Around 4,000 emergency doctors and ambulance personnel in Madrid have been asked to provide only minimum services for the second day in a row after around 85% joined the strike yesterday, according to trade union estimates. The regional Health ministry claims that participation was much lower, at around only 25%.

Yesterday, around 55,000 appointments were cancelled and some patients had to wait for up to two hours to be seen.

Organisers warn that unless their demands are met, there will be further 100% strikes on April 10-11th with 50% strikes on April 3rd, 4th, 7th and 8th.

The president of the strikers' committee, Anga Giménez, denied ministry assertions that the strike was about a pay-rise that has already been implemented, explaining that it is about demanding working "conditions that would enable staff to do their jobs with dignity and to the standard that the people of the Madrid region deserve."

The situation is particularly serious with respect to child care: "around 320 paediatric specialists are required to fill existing vacancies," explained Ms Giménez.

Emergency medics, nonetheless, are demanding the opportunity to negotiate revised rates for working nights.

The photo shows patients queuing up at a health centre in Madrid city centre while Dr Alfonso López García de Viedma chats to journalists.