Prime Minister Keir Starmer has urged resident doctors not to follow their union down the "damaging road" of strike action, which is due to begin on Friday.

Writing in the Times

Resident doctors – the new term for junior doctors – are to start a five-day strike in England at 07:00 BST in a dispute over pay.

The BMA has said it was "very sorry that strikes have become necessary" and they were "something that doctors don't want to have to do".

Sir Keir said the walkouts threatened "to turn back the clock on progress we have made in rebuilding the NHS over the last year".

From August this year, resident doctors will get pay rise of 5.4%, following a 22% increase over the previous two years.

But the BMA said wages were still around 20% lower in real terms than in 2008, even after an increase in August.

The BMA wants pay to be brought back in line with the level it was 17 years ago, when they say their pay started to be eroded.

The prime minister's comments come after Health Secretary Wes Streeting said he deeply regretted the "position we now find ourselves in" in a letter to resident doctors on Thursday.

He said the government could not afford to go further on pay, but he was "prepared to negotiate on areas related to your conditions at work and career progression".

Streeting said the pay deal was "the highest pay award of the entire public sector for resident doctors".

He said that during a series of talks with BMA representatives this month he had outlined three areas he believed "we could work together to make real improvements".

This included tackling the "arduous" training, with him making clear he was prepared to agree actions to reduce costs.

He said improvement was needed on the cost of equipment, food and drink, and he "was prepared to explore how many further training posts could be created".

The strike is going ahead after talks between the government and the BMA broke down on Tuesday.

During five days of negotiations, the two sides discussed extra financial support for resident doctors to cover the cost of exam fees and equipment, as well as faster career progression.

The BMA asked for a scheme to help write off student loans, but the government rejected this.

BMA leader Dr Tom Dolphin said: "We are very sorry that strikes have become necessary and of course if people have emergencies or need urgent care they should still present to the hospital or their GP as usual, as they always would.

"Striking is something that doctors don't want to have to do," he said, adding that the walkouts could have been avoided if "a real pathway" had been made on restoring the "lost value" of pay.

He said the BMA was still open to further discussions about resolving the dispute.

Prof Tim Briggs, a national director at NHS England, said while doctors have a right to strike it should never lead to patient harm.

Senior doctors are being asked to provide cover, but Prof Briggs raised concerns about the impact it would have on both emergency and non-urgent care.

NHS England is aiming to keep the majority of non-urgent care, such as knee and hip operations, going during this strike, which marks a change in approach compared with previous industrial action when such treatment was cancelled en-masse.

The BMA believed this approach was not safe – and said non-urgent care should be cancelled in many cases to ensure emergency services are better covered.

Resident doctors have been involved in 11 strikes in their long-running pay dispute, which have led to the cancellation of more than a million treatments and appointments.

Prof Briggs told the BBC: "We know from the pandemic and the last strike that if you cancel those [non-urgent] patients many have been waiting a significant amount of time, those patients come to harm.

"You cannot decouple elective and emergency care, the two go together."

Meanwhile, NHS managers have also criticised what they say are inflated shift rates being requested by senior doctors to provide cover for striking resident doctors.

Daniel Elkeles, of NHS Providers, which represents health managers, said the strike would be a "crushing blow" for patients.

He said another "huge worry" was the cost, saying the BMA had recommended senior doctors ask for "inflated rates" that were "simply unaffordable".

The BMA had recommended senior doctors insist on premium rates that for consultants can exceed £300 an hour for night shifts.

This can mean they can earn three times what they normally would.

The BMA said doctors needed to be incentivised to take on this extra work.