Junior doctors are to be balloted on industrial action next month in a row with the Government over contracts, the British Medical Association (BMA) has said.
After negotiations broke down despite a series of letters between the BMA and Health Secretary Jeremy Hunt, the union said it had not taken the decision "lightly". Junior doctors across England will be balloted for industrial action - which could include strikes - from Thursday November 5 to November 18.
Dr Johann Malawana, BMA junior doctor committee chair, said: "This is not a decision that we have taken lightly but 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."
The Government has said it plans to impose a new contract on junior doctors, up to consultant level, next summer.
The contract will reclassify doctors' normal working week to include Saturdays and up to 10pm every night of the week except Sunday.
Medics argue they will lose out financially as evenings and Saturdays will be paid at the standard rate rather than a higher rate.
They say this amounts to pay cuts of up to 30%.
Mr Hunt has indicated to the BMA that he will consider extending the current proposals so that more working hours on a Saturday could be paid at a higher rate.
But the BMA argues that Mr Hunt has failed to offer any guarantees on key issues such as pay and protection for doctors who wish to work less than full-time or take parental leave.
If the outcome of the ballot on industrial action is in favour, the BMA will then discuss what form of action it might take.
Dr Malawana said: "The Health Secretary has accused junior doctors of misleading the public over the impact of his changes, yet at the same time he continues to conflate junior doctors' legitimate concerns and the Government's rhetoric on seven-day services.
"The truth is that the junior doctor contract is in no way a barrier to seven-day services, with the vast majority of junior doctors routinely providing care to patients 24/7.
"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.
"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."