A strike by junior doctors in England will continue on Thursday as new figures showed that more than half a million appointments and procedures have been postponed due to industrial action since December.
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Members of the British Medical Association will mount picket lines outside hospitals across the country for the second of a three-day walkout in a long-running row over pay.
The action is expected to lead to tens of thousands more appointments and procedures being delayed. The dispute remains deadlocked, with no talks planned amid a standoff between the BMA and government.
The BMA has urged Prime Minister Rishi Sunak to get involved in talks but it was made clear he is not going to intervene.
Health Secretary Steve Barclay wrote to the BMA, "replying on the prime minister's behalf".
He said: "If you show a willingness to move from your unreasonable position of pay rises of 35% this year, or at least 49% next year, and agreed to pause strikes, I would be ready to continue talks.
"That position remains. If you pause strikes, both ongoing and planned, and show willingness to move significantly, then I will be willing to meet you and the junior doctors committee at your earliest convenience.
"It is only by negotiating in good faith and seeking a reasonable outcome together that we will resolve this dispute."
There is no sign of the BMA changing its demand for a pay rise to make up for a decade of wages falling further behind inflation. A survey by the BMA revealed many junior doctors are planning to quit their jobs over pay and staffing issues.
Junior doctors on picket lines on Wednesday spoke about resigning or emigrating because of the stress of their job.
Julian Hartley, chief executive of NHS Providers, said: "Trust leaders have had to manage a demanding start to what was already going to be a very tough week involving strikes.
"In the days leading up to this walkout, a number of emergency departments were under significant pressure with several reporting record attendances.
"One trust saw over 1,000 people present across their two emergency departments in just one day – hundreds more patients above what's usually considered very high.
"Minor injuries units have also been under stress, with lots of patients with respiratory issues amid rising pollen and pollution levels, as well as dehydration due to the heat.
"Trust leaders' priority is to keep patients safe and deliver high-quality care, but this is becoming increasingly challenging as strikes continue. It's also becoming significantly more expensive due to the cost of covering staff on the picket line.
"More than half a million appointments and procedures have had to be postponed due to industrial action since December, and the chief executive of NHS England today warned this figure will likely rise by tens of thousands this week. ■