Patients and the NHS will ‘be hurt’ as junior doctors walk out on Tuesday morning for the start of a 96-hour strike, a senior medic has warned.

Tens of thousands of staff represented by the British Medical Association (BMA) are expected to walk out over a pay dispute with the Government, forcing the cancellation of up to 350,000 appointments and operations. The estimate is considerably higher than the 250,000 forecast last week.

Both sides of the disputes have faced increasing demands in recent days to return to negotiations rather than allow the strike to go ahead.

The BMA, which represents 47,000 junior doctors, said it was not too late for ministers to bring forward a “credible” pay offer to suspend the action but the government has said the demand for a 35 per cent rise needs to be lowered to a “realistic” level for talks to resume.

“The reality is, this is going to hurt,” Dr Peter Carter, a former chief executive of the Royal College of Nursing, said of the strike.

“It’s going to hurt the NHS… It’s going to hurt patient care. There’s no other way of dressing this up.”

Dr Carter, a former NHS trust chief executive of 12 years who is now an independent healthcare consultant, sympathised with the position of his colleagues ahead of the strike.

He urged the government to restart negotiations with the BMA: “As much as I think the 35 per cent [pay] rise [demand] is unrealistic, if I was advising the Government, I’d be saying open the door, get in, have talks.

“At some stage, both parties are going to have to sit down and see if there’s room for manoeuvre. It’s actually a very sad, sad state of affairs that we’ve found ourselves in… I could never have envisaged junior doctors going on strike for four days, but we are where we are and there are going to be consequences for this.”

The strike will run from 6:59am on Tuesday 11 April until 6:59am on Saturday 15 April. With health staff already on leave because of the Easter bank holidays and school holidays, combined with the length of the strike, this action is set to be one of the most disruptive in NHS history.

In a message to Health Secretary Steve Barclay, co-chairs of the BMA junior doctors committee, Dr Vivek Trivedi and Dr Rob Laurenson, said: “We say to him, ‘Put an offer on the table today, a credible one that truly demonstrates you are serious about addressing junior doctors losing more than 26 per cent of their pay in real terms. An offer which can form the basis of negotiation and lead to the suspension of [the] action.’

“It is not too late to avert four days of strike action, but the onus is on Mr Barclay to do more than write letters and talk about a desire to ‘rapidly’ end this dispute.

“So far that offer is not forthcoming; the clock is ticking Mr Barclay. We are ready to get round the table, so make a credible offer to start negotiations and stop [the] strikes.”

As part of preparations for the strike, health trusts have drafted in GPs, pharmacists, matrons and other healthcare staff to help keep hospitals running.

However, pharmacists have said they are too overworked to plug all the gaps caused by the junior doctors’ strike.

Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies, said: “For years pharmacies have been underfunded and under resourced because of the poor decisions made by NHS bosses, our sector is currently fighting for its survival – we have no capacity to step in and help whilst junior doctors are on strike.

“This is yet another poorly thought through plan by the decision makers and NHS bosses who seem to be remote from the reality.”

Dr Hannbeck’s view was echoed by Thorrun Govind, chair of the Royal Pharmaceutical Society, who told i: “Given that pharmacists and their teams are experiencing burnout due to perpetual underfunding of the system, it’s surprising to hear how this scheme will actually occur.

“Ultimately this comes down to the Government being shortsighted and failing to recognise the important role that pharmacists have in community, and they are not a substitute for other healthcare professionals, but are there to complement and work with other healthcare professionals.”

She said pharmacists worked incredibly hard already, adding: “We simply cannot take on additional roles and our teams cannot suffer due to an underfunded system that fails to value healthcare workers.”

According to The Times, GPs are being offered up to £200 an hour, twice the normal rate, to help A&E wards during the strike.

Matthew Taylor, chief executive of the NHS Confederation, which speaks for the whole healthcare system, said the likely impact of the strike is “heartbreaking” and called on both sides to end their “battle of rhetoric”.

He said there is “no question” this strike will be more disruptive than the 72-hour walkouts by NHS staff last month, which led to 175,000 cancelled appointments.

Up to 350,000 appointments and operations could be cancelled this time, he said. Previously the NHS Confederation has said it expects about 250,000 to be cancelled.

Mr Taylor told BBC Breakfast: “It’s depressing that there seems to be no movement at all from the two sides of this dispute over the last few days.

“We should consider asking the Government and the trade unions to call in Acas, the conciliation service, to provide some basis for negotiations, because if anything the positions seem to have hardened over the last couple of days.”

In a separate interview with Sky News, he warned the “strikes are going to have a catastrophic impact on the capacity of the NHS to recover services”.

“The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid.

“That’s a tough thing to do at the best of times, it’s impossible to do when strikes are continuing.”

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