Outpatient and non-emergency procedures have been rearranged at St George's Hospital as junior doctors stage a full strike for the first-time ever. 

The doctors' union, the British Medical Association (BMA), announced last month that it would be escalating the industrial action to include emergency cover for the first time after the government's "continued refusal" to re-enter talks on controversial contracts.

April 22: Chief executive of St George's Hospital steps down ten weeks after disagreeing with Jeremy Hunt on junior doctor contracts

April 23: Junior doctors appeal for talks with Jeremy Hunt as first full two day walkout scheduled

Junior doctors will withdraw their service in emergency departments for 18 hours between 8am and 5pm on Tuesday and Wednesday.

More than a dozen medical leaders wrote to Prime Minister David Cameron on Monday calling for him to step in "at the eleventh hour" and bring both parties back to the negotiation table.

The letter said: "You have spoken many times about your commitment to the NHS. In our view, as leaders of the medical profession, the ongoing impasse in the dispute between Government and junior doctors poses a significant threat to our whole healthcare system by demoralising a group of staff on whom the future of the NHS depends."

Wandsworth Times:

Speaking in the House of Commons on Monday Health Secretary Jeremy Hunt refused to re-enter negotiations with junior doctors and urged them not to withdraw emergency care.

He said: "Today we reaffirm that no trade union has a right to veto a manifesto promise voted for by the British people.

"I understand the frustration many junior doctors feel that because of pressures on the NHS frontline they are not always able to give patients the highest quality of care that they would like to.

"I understand that some doctors may disagree with the Government over our seven day NHS plans, particularly the introduction of a new contract.

"I also understand that doctors work incredibly hard, especially at weekends, and that strong feelings exist on the single remaining disagreement of substance – Saturday premium pay.

"But, the new contract offers junior doctors that work frequently at weekends more Saturday premium pay than nurses, paramedics, the assistants that work in their own operating theatres, more than police officers, more than firefighters and more than every other worker in the public sector.

"Regrettably during this pay dispute more than 150,000 sick and vulnerable people have seen their care disrupted.

"The public will rightly question whether this is appropriate or proportionate action by professionals whose patients depend on them."

The strike is the third since Health Secretary Jeremy Hunt announced he would impose a new contract by August and claimed the union had refused "point blank to discuss reforms".

Under the contracts junior doctors will get an increase in their basic pay, but will have to work more weekends. Guaranteed pay rises linked to time in the job will be axed and bonus pay for working unsociable hours will be curbed.

Last week, the BMA wrote to Health Secretary Jeremy Hunt saying the union will call off this week's strike if the Government lifts the "imposition" of the new contracts.

Dr Rosena Allin-Khan, an emergency doctor at St George's, said: "More than 1,000 doctors across the county today will stand in solidarity against the imposed new junior doctor contract. This is the first all-out strike of its kind and will include doctors who previously have provided emergency care. 

"Emergency doctors such as myself hoped against all odds that the government would listen but until now, there is no sign of compromise and so, with a heavy heart, emergency doctors have taken to the picket line.

"Having provided emergency care for all of the previous strikes, being on the picket line feels strange for the St George's emergency team, however, we know the A and E department is in good hands with our supportive consultant body."

Dr Allin-Khan said striking was not something any doctor wanted to do, but they had been left with "no choice" because of a "blatant disregard" for doctors by the Government. 

She said: "We are suffering a brain drain all over the UK as many of our finest doctors are leaving for other opportunities abroad.

"With recruitment and retention at an all-time low, how far do we have to go till we are left with none of our UK graduates?"

On Saturday, a coalition of MPs including Labour shadow health secretary Heidi Alexander urged Mr Hunt to test the new work contract in a small number of trusts rather than impose it across England without the support of the BMA.

Mr Hunt dismissed the proposal as Labour "opportunism" and wrote to the BMA on the same day urging them to reconsider the strike action.

Anyone feeling unwell during the strike is asked to the NHS on 111 or speak to your GP or pharmacist.

You can also check your symptoms at nhs.uk/strike.