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Plans being put in place ahead of junior doctors’ strike in Cumbria

“They were offered a detailed statement and this was rejected for inclusion in the final agreement, so I’m bemused to hear the BMA cite lack of detail on this subject as a justification for the most extreme strike action in NHS history”.

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The extra strike dates come on top of the five days of action announced on Wednesday, which will take place from September 12 to 16.

In May, the two sides met for renewed talks at the conciliation service ACAS and brokered by the Academy of Medical Royal Colleges.

This follows a vote by junior doctors in July to reject the proposed contract, and repeated attempts by the BMA over the past two months to work constructively with the government to address the outstanding areas of concern.

The strike will have an enormous impact on health services, with an estimated “30,000 operations and a quarter of a million out-patient appointments” needing to be cancelled, says the Daily Telegraph.

NHS Confederation chief executive Stephen Dalton also urged the BMA to reconsider the planned industrial action, saying they “don’t think there is a strong mandate for the additional strikes given they go well beyond the initial planned action”.

“And we want to resolve this through co-operation, but you can’t have constructive discussions with an atmosphere of trust when people have made a decision to unleash the most devastating doctors’ strike in NHS history”.

But BMA chairman Dr Mark Porter said: “The council is absolutely behind, as is the rest of the BMA, absolutely behind the decision that has been taken”.

Dr Ellen McCourt, who chairs the BMA junior doctors’ committee, said: “This is not a situation junior doctors wanted to find themselves in”. The dispute revolves around the government’s policy of moving towards a 7-day NHS.

A spokeswoman for Barts Health Trust, which manages Newham University Hospital, said: “The Trust’s overriding priority is to ensure we continue to provide high standards of patient safety and care at all times”.

He said hospitals had only been given 12 days’ notice, “which is much less than we’ve ever had before”.

Support in the past has been strong in Salford for the junior doctors’ plight.

They will have to postpone thousands of routine operations and plan rotas to allow consultants to cover their striking junior colleagues in emergency care.

Mr Hopson, chief executive of NHS Providers, which represents frontline NHS leaders, told BBC Breakfast: “We’re talking about four sets of five days of strikes”.

McCourt, who has become the focus of press attention following the strike announcement, said that the drastic action was being taken as a last resort.

There appeared to be a breakthrough in May in the long-running dispute over proposed changes to contracts, which doctors’ leaders say includes pay cuts for unsociable hours.

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She was asked by John Humphrys: “Is it really proportionate to remove half the doctors in the NHS, not just for a week but on and on and on?”

Why are doctors so against the contract?

Doctors have already gone on strike twice this year, once in January and again in April, after communication with Health Secretary Jeremy Hunt repeatedly broke down.

In the wake of the industrial action Prime Minister Theresa May accused the BMA of failing to put patients first and “playing politics” – something doctors have denied.

The BMA said Mr Hunt could avoid strike action by cancelling imposition of a new contract and agreeing to “meaningful negotiations”.

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How will patients be affected?

Junior doctors to stage first five-day national strike in history