NHS doctors could go on an unprecedented three-day strike after their pay was slashed under the Tories.
The British Medical Association has announced junior doctors in England will strike for 72 hours in March if they vote in favour of industrial action.
The ballot begins on Monday but the BMA has urged Health Secretary Steve Barclay to meet with doctors and negotiate a solution to avoid strikes.
NHS leaders have expressed concern that the BMA will not provide “emergency cover” during the latest strike as the NHS buckles following the Covid pandemic and a decade-long funding squeeze.
It is the longest NHS strike yet announced as the Tories refusal to talk pay has sparked ongoing disputes with workers, including unprecedented national action by nurses and ambulance workers in January.
The BMA says junior doctors, who start on salaries of between £25,000 and £30,000, have seen real terms pay cut by 26.1% since 2008/09.
Dr Vivek Trivedi and Dr Robert Laurenson, co-chairs of the BMA junior doctors committee, said in a statement: “The Prime Minister says his door and that of the Health Secretary, are ‘always open’, but after more than a decade of pay cuts no offer to restore our pay has been made, and all our calls to meet, and letters to the Health Secretary and his immediate predecessors, have been ignored.
“When we are faced with such resolute ongoing silence, and there is no agreed settlement on the table, then we are left with no choice but to act.
"Junior doctors are not worth a quarter less than they were 15 years ago nor do they deserve to be valued so little by their own Government.
"Pay erosion, exhaustion and despair are forcing junior doctors out of the NHS, pushing waiting lists even higher as patients suffer needlessly.
"The Government's refusal to address 15 years of pay erosion has given junior doctors no choice but to ballot for industrial action.
"If the Government won't fight for our health service, then we will."
There are around 80,000 junior doctors in the NHS.
They can typically remain ‘junior’ for 8-20 years, and this may be extended by doing research towards a higher degree.
The Government has put junior doctors on a multi-year contract lasting from 2019 to 2023, separate to the rest of the NHS workforce.
It insists over the course of this contract junior doctors will have seen a 8.2% uplift, before inflation. It insists the end of the contract is the “appropriate time” to discuss pay.
However the BMA says the latest 2023 uplift is just 2% - at a time when annual inflation is currently 10.7%.
Miriam Deakin, director of policy at NHS Providers said: "The announcement by the BMA that junior doctors could begin their action with a 72-hour full walkout in March, with no emergency cover if a ballot is successful, is deeply worrying.
"However, the ballot for industrial action by junior doctors is yet to open and it's important not to pre-empt the outcome.
"Should junior doctors vote for industrial action, trust leaders will do everything they can to minimise disruption and prioritise the safe delivery of care and services for patients.
"Trust leaders are very concerned about the possibility of prolonged or co-ordinated strike action by health unions in the coming months.
"They also understand the factors that have driven junior doctors and other healthcare workers to ballot on industrial action.
"We are reiterating our plea to both the Government and union leaders to get around the table and find an agreed solution, including on pay, as soon as possible.
"Prolonged action is something everyone wants to avoid."
The Government-appointed Doctors' and Dentists' Remuneration Body (DDRB) - which advises the Government on pay - suggested a ‘betterment’ clause to the multi-year deal allowing for exceptional circumstances such as inflation, but this was ignored.
The BMA statement continued: "It is particularly galling for junior doctors to see the government repeatedly justify huge real terms pay cuts for NHS staff by claiming that these have been made by so-called 'independent' pay review bodies, free from government interference.
"The reality is that the doctors' pay review body has been constrained by political interference for more than a decade.
"Even after recommendations have been made to increase junior doctors' pay, the Government has completely ignored them and has asked the pay review body to completely exclude junior doctors from its recommendations.
"When even the pay review process, broken as it is, is telling ministers to act, you know something has gone seriously wrong."
Junior doctors went on strike in 2016 after then-Health Secretary Jeremy Hunt imposed contract changes that altered their working conditions.
This escalated into a bitter dispute but included only four single-day strikes. Only one of these saw emergency care also withdrawn as well as routine care.
The March strike which includes emergency care would be the first ever three-day action by junior doctors.
The BMA said it was providing notice of the strike well in advance “to ensure that patients whose appointments are cancelled know well in advance and to ensure that employers can manage their medical rotas appropriately to ensure emergency care is no different to any other day”.
The BMA represents 45,000 junior doctors in England.
A spokeswoman for the Department of Health and Social Care spokesperson said: “The Health and Social Care Secretary has been clear that supporting and retaining the NHS workforce is one of his key priorities, and that includes our hardworking junior doctors.
“Our multi-year pay deal with the British Medical Association is increasing junior doctor’s pay by a cumulative 8.2% by March 2023. We have also invested an additional £90 million to provide the most experienced junior doctors with higher pay, increased allowances for those working the most frequently at weekends, and increased rates of pay for night shifts.
“There are record numbers of staff working in the NHS, and we are committed to publishing a comprehensive workforce strategy next year.”
