Doctors are taking industrial action for the first time in 40 years in a dispute with the government over changes to their pensions.
Up to 100,000 doctors who are members of the British Medical Association (BMA) could take action, although a poll by Pulse magazine has found that only a quarter of GP practices have given notification that they will be taking part.
According to Health Secretary Andrew Lansley, the planned strike could see up to 30,000 operations cancelled, 58,000 diagnostic tests postponed and 200,000 outpatient appointments rescheduled. Mr Lansley also said up to 1.25 million GP appointments would have to be re-arranged.
The BMA announced the strike in May after accusing ministers of pressing ahead with “totally unjustified” increases to pension contributions and a later retirement age for doctors.
All non-urgent work will be postponed, but the BMA said patient safety would be protected. Doctors will see anyone who is ill, or who believes they are ill, although they will not complete paperwork.
NHS South Essex is advising patients not to contact their GP surgery or attend accident and emergency wards unless there is an emergency or urgent care need.
It says pharmacists should be used for information and advice on minor illnesses and ailments. Early indications suggested that 31 of 147 GP practices would be taking part in industrial action in South Essex.
Health trusts have to decide whether to dock the pay of doctors who only treat those in urgent need.
Although the Royal College of Midwives (RCM) has advised its members not to “undermine” the industrial action, it has urged them to “work as normal” on Thursday.
Jon Skewes, director of employment relations and development at the RCM, said: “Our members voted to accept the government’s pension offer and with reluctance the RCM board agreed. It is the best deal that could be obtained by negotiation.
“Midwives have a profound sense of duty to the women and babies they look after, and they will continue to deliver the best care possible on the day.”
In May, GPs voted by 13,837 to 3,687 to take action short of a strike and by 11,062 to 6,426 in favour of strikes. The last time doctors took industrial action was in 1975, when consultants suspended goodwill activities and worked to contract, while junior doctors worked a 40-hour week because of dissatisfaction with the progress of contract negotiations.
The BMA argues that higher-paid NHS staff already pay proportionately more for their pensions than most other public sector workers, a disparity it says increased in April when contributions rose.
The government says pensions reform is needed because people are living longer, but that the NHS scheme will remain one of the best available.
It says a newly qualified doctor who works to 65 will receive the same pension an average consultant retiring today would receive at 60, with those working until they are 68 paid a larger pension of £68,000 a year.