Patients have been warned to expect delays in treatment and disruption in hospitals as Britain's doctors voted to go on strike for the first time in nearly 40 years.
The decision to take industrial action over pensions on 21 June was immediately condemned by Andrew Lansley, the Health Secretary.
He said that, even after the changes, a new doctor joining the NHS could expect a pension of more than £53,000 at age 65, and if they worked three years longer they could expect a pension of about £68,000 a year.
Doctors said this failed to take into account the increased contributions they would be expected to make under the new scheme.
Both sides insisted that patient safety would remain paramount but hospital managers warned the 24-hour strike would "impact on care and cause distress and disruption". Some operations are expected to be cancelled along with routine GP appointments.
This is expected to have a knock-on effect as consultations are rescheduled. More stoppages are predicted later in the year with neither side predicting an early end to the dispute.
The decision to strike, announced by the British Medical Association (BMA), was taken after a ballot of members who are furious over the Government's proposed pension reforms. The BMA claims the reforms will result in doctors working longer, paying more in contributions and getting a smaller pension when they retire. They add that the reforms renege on an agreement reached with the Government on pensions four years ago and comes at a time when the overall NHS pension scheme is in surplus.
The Government says doctors have one of the most generous pension schemes in the country, with many retiring on pensions of around £50,000 a year, and that less well-paid NHS workers – who will also lose out under the new scheme – have not chosen to strike, showing that doctors are putting their interests ahead of patients.
Privately, ministers believe the BMA is on the wrong side of public opinion. A source close to Mr Lansley said: "There is no chance of any negotiation at all because if we give way to the doctors then nurses and other far less well-paid staff who are not striking will rightly say you have got to reopen negotiations with us as well. That would bring the whole house of cards down."
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