Junior doctors working in Britain's National Health Service have launched the longest walkout in NHS history as they try to secure a pay rise of more than one third.
Officials called the doctors' 35 per cent pay demand "unreasonable" and said the five-day strike would put patient safety at risk at a time of record waiting lists for treatment.
Members of the British Medical Association in England started picket lines outside hospitals from 7am on Thursday at the start of the walkout, which will cause huge disruption, affecting operations and consultations.
The strikes are being held amid speculation the government is expected to reveal whether it will accept recommendations from pay review bodies affecting public sector workers including teachers, civil servants and NHS workers.
Those agencies have reportedly recommended pay rises of up to 6.5 per cent.
If the government accepts those suggestions, money would have to be found from existing budgets, it says.
Guy’s and St Thomas' NHS Foundation Trust in London was hit by union-wide strikes on Thursday, while hospital consultants and radiographers will take industrial action later this month.
BMA leaders urged the government to return to the negotiating table to resolve the long-running row, which has already led to a series of strikes and thousands of cancelled operations and consultations.
“Today marks the start of the longest single walkout by doctors in the NHS’s history but this is still not a record that needs to go into the history books," a statement said. “The pay offer on the table to junior doctors in Scotland and how it was reached throws into sharp relief the obstinate approach being taken by the Prime Minister and the Health Secretary, Steve Barclay.
“The Health Secretary has said there can be no talks while strikes are planned – Scotland has proved him wrong. He said above 5 per cent wasn’t realistic – Scotland proved him wrong. He refused to even acknowledge the concept of pay restoration – Scotland proved this is not only possible but essential.
“The complete inflexibility we see from the UK government today is baffling, frustrating and ultimately destructive for everyone who wants waiting lists to go down and NHS staffing numbers to go up."
'Damaging and disruptive'
The NHS has urged both sides to resume talks in a bid to head off more protest action.
“The impact of these disputes is fraying the fabric of the NHS, held together by a unique sense of commitment and shared endeavour across the workforce that has served it so well over so many years," said NHS deputy chief executive Saffron Cordery. "We lose that at our peril.
“The disruption for many thousands of patients and the potential harm of delaying their treatment is a huge and growing risk for the NHS to manage.
“Eight consecutive months of industrial action across the NHS are taking their toll not just on patients, with more than 651,000 routine procedures and appointments forced to be rescheduled, but on already overstretched services – hampering efforts to cut waiting lists.”
Mr Barclay said promising talks had collapsed after the BMA called the latest round of strikes. “It is disappointing that the BMA is going ahead with further strike action," he said. "This five-day walkout by junior doctors will have an impact on thousands of patients, put patient safety at risk and hamper efforts to cut NHS waiting lists.
“We were in discussions about pay and a range of other measures to improve the working lives of junior doctors until their representatives collapsed the negotiations by announcing further strikes. A pay demand of 35 per cent or more is unreasonable and risks fuelling inflation, which makes everyone poorer.
“If the BMA shows willingness to move significantly from their current pay demands and cancels these damaging and disruptive strikes, we can get around the table to find a fair deal to resolve this dispute.”
Polling by YouGov showed public support for strikes has remained consistent since the beginning of the year.
Nurses have the strongest public backing, with three in five people surveyed supporting them and three in 10 opposed.
Ambulance workers have similar levels of support, with 58 per cent in favour of strike action and 33 per cent against.