Porters and cleaners say they do not earn a "decent living wage"

Staff at the Royal Bolton Hospital are in dispute with their employers over their demands for a "decent living wage".

The action - the first of two strikes - comes after a break down in negotiations with their employer, ISS Mediclean.

Bolton Hospitals NHS Trust said it was "extremely concerned" about the strike and admitted care in certain areas would be reduced at the hospital.

ISS Mediclean is due to bring in other staff in order to ensure the hospital continues to operate as normal.

The workers' union Unison has told the trust that in the event of a major incident the staff will return to work.

This is a classic two-tier problem which leaves many staff under-paid and under-valued Andy Gill, Unison

However, Andy Gill, Unison regional officer, said "Staff are no longer prepared to put up with pay rates and employment conditions that are significantly worse than those of their hospital staff colleagues that they work alongside.

"This is a classic two-tier workforce problem which leaves many staff under-paid and under-valued".

In a statement, the trust said it was "doing everything we can to reduce any impact on patient care".

"We have asked ISS Mediclean to ensure there are adequate contingency plans," it said.

Critical areas such as theatres, ICU and patient movements have not been affected ISS Mediclean

"[Replacement] staff will be providing portering cover.

"In terms of cleaning, ISS Mediclean will provide a normal service in clinical areas such as theatres."

Service in areas such as outpatient clinics and wards will be reduced and there will be no service in office areas.

Cleaning staff are currently employed by ISS Mediclean on �4.47 an hour and porters earn �4.61 an hour.

The dispute arose after a pay claim was lodged to increase wages to �5 an hour for cleaners and �5.50 for porters.

Further stoppages

An ISS Mediclean spokesman said it had offered a 3.23% rise backdated to April, in line with national pay guidelines.

The spokesman added: "The current union demand for porters equates to more than 21% and is equivalent to a similar role being carried out on central London.

"We are providing a near normal portering service with the exception of mail deliveries and a limited domestic service with priority given to the wards and clinics.

"Critical areas such as theatres, ICU and patient movements have not been affected."