For the first time, some 50,000 junior doctors today began an all-out strike across England to protest a new contract, with the government admitting that it was a "very bleak day" for the country's health service.
The all-out strike is the first in the history of the National Health Service (NHS) as the doctors have also withdrawn emergency services cover, which had been provided in the previous walkouts over the past few months.
UK health secretary Jeremy Hunt described it as a "very, very bleak day" for the NHS, one of Britain's most respected institutions which largely provides free medical care. But Hunt said no union had the right to stop a government trying to act on a manifesto promise.
"The reason this has happened is because the government has been unable to negotiate sensibly and reasonably with the BMA (British Medical Association)," he said.
NHS England said "military level" contingency planning had been carried out to protect urgent and emergency care.
Talks between the UK government and British Medical Association (BMA) broke down in January, prompting the government to announce in February that it would be imposing the new contract by force.
Currently junior doctors are paid more for working "anti-social hours" at night or at the weekend, but under the imposed new contract the Saturday day shift will be paid at a normal rate in return for a rise in basic pay.
The doctors have also warned that the new contract creates unsafe shift patterns as the existing number of doctors within the NHS will have to work extra and longer shifts, which would ultimately risk patient safety.
"No doctor wants to take any action. They want to be in work, treating patients, but by refusing to get back around the negotiating table the government has left them with no choice but to take short-term action to protect patient care in the long term," said BMA junior doctor leader Johann Malawana.
There is a wide public support for the strikers, with passers-by stopping to shake hands with picketing doctors and wishing them luck.
Further all-out strike action is due to take place tomorrow, between the same hours of 8 am and 5 pm local time.
Prime Minister David Cameron's government argues that reforms to junior doctors' contracts are necessary to ensure that the quality of care for patients is as high at weekends as it is during the week.
