Junior doctors in England are to stage more strikes in December and January after talks between the Government and British Medical Association (BMA) broke down.
Junior doctors will walk out for nine days in total - from 7am on December 20 to 7am on December 23, and from 7am on January 3 to 7am on January 9 - the BMA announced on Tuesday.
The strike in January is six full days – thought to be the longest single period of industrial action in the history of the health service, the union said.
Ministers and representatives from the BMA have been locked in negotiations for five weeks, trying to find a resolution to the pay dispute.
But the BMA said the Department of Health and Social Care (DHSC) has not been able to put forward a "credible" offer to end the industrial action.
After the strikes were announced on Tuesday, Health and Social Care Secretary Victoria Atkins said the Government would “immediately look to come back to the table” if the junior doctors’ strikes were called off.
She warned the walkouts will put extra pressure on the NHS during the busy winter period and “risk patient safety”.
Hospital leaders said the breakdown of talks is the outcome they were “dreading” and warned that the strikes will “undermine efforts to cut waiting lists” – one of Prime Minister Rishi Sunak’s key priorities.
Junior doctors were offered a three per cent rise on top of the average 8.8 per cent increase they were already given in the summer.
But the BMA said the money would have been split unevenly across different doctor grades and would “still amount to pay cuts for many doctors”.
BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said: “We have been clear from the outset of these talks that we needed to move at pace and if we did not have a credible offer, we would be forced to call strikes. After five weeks of intense talks, the Government was unable to present a credible offer on pay by the deadline.
“Instead, we were offered an additional 3%, unevenly spread across doctors’ grades, which would still amount to pay cuts for many doctors this year. It is clear the Government is still not prepared to address the real-terms pay cut doctors have experienced since 2008.
“It is a great shame that even though the approach was more constructive, there was not enough on offer to shape a credible deal, which we hoped would end the dispute. Without enough progress by the deadline, we have no choice but to take action that demonstrates doctors are as determined as ever in reversing their pay cuts.
“However, we can still avoid the need for these strikes. We will be ready and willing any time the Government wants to talk. If a credible offer can be presented the day before, or even during any action, these strikes can be cancelled."
They said the approach from Health Secretary Victoria Atkins and her team "has been productive but ultimately that alone is not sufficient to make up for 15 years of declining pay".
“A year after our dispute started, we are still too far from turning the tide on plummeting pay, morale, and retention of doctors," they added.
"Rather than waste more time and money and have further disruption to patient care, the Health Secretary needs to make a credible offer now.”
Health and Social Care Secretary Victoria Atkins said the Government would “immediately look to come back to the table” if the junior doctors’ strikes were called off.
“It is disappointing that despite significant progress the BMA junior doctors committee have walked away from negotiations and declared new strikes, which will result in more disruption for patients and extra pressure on NHS services and staff as we enter a busy winter period, risking patient safety,” she said in a statement.
“I have been clear that I respect the work of doctors in training and want to work with them to settle this dispute.
“We have agreed a fair and reasonable offer with the BMA’s consultants committee which is being put to members for vote following constructive talks.
“If the junior doctors committee call off their strikes, we will immediately look to come back to the table to continue negotiations.”
Commenting on the announcement, Sir Julian Hartley, chief executive of NHS Providers, said of the strikes: "This is the outcome that trust leaders were dreading.
“This will be the longest strike in NHS history during the busiest and toughest time of the year for the NHS.
“These strikes will undermine efforts to cut waiting lists further, they’ll have a serious knock-on effect on services right across the NHS, and they’ll impact the quality of care for patients.
“The planning starts now to minimise the impact of this industrial action and safety will be the overarching priority. But, as we have seen with previous walkouts, patients will once again pay the price through renewed delays and disruption.
“We know this walkout will be especially hard for trusts to manage, given lots of staff will have annual leave booked over the festive period.
“Strikes have cost the NHS more than £1.3 billion already and more than one million delayed patient appointments. The strikes announced today will only add to the toll.
“It isn’t too late for the Government and unions to sort out this dispute and to prevent more strikes. Trust leaders hope the walkouts will be avoided.”
Consultant doctors from the BMA have reached a deal with the Government which will see consultants earn more money from January 2024, although it will not be paid until April 2024.
England’s top hospital doctors are now voting on the deal, which would see them get a pay rise of between six and 19.6 per cent.
Talks with specialist, associate specialist and specialty doctors (SAS) in England are continuing.