Health Secretary, United Kingdom, Jeremy Hunt wrote two consecutive letters to Mr Mark Porter, the council chair for British Medical Association to call off the junior doctors strikes on April 26-27, 2016.

Health Secretary asked Mr Porter to meet with him and see that potentially lifesaving care is not withdrawn from the patients as a result of the strike. The second letter was written on April 25, after a phone call to reiterate his offer of talks.

The issue started with the ministries drawing up plans to change the existing contracts with junior doctors in England. The efforts began in 2012 but the talks broke down in 2014. The talks were restarted at the end of 2015 through conciliation service Acas, but no deal was finalized.

The government maintained their stance that the current contracts were ‘unfair and outdated’, and pointed out that they were introduced in 1990s. Ministries announced in February that the new contracts would be imposed from the summer of 2016.

The issue is only confined to England. Wales and Scotland are sticking to the contracts already in place as they do not have financial constraints to ensure seven-day service. Northern Ireland is still undecided.

Currently the junior doctors are paid more for working ‘unsocial hours’ at the weekend or at night, but under the new contract the Saturdays would be paid at the normal rate with a raise in basic pay. The ministries believe that this arrangement is needed to improve care at weekends and would help create a ‘seven-day service’. The BMA is disputing the proposed arrangement.

Hunt acknowledged that there are issues present that are creating discontent amongst junior doctors for many years, but all of these are outside the ‘remit of the negotiations’ they had on the new contracts.

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Mr Porter, in response, has said that the talks are only possible if Jeremy Hunt removes his threat to force the new contract on junior doctors nationwide.

This is the first time that the maternity, A&E, and intensive care services have been hit in a long running dispute.

National Health Services is prepping for the all out strike and believes that the plans they have come up with to ensure care will work. NHS has ‘military level’ contingency plans in place to protect emergency and urgent care.

A website has been set to give details to public about what services would be available in the areas of their residences.

Steps like postponement of an estimated 13,000 routine surgeries and 100,000 appointments to free the staff, cancellation of study leave, recall of staff on holidays, redeployment of consultants, nurses, middle-grade doctors into emergency care, have been taken. General physician’s appointments are kept free for last minute and 111 phone service staff has been increased to handle more phone calls.

Anne Rainsberry for NHS England commented, “Clearly industrial action of this type can put significant pressure on the NHS. We have been working with all hospitals to make sure they have plans in place to provide urgent and emergency care.”

On another front, fourteen of Britain’s Royal Colleges of Medicine have written a letter to the Prime Minister, David Cameron, to end the dispute by starting fresh talks.

The unprecedented effort comes as a result of the threat of first all out withdrawals of medical care in 68 years of NHS history. The signatories urge the prime minister that the dispute poses a threat to the whole healthcare system by demoralizing the junior doctors.

The letter reminds the PM about his commitment to healthcare system and NHS in the past and informed him that they believe demoralizing the people on whom the future of NHS depends is not the right thing to do in this circumstance.

Royal College of Surgeons of England (RCS) and the Royal College of Psychiatrists (RCP) are the only two colleges not involved in the efforts.

No letters from NHS were written to the Health Secretary Jeremy Hunt. Senior doctors have maintained a neutral stance on the situation and have urged both parties to end the ‘stand-off’ and return to the talks.

Two legal actions are in the works by BMA and Just Health, separately against the government.

A research survey by Dr Sethina Watson, trainee anaesthetist in Bristol, has found that more than half of junior doctors are thinking to quit the NHS England in protest. More than 52% have said in the survey that they would definitely or were likely to give up medicine or were considering moving to Scotland, Wales or abroad before August.

In an Ipsos MORI poll, it was observed that 57% of the public supports the all-out strike and 35% people believe both parties are at fault.