LONDON: Junior doctors in England will begin a six-day walkout on Wednesday, the longest strike in the state-run National Health Service's (NHS) 75-year history which is set to hit patient care during its seasonal winter peak in demand.

Like in other key sectors over the past year, junior doctors represented by the British Medical Association (BMA) have staged a series of walkouts in demand of better pay in the face of soaring inflation.

Cumulatively, the NHS, which has provided healthcare free at the point of use since it was founded in 1948, cancelled 1.2 million appointments in 2023 due to strikes.

The BMA abandoned talks with the government after being offered a pay rise of 8-10%, and held strikes on Dec. 20-23. The union is seeking a 35% improvement which it says is needed to cover the impact of inflation over several years.

The government, which has agreed new pay deals with other healthcare workers, including nurses and senior doctors in recent months, has resisted hikes it says would worsen inflation.

The strikes threaten to increase the pressure on the health service where over 7.7 million patients are on waiting lists for procedures and appointments.

"This January could be one of the most difficult starts to the year the NHS has ever faced," NHS National Medical Director Stephen Powis said in a statement.

"The action will not only have an enormous impact on planned care, but comes on top of a host of seasonal pressures such as covid, flu, and staff absences due to sickness."

Junior doctors are qualified physicians, often with several years of experience, who work under the guidance of senior doctors and represent a large part of the country's medical community.

A spokesman for Prime Minister Rishi Sunak said deals with other healthcare workers' unions showed that the striking junior doctors were "outliers".

"We have sought to come to a fair resolution - fair for the taxpayer, fair for hardworking doctors and health workers. We have achieved that in the majority of cases ... we are willing to have further discussions. But obviously the first thing to do is to stop striking," he told reporters.

The BMA said a record waiting list and underinvestment over the past decade had undermined the NHS.

"As a profession we are exhausted, disenchanted, and questioning whether we want to stay in the health service at all. Add to this years of pay erosion, and it’s no wonder that morale on the frontline has never been lower," the union said.