Lineker has become the latest high-profile figure to express his shock at Matt Fitzpatrick’s BBC’s Sports Personality of the Year snub. The Match of The Day host, who is known to be a golf fan, took to social media to share his disbelief that the US Open winner, the only British player to win a major this year, had failed to make the six-contender shortlist for the coveted award. Lineker’s comment comes after Ian Poulter branded the coveted awards ceremony a “farce and a joke” because Fitzpatrick was not named on the six-person shortlist. Meanwhile, Emiliano Martinez reignited his feud with Kylian Mbappe feud by taunting him with a baby doll during an open-top bus parade in Buenos Aires.

Editor’s choice

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Business news: Borrowing doubles to record high

Public borrowing more than doubled to £22bn last month as unprecedented energy bills support and surging debt interest costs pushed the deficit to its highest ever November level. In the first set of figures since Jeremy Hunt’s Autumn Statement, the Office for National Statistics (ONS) said November’s borrowing was £13.9bn higher than a year ago. Our economics editor Szu Ping Chan reports that it was also well above the £14.8bn predicted by economists and represents the highest November borrowing figure since records began in 1993. Meanwhile, Sir Richard Branson has been given an early Christmas present after his space company was given the green light to carry out the first rocket launch on British soil.

Tonight starts now

The 10 best ski resorts for guaranteed snow | Ski holidays are back and skiers and snowboarders are eager to make the most of every second on the slopes. But, the question remains, how’s the snow looking? Whether you’re keen to get your first turns in on fresh snow early in the winter or want to avoid the slushy remains of the season on an end-of-season blast, booking a high-altitude ski resort is your safest option if in search of perfect pistes. It will ensure that good conditions are pretty much a certainty, no matter how the forecast has fared. The beauty of snow-sure resorts is that you’re unlikely to be disappointed no matter what month of the season you choose to travel – here are 10 of the best.

Three things for you

And finally… for this evening’s downtime

‘Get Carter? I thought no reputable actor would do it’: how Mike Hodges shook up British film | In this archive interview with Robbie Collin, the late director revealed how he beat ‘ignorant’ studios to make the Michael Caine classic – and Flash Gordon. Sitting in his Dorset farmhouse in front of a pinboard covered in photographs, sketches and clippings, the director – who has died aged 90 – talked warmly and often hilariously about one of the most heterodox careers in British cinema.

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