Junior doctors in England are gearing up for another round of strikes in protest over government's planned imposition of a new working contract, after refusing to accept its terms.
The British Medical Association's junior doctors committee is now seeking approval for a new spate of industrial action - the nature of which remains unclear - starting in September, over remaining concerns relating to the contract.
Back in May the government and NHS Employers reached a "historic agreement" with the trade union on a new contract for junior doctors after more than three years of negotiation and strike action. But it was rejected by 58 percent of the 68 percent of BMA members voting.
Health Secretary Jeremy Hunt then confirmed that the government would push through the contract in its current form, despite widespread objection.
Now, in a letter to members, Ellen McCourt, chair of the Junior Doctors Committee, said: "I have continued to push for improvements which would demonstrate the Secretary of State for Health was serious when he stated in Parliament that his door was always open. But when it comes to the issues that need to be resolved by the government, we have simply seen nothing".
While there has been some "last-minute movement" by Health Education England on whistle-blowing protections and from NHS leaders with regard to the Guardian of Safe Working role, "the government remains persistently silent," she writes.
"Forcing a contract on junior doctors in which they don't have confidence, that they don't feel is good for patients or themselves, is not something they can accept."
In a message to Twitter followers, she added: "The road ahead will not be easy, by standing together we speak with one voice, our unity remains our strength".
But Daniel Mortimer, the chief executive of NHS Employers, told the media: "Industrial action achieves little or nothing but places pressure on already stretched teams and services and causes worry, distress and disruption for patients, carers and their families".