A doctors’ leader has warned that consultants will not back down in their pay dispute and warned of further strikes next month unless the government offers “meaningful talks” on a settlement. Vishal Sharma, chair of the British Medical Association’s consultants committee, said the NHS was at a “tipping point”, with many senior doctors considering quitting over healthcare failures and the erosion of their pay. He said there was a risk of a two-tier service emerging similar to the one in NHS dentistry, with patients going private to avoid long waits. His comments came as NHS leaders called on the government to hold talks with doctors to resolve the dispute after a 48-hour strike by consultants last week – their first strike in more than a decade. The Department of Health and Social Care (DHSC) said a pay offer for consultants of 6% for 2023-24 was “final” and that industrial action was hampering efforts to cut waiting lists. The BMA has announced provisional strike dates for consultants in England on 24 and 25 August. Sharma said: “We hope the government will come back to us and have some meaningful talks, but if that doesn’t happen the mood is really clear. People aren’t going to back down and the government needs to take it seriously. If there’s no movement from the government, the strikes will be going ahead at the end of August.” He said the action already taken by consultants showed the anger and determination of the workforce. “If we don’t do something, we are going to lose a lot of doctors,” he said. The BMA says that since 2008-09, the take-home pay of consultants in England has been cut by 35% in real terms, and it wants to see a pay increase above inflation. It also wants a long-term strategy to review doctors’ pay and restore what it considers are fair levels of remuneration. Sharma said fairer pay for doctors would ensure a better service for patients. He said: “We are incredibly sorry at the impact. It’s a really hard thing for us to do, but the reason we are doing it is that every single day we are telling people they can’t get an operation for 12 or 18 months, or we’re treating people in corridors. We haven’t got enough doctors.” He said there was a “huge risk” of doctors leaving to work overseas or move to private practice. “We are at a tipping point because we already have a low number of doctors and if we lose more, I worry the NHS as a whole becomes unsustainable.” He said some patients who were frustrated by long waiting lists were already switching to private healthcare, and he was concerned at the risk of a two-tier service. “We’ve seen what has happened to NHS dentistry, with patients only able to access a minimal level of service, and there are lots of parallels with what is happening in the [wider] NHS. No patient should ever have to pay for their treatment out of necessity.” NHS professional organisations are urging the government to hold talks to try to resolve strikes after junior doctors and consultants rejected the pay offer from government earlier this month. More than 600,000 operations and appointments have been affected by the action. Matthew Taylor, chief executive of the NHS Confederation, the membership organisation for the healthcare system in England, Wales and Northern Ireland, said there should be further talks. “This is not a time for ultimatums or standoffs,” he said. “This is a time for engagement and trying to find a way through.” He added that further action by junior doctors and consultants would jeopardise the prime minister’s pledge to cut NHS waiting lists. Saffron Cordery, deputy chief executive of NHS Providers, the membership organisation for NHS hospital, mental health, community and ambulance services, said: “A huge amount of effort goes on preparing for strikes, managing them and then picking up the pieces afterwards. Trusts have become increasingly adept at managing the impact of industrial action, but they would rather be focusing on getting waiting times down for a whole series of procedures.” She said there had been a “mixed picture” regarding the impact of the strikes last Thursday and Friday, with entire operating lists being cancelled in some trusts but “minimal” cancellations in others. A DHSC spokesperson said: “It is disappointing that the BMA went ahead with consultant strike action after the five-day walkout by junior doctors, affecting thousands of patients, putting patient safety at risk and hampering efforts to cut NHS waiting lists. “We have accepted the independent pay review body recommendations in full, giving consultants a 6% pay rise that will see average basic full-time pay increase by around £6,300 to £111,800. This is on top of the 4.5% rise they received last year and generous changes to pension taxation. “This pay award is final and we urge the BMA to call an end to strikes.”