Why junior doctors are going on strike again

Medical unions have announced the first full walkout in the history of the NHS, escalating the row between junior doctors and the government.

Stoppages, including a walkout in A&E departments, will take place between 8am and 5pm on 26 and 27 April. An additional 48-hour strike on 6 April will not hit emergency care.

The long-running dispute over planned new contracts has already led to three days of industrial action, but previous strikes have not affected A&E.

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However, the British Medical Association (BMA) said it had been left with "no choice" but to extend action after the government moved to impose the controversial contracts on doctors.

Both sides accuse one another of refusing to return to the negotiating table. "In refusing to listen to junior doctors' outstanding concerns, the government will bear direct responsibility for the first full walkout of doctors in this country," said Dr Johann Malawana, the BMA's junior doctor leader.

The Department of Health hit back by saying a deal would have been reached if the BMA had agreed to negotiate on Saturday pay "as they promised to do".

The government also warned that patients will "inevitably" be put in harm's way as a result of the "desperate and irresponsible" walkout.

Unions and doctors stressed that emergency cover would still be provided by more senior medics. "It is important to remember that it is only junior doctors that are taking industrial action and so other doctors and healthcare staff will attend work as normal," said the BMA.

However, there is concern that may have knock-on effects in other departments. "Consultants will have to be drafted in from across the hospital to staff emergency care, potentially causing lots of disruption to many routine services," says the BBC.

What is the dispute about?

It stems from government plans to introduce seven-day working throughout the NHS, which ministers say will lead to a better, safer service for patients.

Junior doctors argue that proposed changes to their contracts will mean cuts to pay, especially for work during evenings and weekends, and long working hours that will compromise the safety of both doctors and their patients.

The British Medical Association (BMA) says the contracts are "bad for patients, bad for junior doctors and bad for the NHS" and estimates that junior doctors could face pay cuts of between 15 and 30 per cent as a result.

What does the government say?

David Cameron pleaded with doctors after negotiations stalled in January and warned patient safety could be put at risk. "You cannot have a strike on this scale in our NHS without real difficulties for patients and potentially worse," he said.

Hunt, meanwhile, provoked fury from the BMA after accusing some within the union of political point-scoring and using the strike as an "opportunity to bash a Tory government that they hate". He has since said he will force the contracts on all junior doctors from 1 August.

What do doctors say?

Medics insist the walkout is not about pay or politics but simply about protecting both patient and doctor safety. "We are not asking for a pay rise," Dr Bishakha Chowdhury told the Daily Mirror. "But we are asking for the people with the purse strings to listen to us, talk to us to try and sustainably save the pride of Britain and the envy of the world - the NHS."