A British Medical Association survey suggests a majority of doctors would support industrial action over proposed pension reforms.

But the ruling BMA council declined to order an immediate ballot of its 130,000 members until an emergency meeting on 25 February. Instead, it settled for a formal letter to the Government rejecting its latest offer and demanding the reopening of negotiations. It said it would "work up detailed plans on taking industrial action". Last month, the BMA accepted that the Government had made its "final" offer and that talks had gone "as far as they can".

The announcement came as the Royal College of Nursing declared it was moving to oppose the Health and Social Care Bill, citing concerns about privatisation and staffing levels, and the head of the BMA warned of a "perfect storm" heading for the NHS, with rising waiting lists and "impossible" efficiency savings, in an interview in the New Statesman.

The pensions dispute is over changes that will see doctors pay more in contributions, work longer and receive less, in line with Government proposals for all public-sector pensions.

The BMA calculates that a doctor aged 25 today who becomes a consultant will pay more than £240,000 extra over a lifetime and work eight years longer (from the current retirement age of 60 to 68) to receive an annual pension of £70,000. But the average pension in the public sector is about £7,000 and senior doctors know there would be little public support for a BMA-led dispute.

The committee chairman Dr Tom Black said recently: "It's not going to be pleasant and we won't come out looking like knights in shining armour. That's our job, this is the BMA, and our job is to fight for the members."

The last time doctors went on strike was in the 1970s over junior doctors' working conditions. Consultants also worked to rule in protest at a government plan to remove private patient beds from hospitals. The BMA has threatened action several times since but has always stopped short of taking it.

Dr Hamish Meldrum, chairman of BMA Council said: "Forcing doctors to work to almost 70 is one of our most serious concerns as it could put pressure on doctors to work beyond the age at which they feel competent and safe. The Government must urgently reconsider its damaging plans."

But a Department of Health spokesman said: "Under the current scheme, a typical consultant retiring at 60 will receive a pension of £48,000 a year for life. In addition, they will receive a tax-free lump sum of around £143,000 – this equates to a pension pot of over £1.7m in the private sector. This is unsustainable."

* Hospital finances will be assessed by credit-rating agencies, like those that keep downgrading eurozone countries, under plans proposed by Monitor, the NHS regulator. Hospitals that fail to reach minimum levels will lose their licence to operate.

Pensions row: Where the unions stand

Royal College of Nursing To ballot all its members on whether to accept the Government's pension reforms. Result due 28 February.

GMB Still negotiating with local government employers over changes to council workers' pension scheme.

Unite Has rejected proposals on the local government, health and civil service schemes. Consulting members on next move.

Public and Commercial Services Union Has rejected all plans for reforming civil servant pensions. No longer part of talks.

NUT Along with the other teaching unions the NASUWT, UCU and UCAC, it has not "signed up" to the heads of agreement document. Now consulting its members on the next move.

Association of Teachers and Lecturers Along with the ASCL, NAHT and Voice, the ATL is consulting its members on the agreement put forward in December. The result is expected by the end of this month.

Unison Still in negotiations with its executives, and due to discuss next steps today.