AMBULANCE crews are being balloted on industrial action in the region.
Members of the North-East Ambulance Service (NEAS) are voting on whether to support an overtime ban.
Workers are concerned at the failure to resolve a long-running dispute over pay rates for lunch breaks.
Ambulance crews who work for the service, which includes Newcastle, Sunderland and County Durham, are not paid during meal breaks.
The NEAS argues that this is in line with a national pay agreement.
However, the NEAS union, Unison, wants ambulance crews to be paid in meal breaks
The service has offered to pay crew members £20 if they agree to respond to a call during a meal break.
Some Unison members have agreed to the offer, but others have refused, which means potential gaps in emergency cover.
NEAS chief executive Simon Featherstone said he was surprised and astonished at the union's decision to ballot members on action.
He said: "We have made significant efforts to resolve the meal break issue locally, yet all our offers have been rejected."
He said he was prepared to take part in discussions, but that it seemed the union was trying to challenge a national agreement on meal breaks.
Dave Armstrong, of Unison, said: "Our ballot started yesterday and we are likely to know the outcome next week.
"Our members are concerned at the failure to reach agreement over the meal break issue."
Mr Armstrong accused the service of being alarmist about the ballot and pre-empting the result.
He said: "We would like a national agreement which includes paid meal breaks.
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