Junior doctors in England are taking part in the second day of an all-out strike between 08:00 and 17:00 BST
Action affects emergency, maternity and intensive care for the first time in the long-running dispute
Health Secretary Jeremy Hunt describes it as "bleak day" for NHS
Junior doctors are angry at the government's imposition of a new contract
The new contract makes it cheaper to rota doctors on at weekends, as part of plans for a seven-day NHS
Patients who have had appointments cancelled during this week's all-out junior doctors' strike have told the BBC why they support or oppose the walkouts.
Read MorePrime Minister David Cameron says it is "irresponsible" of junior doctors to withdraw emergency cover today and tomorrow.
Downing Street says Health Secretary Jeremy Hunt has the full support of the PM for his handling of the dispute.
Mr Hunt has been keeping Mr Cameron informed about the progress of the negotiations, they added.
Downing Street questioned why junior doctors have chosen to go on strike, saying they had received a 13.5% pay rise.
A source said:
Quote MessageThe reason for this strike keeps changing and the BMA need to be asked - why are they striking?"
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Junior doctors in the county and nationwide are taking part in a nine-hour walkout today as part of an ongoing dispute with the Government over a proposed new contract.
For the first time in the history of the National Health Service, junior doctors are refusing to provide emergency care during the action.
Hundreds of appointments and operations have been cancelled across Cumbria.
NHS Cumbria Clinical Commissioning Group, which decides how healthcare is provided in Cumbria, says that more consultants and other staff are being brought in to cover the strike, external.
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Junior doctors are striking outside the Royal Berkshire Hospital in Reading.
Chair of the Junior Doctors' Committee at the British Medical Association tweets...
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BBC News Channel
The BBC's health editor Hugh Pym said it was difficult to know how hospitals would cope with the strikes, but he said some of the smaller hospitals "might struggle to cope".
He said the BMA had reached local agreements with NHS England if there was a major incident.
Hugh added that doctors and the government were "as far apart as ever" over the contract dispute.
He said he did not think the BMA would "back off" and would be considering whether to "escalate" the dispute in the future.
Nick Hulme, chief executive of Ipswich Hospital NHS Trust, said: "It has been difficult to plan for today - a day we hoped we'd never see in the NHS."
He said consultants had "stepped up" to provide care for patients today.
Quote MessageAt the moment, it's relatively quiet - it's been quieter than usual since around midnight. We haven't seen the numbers we would usually see. I don't know if patients are deciding not to come today.
Quote MessageObviously we hope that patients will use alternatives, in terms of GPs and pharmacies. If they do need to come to hospital today, we can assure them the care they receive will be safe.
Nick Hulme
Mr Hulme added it was "difficult to see an end in sight" as views had become so polarised over the issue, but added that he hoped there was "a way through this crisis", adding: "This is not sustainable."
Email your views to haveyoursay@bbc.co.uk
Stefan Green, from Sutton Coldfield in West Midlands, emails:
All this strike is over one thing and that’s they don’t want to work nights or the weekends. I have been in hospital on a ward and from 7pm until 7am there is only nursing staff and no doctors. Then from Friday 7pm until 7am Monday again there is only nursing staff and no doctors. When this junior doctors’ strike first occurred a junior doctor told a reporter, “Why should I work weekends, I did not become a doctor to work weekends”. The government was elected by the majority to have a working 24/7 NHS and now the few are trying to stop then from happening.
Chris, from Belper in Derbyshire, writes:
I support the junior doctor's strikes because I have experienced what happens if you give in. Twenty years ago, those who cared for adults with learning disabilities had NHS contracts with a good wage and pay progression. Bit by bit, we gave things away and didn't complain because we didn't want to disrupt the people we support. Adult social care is now mostly minimum wage and finding good, stable staffing is a constant battle. We already have a 7-day NHS for everything that matters, so there is no excuse for the government to gamble with our lives through imposing the contract.
John Moore, a junior doctor in Newcastle, told the Press Association news agency that Health Secretary Jeremy Hunt had "mishandled this dispute from day one".
"He has refused to listen to any advice, even from his own MPs and researchers.
"He's misused statistics, he's outright lied, he's worried the public into not attending the NHS when they need to, and I think he should resign.
"He's completely lost the trust of an entire profession so unfortunately I don't see a route back to negotiations with him."
However, Mr Moore added that doctors were "always happy to negotiate" and did not want to go on strike.
He said he thought negotiations would be "more fruitful" with a new health secretary.
Rahil Sheikh
BBC News Oxford
Striking junior doctors have gathered outside Oxford's John Radcliffe Hospital, saying the imposition of a new contract by government will be "unsafe in the long term for the NHS".
Junior doctors on strike at Oxford's John Radcliffe Hospital
Nadia Randazzo, a junior doctor on the picket line, says she and her colleagues in the NHS are already over-stretched - a situation that would be made worse by government plans to change working hours and pay.
Quote MessageThis is about working conditions causing doctors to leave, causing unsafe conditions, in a situation where we're all stretched beyond our means. The NHS relies on the goodwill of all staff working longer hours than necessary, and we're going to have a situation where we're even more short-staffed, even more stretched and we feel this is unsafe in the long term for the NHS.
Nadia Randazzo, Oxfordshire junior doctor
BBC correspondents are out and about at hospitals across England.
Phil Mackie said there were more than 30 junior doctors outside Warwick Hospital. A total of 29 elective operations have been cancelled today and tomorrow, and 22 clinics he said, affecting hundreds of patients.
Many people are showing their support as they drive past the hospital by beeping their horns, he said.
First year junior doctor Emily Sherwood told him:
Quote MessageSo far, we've had absolutely fantastic support from the public. The Patients' Association have already shown their support alongside countless other organisations. In general, they believe their safety is going to be put at risk in the long term, which is why we're here today.
Quote MessageIt's not a decision that any of us have taken lightly at all. And it really breaks my heart that we have been forced into this corner by the health secretary because he won't come back to the negotiation table and he won't drop this imposition of this contract that we just really do not think is safe for our patients at all.
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A junior doctor from Oxfordshire, who began a protest outside the Department of Health, said today's strike is the "saddest day in the history of the NHS".
Image source, Rachel ClarkeDr Rachel Clarke, who spent the night on the pavement outside the Department of Health, said no junior doctor wanted to strike
Rachel Clarke told BBC Radio Oxford today's strike - the first time services such as A&E, maternity and intensive care have been hit in the long-running dispute - was to protect patients from the imposition of a new contract by the government.
Quote MessageThis is the saddest day in the history of the NHS, there isn't a junior doctor in the country who wants to be on strike today. We're doing this because we want to protect patients in the future from this contract. It's a nasty, wretched day for everybody.
Rachel Clarke, Oxfordshire junior doctor
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Junior doctors held a candlelit vigil outside the Department of Health in Westminster, central London, last night - the eve of two days of strikes.
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