Jeremy Hunt admits health brief is his 'last big job' as 20,000 doctors strike
More than 20,000 junior doctors are thought to have gone on strike on Tuesday as the Health Secretary admitted this was likely to be his "last big job in politics".
Figures complied by NHS England suggest 78% of junior doctors (21,608) who were expected to be working on Tuesday did not report for duty.
However, NHS England said the figures had not been fully validated and included those who may have been off due to sickness or other reasons.
During the previous strike earlier this month, around 14,600 junior doctors were not at work on each of the two days. Of those, around 12,800 (88%) were actually on strike, with the remainder absent for other reasons such sickness, NHS England said.
Health Secretary Jeremy Hunt has insisted the Government will not be "blackmailed" into dropping its manifesto pledge of improving seven-day services as the dispute with the British Medical Association (BMA) over a new contract continues.
He denied the Government had been looking for a battle with public sector unions and accused "elements" within the BMA of refusing to reach any compromise agreement.
"The last thing we are doing is itching for a fight," he told the BBC Radio 4 Today programme.
"Insofar as it is a political strike, I do think there are some elements - not the majority and certainly not the majority of junior doctors - but there are some elements at the very top of the BMA who are absolutely refusing to compromise."
Mr Hunt acknowledged that his position as Health Secretary was likely to be his last major role.
He said: "This is likely to be my last big job in politics. The one thing that would keep me awake is if I didn't do the right thing to help make the NHS one of the safest, highest quality healthcare systems in the world.
"Health secretaries are never popular. You are never going to win a contest for being the most liked person when you do this job. But what history judges is did you take the tough and difficult decisions that enabled the NHS to deliver high-quality care for patients. For me, that's what it's about."
David Cameron told ITV News the strike was "not right", adding: "There is a good contract on the table with a 13.5% increase in basic pay - 75% of doctors will be better off with this contract.
"It's the wrong thing to do to go ahead with this strike, and particularly to go ahead with the withdrawal of emergency care - that is not right."
Thousands of junior doctors and their supporters - among them union members and teachers - marched from St Thomas Hospital in central London to the Department of Health in Whitehall to protest against Mr Hunt's stance.
Leading the crowd was Labour leader Jeremy Corbyn and shadow chancellor John McDonnell, who both addressed the crowds of protesters.
Mr Corbyn told them it was "utterly contemptible" that Mr Hunt had failed to reach an agreement with junior doctors, despite having "every conceivable opportunity".
He said: "They are the ones who have behaved in the responsible manner of saying they are there to defend the NHS. His response is to try and impose a contract and impose something on them.
"That is no way for a secretary of state to behave towards one of the most crucial elements of the NHS workforce."
The strike is the first time junior doctors have withdrawn full labour, including emergency care, which has been mostly provided by their more senior consultant colleagues.
More than 125,000 appointments and operations have been cancelled and will need to be rearranged as a result of the latest strike, which will continue from 8am to 5pm on Wednesday.
Across England, hospitals appear to have coped well, with low waiting times across A&E departments and no urgent calls for doctors to return from the picket lines.
Oliver Warren, a consultant colorectal surgeon at the Chelsea and Westminster Hospital NHS Foundation Trust, tweeted: "Update from frontline - all going well! 3 consultant ward round, all pts (patients) seen - morale high. Off to ED to review a pt."
Kingston Hospital said: "We've got consultants from ITU (intensive care), Medicine + Gynae caring for patients in A&E majors today."
Barts Health NHS Trust, which runs five hospitals in London, said around 11% of about 1,000 junior doctors were working on Tuesday across the trust.
Nick Hulme, chief executive of Ipswich Hospital, tweeted a picture of contingency planning maps for his hospital, adding: "Great work from all the teams."
The BMA's junior doctors committee chairman, Johann Malawana, said: "Today is an incredibly sad day for doctors, and the rest of society.
"These two days of industrial action mark one of the lowest points in the wonderful history of the NHS.
'We deeply regret the disruption caused to patients, but we know experienced staff will be working hard to provide the emergency care they need and it is for the benefit of the same patients and people who need to use the NHS in future that we take this action."
He said Mr Hunt had refused a chance for the strikes to be called off by failing to lift his threat to impose the contract.
Dr Anne Rainsberry, national incident director for NHS England, said: "The NHS exists to help the sick and people in need and we'd like to sincerely apologise to the more than 100,000 people facing disruption during this strike alone, as well as the thousands more affected over the last few months.
"This is an unprecedented situation and staff across the NHS have made herculean efforts to ensure continued safe services for patients, which is always our top priority.
"However the escalation of this action does bring heightened risk and we are continuing to vigilantly monitor the picture across the whole of the country."