Thousands of junior doctors in England will start voting on Monday on whether to strike over pay in the latest outbreak of industrial unrest sweeping the country.

Around 45,000 members of the British Medical Association (BMA) are being balloted, with the result due at the end of February.

The BMA has told the Government if there is a yes vote, junior doctors will begin their action with a 72-hour “full walkout” in March.

It urged the Health Secretary to meet doctors and negotiate a solution to avoid strikes.

The association said Steve Barclay is the first Health Secretary for over 50 years to continue to “ignore” all invitations from the BMA to meet doctors to discuss their pay, making attempts to find a negotiated settlement “virtually impossible”.

When we are faced with such resolute ongoing silence and there is no agreed settlement on the table, then we are left with no choice but to act

The BMA said successive governments have overseen 15 years of real-terms pay cuts for junior doctors in England, which amounts to a “staggering and unjustifiable” 26.1% decline in pay since 2008/09.

The BMA said patients are suffering and exhausted staff are burning out and leaving the NHS and yet the Government “fails to see the crisis in front of it”.

Ministers are accused of ignoring all the evidence to the contrary and preferring to treat the public as “fools” with assurances the NHS has all the resources it needs.

The Government’s door is “firmly shut to dialogue”, let alone talks, so there is no option left other than to ballot junior doctors in England for strike action, the BMA said.

Dr Vivek Trivedi and Dr Robert Laurenson, co-chairmen of the BMA junior doctors committee, said: “The Prime Minister says his door and that of the Health Secretary are ‘always open’.

“But after more than a decade of pay cuts, no offer to restore our pay has been made and all our calls to meet and letters to the Health Secretary and his immediate predecessors have been ignored.

When even the pay review process – broken as it is - is telling ministers to act, you know something has gone seriously wrong

“When we are faced with such resolute ongoing silence and there is no agreed settlement on the table, then we are left with no choice but to act.

“Junior doctors are not worth a quarter less than they were 15 years ago nor do they deserve to be valued so little by their own Government. Pay erosion, exhaustion and despair are forcing junior doctors out of the NHS, pushing waiting lists even higher as patients suffer needlessly.

“The Government’s refusal to address 15 years of pay erosion has given junior doctors no choice but to ballot for industrial action. If the Government won’t fight for our health service then we will.

“It is particularly galling for junior doctors to see the Government repeatedly justify huge real-terms pay cuts for NHS staff by claiming that these have been made by so-called ‘independent’ pay review bodies free from government interference.

“The reality is that the doctors’ pay review body has been constrained by political interference for more than a decade. Even after recommendations have been made to increase junior doctors’ pay, the Government has completely ignored them and has asked the pay review body to completely exclude junior doctors from its recommendations.

“When even the pay review process – broken as it is – is telling ministers to act, you know something has gone seriously wrong.”

Junior doctors will not provide emergency care during any strike, the BMA said, adding trusts will need to arrange emergency cover to ensure patient safety.

Should junior doctors vote for industrial action, trust leaders will do everything they can to minimise disruption and prioritise the safe delivery of care and services for patients

“We will be giving trusts and the Government enough notice to prepare for this. This is to ensure that patients whose appointments are cancelled know well in advance and to ensure that employers can manage their medical rotas appropriately to ensure emergency care is no different to any other day,” the BMA said.

The ballot will open ahead of fresh strikes in the coming weeks by ambulance staff and nurses over pay and staffing.

Miriam Deakin, director of policy at NHS Providers, said: “The announcement by the BMA that junior doctors could begin their action with a 72-hour full walkout in March, with no emergency cover if a ballot is successful, is deeply worrying.

“Should junior doctors vote for industrial action, trust leaders will do everything they can to minimise disruption and prioritise the safe delivery of care and services for patients.

“Trust leaders are very concerned about the possibility of prolonged or co-ordinated strike action by health unions in the coming months.

“They also understand the factors that have driven junior doctors and other healthcare workers to ballot on industrial action.

The Health and Social Care Secretary has been clear that supporting and retaining the NHS workforce is one of his key priorities, and that includes our hardworking junior doctors. Our multi-year pay deal with the British Medical Association is increasing junior doctors' pay by a cumulative 8.2% by March 2023

“We are reiterating our plea to both the Government and union leaders to get around the table and find an agreed solution, including on pay, as soon as possible. Prolonged action is something everyone wants to avoid.”

A Department of Health and Social Care spokesman said: “We have been clear that supporting and retaining the NHS workforce is one of our key priorities and that includes junior doctors.

“The multi-year pay deal with the British Medical Association is increasing junior doctors’ pay by a cumulative 8.2% by March 2023.

“We have also invested an additional £90 million to provide the most experienced junior doctors with higher pay, increase allowances for those working the most frequently at weekends and increase rates of pay for night shifts.

“The Health and Social Care Secretary wants to have an honest conversation with unions – including the BMA – about what is affordable in pay settlements for next year during these challenging times, and has invited them to discuss as soon as possible.”

In 2019, the Government and BMA agreed a multi-year pay deal for doctors and dentists in training.

That ends in March and the Government believes the upcoming pay round is the appropriate time to discuss pay.