Industrial action by Waterford ambulance staff resumed this morning, and will continue for four days, the UNITE union has confirmed.
The staff say since the south east area was integrated into the National Emergency Operations Centre in Tallaght last summer, a number of issues have arisen.
These include emergency crews being deployed to non-essential duties, leaving little or no emergency cover in Waterford city and county.
Staff working hours and break times are also being raised.
Union representatives met with the HSE yesterday, after which it was decided to reject the proposals advanced by management "since members did not feel they represented a long-term, sustainable resolution of the issues in dispute", according to a UNITE statement..
"UNITE remains available to discuss our concerns," said regional officer Tony Kelly.
"Our priority remains to ensure that our members can provide patients with the very highest standards of service and care.
"I would like to take this opportunity to thanks all the members of the public who have expressed their support for our action, which has been designed to avoid affecting patient care."