More strike action could take place in the summer if the next government does not move forward negotiations with junior doctors in a “timely manner”, medics warned as they started a five-day walkout across England.

The British Medical Association (BMA) said it stands ready to talk and the union has already had some discussions with the Labour Party.

Junior doctors said shadow health secretary Wes Streeting has promised talks on July 5 if the party wins the General Election.

Sir Keir Starmer said he would open discussions with junior doctors on day one of a Labour government if he is elected on July 4.

The Labour leader told reporters during a campaign visit to Staffordshire: “I don’t want these strikes to be going ahead.

“This is a problem the Government has failed to deal with, and if we’re elected into government we will have to pick it up. What we will do is ensure on day one we start the discussion.”

The BMA’s junior doctors committee said Mr Streeting’s remark that raising pay would be a “journey and not an event” align with their pay restoration goals.

Health leaders have implored the next government and junior doctors to “reset industrial relationships and prevent any more walkouts”, saying that strikes “can’t become business as usual for the NHS”.

Junior doctors in England have said their pay has been cut by more than a quarter over the last 15 years and have called for a 35% increase.

But Mr Streeting has said he would not meet the 35%, saying that if he gave in to the demand then “any trade union worth their salt” would come back the following year with the same request.

He has said there is “space for a discussion” on pay, as well as negotiations on how to improve working conditions for medics in training.

Senior BMA members have conceded the union had not pushed enough over the last 15 years, saying they had pinned their hopes on the independent pay review body, which sets the pay of doctors.

They praised the “WhatsApp generation” for their determination and ability to mobilise “instantaneously” using the messaging app.

Junior doctors industrial action
Junior doctors, joined by a Just Eat delivery courier (right), on the picket line outside St Thomas’ Hospital in London (Jordan Pettitt/PA)

The latest walkout marks the 11th strike by junior doctors in England since their dispute began some 20 months ago.

NHS leaders have raised concerns about the “major disruption” the strike will cause in the aftermath of a heatwave which prompted a yellow “heat-health alert” across much of the country.

Junior doctors said they would call off the strike if Prime Minister Rishi Sunak made a credible commitment to restore their pay.

“We were hoping that maybe this would allow him to see how this could be a mutual win for both,” said Dr Vivek Trivedi, co-chairman of the BMA’s junior doctors committee.

He said the current strike mandate ends on September 19, adding: “If talks do not move in a timely manner, then of course our members would expect us to call for strike action.

“We have had three 98% ‘yes’ votes to our ballots for industrial action to restore their pay because they know, unfortunately, words don’t mean anything unless it’s written down and action is taken to achieve something.”

Asked about talks with Mr Streeting, committee co-chairman Dr Robert Laurenson said: “He is talking about things like ‘journey, not an event’ – we’re happy to have a multi-year pay deal. He has seemingly heard that and (his remark of) ‘journey not an event’ matches that.”

Dr Trivedi added: “The main thing that I’ve taken away from discussions is that there does seem like there is a willingness to try and at least engage in constructive and meaningful (talks).”

The BMA’s chairman of council, Professor Philip Banfield, said: “It’s got to a point where doctors felt completely disempowered and what has happened is the juniors have got together and power of social media and WhatsApp, they started talking to each other and saying ‘You know what, enough is enough’.

“The junior doctors are really good at communicating with each other via WhatsApp and that has been the key to the success of their strike action because the junior doctors committee can talk almost instantaneously with their membership – they can talk to 50,000 people really quickly and get instant reports back. I’d love to have an organisation that actually can do that.

“You’ve seen industrial action now go on for well over a year. It’s incredibly disappointing that this has gone this far.”

He added: “We have met with Labour several times over the last two years – we haven’t always agreed, we’ve had disagreements. So, do I expect the conversation to take place? Yes. Do I expect that conversation to be one that is easy or tough? It’ll be a tough conversation.”

Prof Banfield said Mr Sunak’s Government “felt that although there was a probably a deal to be done with consultants and specialist doctors, that the junior doctors weren’t interested in a deal at all”.

“It just has felt as if Government has wanted to do a deal with consultants first, which has cost them a considerable amount of money, then done the specialists and they’ve just procrastinated over the juniors.”

Sir Julian Hartley, chief executive of NHS Providers, said: “We can’t go on like this. Strikes can’t become ‘business as usual’ for the NHS and patients.

“It’s vital that the next government and junior doctors reset industrial relationships and prevent any more walkouts.

“Preparing for strikes, keeping patients safe throughout them and having to rebook thousands of treatments takes an enormous amount of time.

“Failure to resolve the dispute means more disruption for patients and staff, with more operations, scans and other care postponed on top of the 1.5 million already hit by industrial action across the NHS.”

Siva Anandaciva, chief analyst at The King’s Fund think tank, said: “An immediate challenge facing the next government will be resolving industrial action in the NHS which has lasted for well over a year now.

“It is difficult to comprehend how either the Conservative Party or the Labour Party can deliver on their manifesto commitment to recover NHS performance over the next parliament without first ending the dispute.”

Junior doctors industrial action
Jeremy Corbyn (left) joins junior doctors on the picket line outside St Thomas’ Hospital in London (Jordan Pettitt/PA)

Junior doctors make up half of the medical workforce and their last walkout in February led to 91,048 appointments, procedures and operations being cancelled.

The strike started at 7am on June 27 and ends on July 2, two days before voters go to the polls.

NHS leaders have said people should continue to use 999 in life-threatening emergencies and NHS 111 – on the NHS app, online, or by phone – for other health concerns.

Health Secretary Victoria Atkins said: “Last year, the Government accepted the recommendations of the independent pay review bodies in full, which saw junior doctors receive a pay rise of between 8.1% and 10.3%. This was the most generous workforce settlement in the private sector.

“There is Cabinet Office guidance determining what is appropriate Government behaviour during the pre-election period. In line with the guidance, it would not be appropriate for Government to make a pay offer. The BMA know this but have refused to call off the strikes.

“The deals brokered with the consultant and SAS doctors committees show that we will always act in good faith to end disputes. Before the election was called, we had entered into negotiations with the junior doctors’ committee overseen by an external mediator.

“We commit to getting back into the negotiating room immediately after the election and seek to reach a similar resolution with junior doctors.”

It comes as a leading think tank published data showing how much is spent on health by leading EU countries.

The UK falls behind Ireland, Belgium, Denmark, Sweden, Luxembourg, France, Austria, the Netherlands and Germany when it comes to health spending.

Indeed in 2022, Germany spent 55% more on health per head of population than the UK and France spent 26% more, according the Health Foundation’s analysis of OECD data.

Toby Watt, lead economist at the Health Foundation, said: “The main political parties have said they want to fix the NHS, yet the funding they have so far promised falls well short of what is needed.

“This latest data from OECD show the UK is in the lower half of the EU14 when it comes to spending on health.”