Junior doctors across England began their fourth strike on 6 April as the dispute over new NHS contracts continues. Health bosses have warned that more than 5,000 procedures and operations have been postponed because of the 48-hour-long walkout.

The industrial action, which started at 8am BST, comes after the British Medical Association (BMA) and Department of Health failed to find a resolution to the pay and conditions row. Around 45,000 medics are expected to take part in the protest, which will see junior doctors only provide emergency care.

The BMA has blamed the government for the strike after Health Secretary Jeremy Hunt said he would impose the new contracts on the junior doctors.

"By pursuing its current course, the government risks alienating a generation of doctors," said Dr Johann Malawana, the junior doctor committee chair of the BMA.

"If it continues to ignore junior doctors' concerns, at a time when their morale is already at rock-bottom, doctors may vote with their feet, which will clearly affect the long-term future of the NHS and the care it provides.

"Responsibility for industrial action now lies entirely with the government. They must start listening and resume negotiations on a properly funded junior doctor's contract to protect the future of patient care and the NHS."

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But the Department of Health branded the walkout as "irresponsible and disproportionate" and urged the BMA to get back around the negotiating table.

"If the BMA had agreed to negotiate on Saturday pay, as they promised to do through Acas in November, we'd have a negotiated agreement by now," a spokesperson for the ministry added.

"We ask doctors to look at the detail of the contract and call on the BMA to cancel their plans to escalate strike action even further."

The union has warned its members plan to stage a total walkout between 8am and 5pm on 26 April, and again on 27 April. The action would see the NHS medics refusing to take part even in emergency care.