NHS England is facing a walkout as junior doctors are being balloted for strike action from Thursday 5 November to protest at changes to their contracts from August 2016. The British Medical Association (BMA) is organising industrial action after talks with NHS employers about the new contracts terminated without result.

Health secretary Jeremy Hunt has come under fire for the proposed changes but the government is arguing that the changes are necessary for a seven-day-a-week NHS.

The BMA said that the pay cut of up to 40% for junior doctors and the extension of working hours to Sundays and evenings is a threat to the NHS and to patients' safety as well. Junior doctor committee chair Johann Malawana said that the strike decision had not been taken lightly.

"The government's refusal to work with us through genuine negotiations and their threat to impose new contracts that we believe are unsafe for patients and unfair for doctors, leaves us with few options," Malawana said. "The BMA has been clear that it wants to deliver a safe and fair contract for junior doctors and the patients they care for. Instead of genuine negotiations, the government has insisted that junior doctors accept recommendations without question.

"This is unacceptable and would not have allowed the BMA to negotiate over proposals we believe are unsafe for patients, unfair for doctors and undermine the future of the NHS."

Hunt has accused the BMA of misleading the public over the government's stance and the impact the contract changes would have. The BMA said that the situation at the moment already sees many junior doctors looking after passengers "24/7".

The health secretary has also said that the department only wants to make changes to the system which forces hospitals to employ three times less staff during weekends than during the week. Hunt has claimed that people are 15% more likely to die if they are admitted to the hospital on a Sunday.

The changes proposed by Hunt are aimed at saving the NHS £22bn ($34bn) as the government clamps down on the deficit. The NHS is feared to report a £2bn full year loss over 2015, as spending continues. Trainee doctors are paid less than £23,000 a year and wages can go up to £30,000 after four years of experience.

Caroline Lucas, the only Green Party MP, set up a petition on Monday (19 October) protesting the plans, in cooperation with the BMA.

"Until the government lifts the threat of contract imposition and gives the BMA the concrete assurances we require we will continue with the action junior doctors are demanding," Malawana said. "The time is well overdue for ministers to listen to what junior doctors are telling them."

The MBA is asking for the proper compensation for working unsocial hours and is demanding that junior doctors working less than full time will not be negatively impacted by the changes when it comes to taking up parental leave.