(Bloomberg) -- Tens of thousands of junior doctors will strike again for four days next month, threatening the worst disruption to England’s struggling National Health Service since a wave of industrial action began in December.

A 96-hour walkout will take place between 7 a.m. on April 11 and 7 a.m. on April 15, the British Medical Association said on Thursday. 

Talks broke down on Wednesday after BMA leaders met Health Secretary Steve Barclay. A spokesperson for the Department of Health and Social Care blamed the BMA for making a 35% pay rise a pre-condition of the negotiations. “That is unreasonable,” the spokesperson said in an emailed statement. “Further strikes will risk patient safety and cause further disruption.”

The BMA argues that junior doctors have suffered below-inflation pay rises for around 15 years. It says “pay restoration” would mean a raise this year of 35%.

The government had “not presented any credible offer and is refusing to accept that there is any case for pay restoration,” according to Vivek Trivedi and Robert Laurenson, co-chairs of the BMA’s junior doctor committee.

In the UK, junior doctors are qualified with a medical degree and are undertaking clinical training, according to the BMA. Many already have years of experience.

The walkout “threatens the biggest disruption from NHS walkouts so far,” according to Saffron Cordery, deputy chief executive at NHS Providers, an organization representing health trusts. She said the timing of the strike, coming immediately after the Easter bank holiday weekend, would add to pent-up demand on the NHS.

QuickTake: Why Strike-Averse Britain Is Gripped by Labor Unrest

Junior doctors walked out in protest over pay for 72 hours in March, but hopes were raised of an end to the dispute when they entered talks this week. 

Unprecedented strikes have rocked the NHS since December. However, ministers made progress last week when several health unions put a new offer to their members. The government has offered a one-off bonus and a 5% pay rise to nurses, midwives and ambulance workers in England in a bid to end months of industrial action.


“We are not going to stop until we are paid what we are worth, and if ministers don’t accept that when we tell them in person, we will have to tell them from the picket line,” the BMA said Thursday in an emailed statement. 

Sarah Abrams, a junior doctor from the UK, told a World Health Organization meeting on Wednesday that she is only 18 months into her training and is already considering alternative careers to the NHS. She said the working conditions are poor and unsustainable and she is regularly looking after two or even three times the patients she should be.

During the Christmas weekend shift just three junior doctors were covering wards of 500 patients and at the end of a stressful shift she was “left crying and sat in a broom cupboard to think about what happened.”

“I regularly go home very late after my shift and I nearly always feel that I haven’t done the best for my patients,” she said. “It’s so disheartening and the exact opposite of the empowering and inspiring role I think being a doctor should be.”

Abrams was speaking in Bucharest, Romania, where countries across Europe adopted a plan to help protect and support health workers, as strikes over working conditions ripple through the region.

Read More: Europe Is Running Out of Doctors and Nurses, WHO Warns

“The health workforce crisis in Europe is no longer a looming threat — it is here and now,” said Hans Kluge, WHO’s regional director for Europe.

(Updates with response from government and comment from NHS Providers.)

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