NICOLA Sturgeon has today intervened in the junior doctors’ strike in England, calling on David Cameron to get back around the negotiating table and expressing concerns of the “knock-on effect” on the NHS in Scotland.

For the first time in the NHS’s 68-year history, the service is experiencing its first all-out strike, affecting emergency cover with more than 125,000 appointments and operations cancelled.

Jeremy Hunt, the Health Secretary south of the border, has said the UK Government will not be "blackmailed" into dropping its election manifesto pledge for a seven-day health service.

But the junior doctors argue the proposed changes will mean cuts to pay, especially for work during evenings and weekends as well as long working hours, which will compromise the safety of both doctors and their patients.

As the two-day strike began, the Prime Minister denounced it, stressing how he was backing Mr Hunt’s handling of the dispute.

"There is a good contract on the table with a 13.5 per cent increase in basic pay; 75 per cent of doctors will be better off with this contract,” he declared.

Mr Cameron added: "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."

But the First Minister has now written to the PM, expressing her “increasing concerns” about the knock-on effect it could have in Scotland.

She has made her intervention following a request for support from the presidents of the three Scottish-based royal colleges after they raised concerns over spill-over effects in Scotland, Wales and Northern Ireland.

In their letter earlier this week to Ms Sturgeon, the presidents of the Royal College of Physicians of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Surgeons of Edinburgh said the imposition of the contract on junior doctors in England would “have far-reaching and unintended consequences for healthcare across all nations in the UK for the foreseeable future”.

They added: “The imposition of the contract in England risks jeopardising our shared ambition for the future of the NHS by undervaluing and demotivating a group of doctors already under significant pressure. They represent the future and we risk alienating such able doctors from training or losing them to international health systems.”

In response, Ms Sturgeon said the SNP Government had been clear throughout that it would not impose a contract on junior doctors in Scotland.

“Having served as Health Secretary in Scotland I have worked closely with medical professionals for a number of years and I know that no doctor will have taken the decision to strike lightly.

“The NHS in England and relations between the UK Government and the NHS workforce are not a direct matter for me but the longer this strike continues the more concerned I have become about a knock-on effect on the profession across the whole of the UK.”

In her letter to Mr Cameron, she noted that while the NHS was devolved, there was “considerable cross-over between medical schools, training of junior doctors and the development of professional skills by the royal colleges between Scotland, England, Wales and Northern Ireland.”

The FM pointed out how the royal colleges in Scotland had raised their considerable concerns with her that the imposition of a contract on junior doctors in England put “at risk the retention of a world-class medical workforce throughout the UK and risks their ambition for the future of the NHS by demotivating a part of the workforce, which is already under severe pressure”.

She went on: “To alienate or drive away this group of doctors from the profession risks the skills and resources that would be available across the UK in the future and the on-going dispute and apparent refusal of your government to return to negotiations risks the reputation of the UK as an employer internationally.”

Ms Sturgeon added: “Given my increasing concerns about the spill-over effect of the current impasse and the message it sends across the world over the support of the medical profession in the UK, I would urge you to reconsider the current position and to return to the negotiations with the BMA.”

The impasse between the UK Government and the British Medical Association(BMA) means that for the first time services such as A&E, maternity and intensive care will take place in industrial action, from 8am to 5pm today and again tomorrow.

The Department for Health has made clear contingency plans are in place with senior doctors covering for their junior colleagues.

Mr Hunt, speaking on BBC Breakfast, explained: "It was the first page of our manifesto that we'd have a seven-day NHS. I don't think any union has the right to blackmail the Government, to force the Government to abandon a manifesto promise that the British people have voted on."

Despite an intense three days of letters back and forth and a phone call between Mr Hunt and the head of the BMA on Monday, no agreement on a way forward has been reached.

Mr Hunt stressed how the disruption over the next two days was "unprecedented" but the NHS had made "exhaustive efforts" to ensure patient safety.

"I wish to appeal directly to all junior doctors not to withdraw emergency cover, which creates particular risks for A&Es, maternity units and intensive care units."

Mr Hunt said the NHS was "busting a gut to keep the public safe" and appealed to the junior doctors not to withdraw emergency cover.

The Secretary of State 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 declared. "Insofar as it is a political strike, 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."

On Monday, Mark Porter, the head of the BMA, said the Government had "distorted" weekend death statistics and stressed that emergency cover would be provided by consultants during the strike.

Responding to Mr Hunt's claim that lives were being put at risk by the strike, he added: "The Health Secretary is trying to find some way to throw mud at the junior doctors of this country, who have been providing weekend and night emergency cover since the NHS started."