Doctors’ leaders and government ministers accused each other of putting patients’ lives at risk on Sunday as hospitals prepared for the first mass walkout of medics since the 1970s.

On Tuesday up to 38,000 junior doctors will stage a 24-hour strike across the NHS in England in their dispute over new contracts that would allow hospitals to rota more weekend staff.

The doctors’ union, the British Medical Association, argues that the proposed changes amount to a pay cut for some staff and would result in doctors working dangerously long shifts. The Government denies this and claims that the contracts are the only way to increase NHS services across seven days a week and reduce death rates at the weekend.

Both sides have described the chances of a deal before the planned walkout as “infinitesimally” small. As a result at least 4,000 operations will be cancelled.

Two further strikes are planned over the coming weeks including the first-ever strike in which junior doctors will stop providing all care – including emergency procedures – which is due to take place on 10 February.

As a result of the action every hospital in England has been asked by the Medical Director of the NHS to ensure they have plans in place to monitor “exceptional and sustained” deterioration in performance and contingency arrangements to ensure patient safety is not compromised.

Junior doctors strike

This could include shutting services or agreeing circumstances with local BMA members when striking doctors could be called back into work “to mitigate the risk of harm to patients”.

In an interview the Health Secretary, Jeremy Hunt, said that the Government was going through the “exhaustive process” of contacting every A&E department in the country to establish whether they will have enough staff to stay open.

In pictures: Junior doctors protests in UK Show all 10 1 /10 In pictures: Junior doctors protests in UK In pictures: Junior doctors protests in UK 20,000 Junior Doctors marched through central London in protest at the new contract changes the government is trying to impose which they say will be unfair and unsafe In pictures: Junior doctors protests in UK Junior doctors protest in London In pictures: Junior doctors protests in UK 4 year old Cassius takes part in a demonstration in Westminster, in support of junior doctors over changes to NHS contracts, London In pictures: Junior doctors protests in UK Protest over proposed changes to junior doctors' contracts, Leeds In pictures: Junior doctors protests in UK Junior doctors and NHS staff protesting against the health service cuts and the proposed contract changes offered by the government outside Parliament In pictures: Junior doctors protests in UK Junior doctors and NHS staff protesting against the health service cuts and the proposed contract changes offered by the government outside Parliament In pictures: Junior doctors protests in UK Over 5000 junior doctors rallied in Waterloo place, before marching through Whitehall and onto Parliament Square, in opposition to Jeremy Hunt's new working conditions for doctors In pictures: Junior doctors protests in UK Demonstrators listen to speeches in Waterloo Place during the 'Let's Save the NHS' rally and protest march by junior doctors In pictures: Junior doctors protests in UK Junior doctors marched in London to highlight their plight In pictures: Junior doctors protests in UK A protester at a demonstration in support of junior doctors in London

“I know that many hospitals will ask consultants and other staff to step in for that day. But we also have to be honest that hospitals are stretched at the moment,” he said.

“We will do everything we can to keep every A&E department open but junior doctors are the backbone and that will depend on finding consultants who can step in. That is a huge logistical exercise which is now under way.”

Mr Hunt also claimed patients were being put at risk because doctors were “basically saying ‘we won’t be there for you in life-threatening situations’”.

He also accused “some elements” of the BMA of using the strikes as a “political opportunity to bash a Tory Government that they hate”.

“Patients must always come before politics,” he said. “Whatever the political heat of the moment; whatever the anger, patients have to come first.

“Doctors do have a right to strike, but I just urge all doctors to work really closely with us to make sure that whatever decision they take, their patients aren’t put at risk.”

Patients must always come before politics – whatever the political heat of the moment; whatever the anger, patients have to come first <p>Jeremy Hunt</p>

But a BMA spokesman denied that doctors were the ones endangering patient safety and claimed the biggest danger to the NHS was the new contracts. “No doctor takes industrial action lightly and we regret the disruption it will cause,” he said. “However, junior doctors now feel that they have no option.

“The biggest threat to patient care is the Government’s insistence on removing safeguards which prevent junior doctors from being forced to work dangerously long hours without breaks, with patients facing the prospect of being treated by exhausted doctors.”

Both sides have engaged in a war of statistics over whether the new junior doctor contract – designed to open up the NHS to carrying out routine procedures seven days a week – would improve or worsen patient care.

The Government says “too many” studies have been published that highlight increased fatality rates over weekends, including a 29 per cent increase in cancer surgery deaths, a 20 per cent increase in stroke mortality and an 11 per cent rise in general surgery deaths.

But doctors point to a 2009 article in the Journal of the American Medical Association that stated that doctor fatigue could cause a 15 per cent rise in the likelihood of medical errors and say the Department of Health has not done a comprehensive risk assessment of its plans.

The Government’s Chief Medical Officer, Professor Dame Sally Davies, expressed sympathy for the doctors but urged the BMA to suspend strikes. “As a doctor, I can understand the anger and frustration felt by many junior doctors at this time,” she said.

“In part, this dispute is a symptom of frustration and low morale that has been building for decades and the strain that a career in medicine can place on your work-life balance.

“Junior doctors are the backbone of the NHS, working long and antisocial hours. Training now is very different from when I went through it. It is vital that, as senior medical leaders, we ask ourselves whether we are doing everything we can to ensure our junior colleagues feel valued.