Junior doctors in England are in an all-out strike for the first time in the nearly 70-year history of the National Health Service (NHS) after a dramatic escalation in a long-running dispute with the government over a new contract.
Recent medical school graduates right through to doctors who have been working for well over a decade, walked out from all services including accident and emergency, maternity and intensive care.
NHS England said "military level" planning had gone into making sure that patients in need of urgent care would be properly treated, with more senior doctors known as consultants on hand to provide essential services.
NHS provides all types of medical care for free to everyone in Britain. It was created in 1948 and it is funded by taxpayers. The system is considered a pillar of national unity, which has made the labour dispute emotive not just for junior doctors but for many members of the public.
The government plans to impose a new contract on junior doctors from this summer after months of talks to agree on changes in pay and working hours broke down in January.
According to the new contract patients will access services and good care seven days a week,
However the doctors opposes, as they don’t want to work for longer hours at anti-social times.
NHS England said some 13,000 elective operations and 113,000 outpatient appointments had been cancelled to free up consultants to provide urgent care during the strike.
The strike will continue on Wednesday.
"TIRED DOCTORS MAKE MISTAKES"
Junior doctors make up one third of the medical workforce, as their number reaches 55,000.
NHS services in Scotland, Wales and Northern Ireland, which are managed separately from England, were not affected by the strike.
"None of us wants to strike. We'd all rather be caring for patients at work, but unfortunately we feel this is the only option available to us," said Joe Mayhew, a striking junior doctor outside St Thomas's Hospital in central London.
Health Secretary Jeremy Hunt, who has been leading the government's efforts to bring in the controversial new contract, told the BBC it was a "very, very bleak day" for the NHS and accused the junior doctors of refusing to negotiate sensibly.
The strike is the fifth by junior doctors since the dispute began last year, but during the four previous ones only non-urgent services were affected.
Opinion polls have consistently shown that most members of the public blamed the government for the dispute, although the latest Ipsos MORI poll suggested the all-out strike may have eroded support for the junior doctors to an extent.
The poll found that 57 percent of people supported the strike, down from 65 percent ahead of a strike in March.
The new contract increases junior doctors' basic pay but increases working hours and reduces anti-social hours when they can attract additional pay.
For example, junior doctors will no longer be paid extra for daytime work on Saturdays.
Hunt says these new arrangements will enable the government to fulfill a campaign promise to deliver "a truly seven-day NHS".
The doctors say they already do work seven days a week and the new arrangements will damage morale and endanger patient safety.
"Tired doctors make mistakes" has been one of the slogans on the picket lines.