PA MediaThe health secretary has said he deeply regrets the “position we now find ourselves in”, in a letter to resident doctors on the eve of their strike action.
Wes Streeting said he does not believe representatives from the British Medical Association (BMA) “engaged with me in good faith” in efforts to stop the strike going ahead.
Resident doctors – the new term for junior doctors – will start a five-day strike in England at 07:00 BST on Friday in a dispute over pay.
The BMA has said it is “very sorry that strikes have become necessary” and that the walkouts are “something that doctors don’t want to have to do”.
In a letter sent on Thursday, Streeting said strike action “should always be a last resort”.
Resident doctors were given an average pay rise of 5.4% by the government, following a 22% increase over the previous two years.
But the BMA said wages were still around 20% lower in real terms than in 2008.
Streeting wrote that the government could not afford to go further on pay, but that he was “prepared to negotiate on areas related to your conditions at work and career progression”.
He said that during talks with BMA representatives between 8 and 19 July, he outlined three areas he believed “we could work together to make real improvements”.
This included tackling the “arduous” training pathway.
“I made it clear that I was prepared to agree actions to reduce the costs you face as a result of training,” Streeting said.
He said another area that needed improvement was the cost of equipment, food and drink, and added that he “was prepared to explore how many further training posts could be created”.
The BMA chose the path that will lead to the “government and the NHS paying for strikes”, rather than improving resident doctors’ working lives, he added.
Prof Tim Briggs, who is a national director at NHS England and has been involved with talks with the BMA on strike planning, said while doctors have a right to strike it should never lead to patient harm – but it is now clear the walkouts by resident doctors will harm patients.
Senior doctors are being asked to provide cover, but Prof Briggs was worried about the impact it would have on both emergency and non-urgent care.
NHS England is aiming to keep the majority of non-urgent care, such as knee and hip operations, going during this strike, which marks a change in approach compared with previous industrial action when such treatment was cancelled en-masse.
The BMA believed this approach was not safe – and said non-urgent care should be cancelled in many cases to ensure emergency services are better covered.
Resident doctors have been involved in 11 strikes in their long-running pay dispute.
They have led to the cancellation of more than a million treatments and appointments.
Prof Briggs told the BBC: “We know from the pandemic and the last strike that if you cancel those [non-urgent] patients many have been waiting a significant amount of time, those patients come to harm.
“You cannot decouple elective and emergency care, the two go together.”
He said that was because cancelled operations can have serious adverse effects on patients both mentally and physically, citing examples of patients facing long waits for a hip replacement and being left on strong painkillers unable to get out of their chair or go upstairs.”
BMA leader Dr Tom Dolphin said: “We are very sorry that strikes have become necessary and of course if people have emergencies or need urgent care they should still present to the hospital or their GP as usual, as they always would.
“Striking is something that doctors don’t want to have to do,” he said, adding that the walkouts could have been avoided if “a real pathway” had been made on restoring the “lost value” of pay.
He said the BMA was still open to further discussions about resolving the dispute.
The strike is going ahead after talks between the government and BMA broke down on Tuesday.
During five days of talks the two sides discussed extra financial support for resident doctors to cover the cost of exam fees and equipment as well as faster career progression.
The BMA asked for a scheme to help write off student loans, but the government rejected this.
Meanwhile, NHS managers have also criticised what they say are inflated shift rates being requested by senior doctors to provide cover for striking resident doctors.
Daniel Elkeles, of NHS Providers, which represents health managers, said the strike would be a “crushing blow” for patients.
He said another “huge worry” was the cost, saying the BMA had recommended senior doctors ask for “inflated rates” that were “simply unaffordable”.
The BMA had recommended senior doctors insist on premium rates that for consultants can exceed £300 an hour for night shifts.
This can mean they can earn three times what they normally would.
The BMA said doctors needed to be incentivised to take on this extra work.
