Junior doctors in England started a six-day walkout over pay on Wednesday, the longest strike in the 75-year history of the state-run National Health Service (NHS), which will hit patient care during a seasonal winter peak in demand.

As in other key sectors over the past year, junior doctors represented by the British Medical Association (BMA) have staged a series of walkouts to demand better pay in the face of soaring inflation.

In a statement, the union urged the government to make a "credible" pay offer to end the strikes, which threaten to increase the pressure on the health service, where more than 7.7 million on waiting lists seek treatment.

"Morale across the health service is at an all-time low ... Many will be wondering if their chosen career is still worth pursuing – the government has the chance to show those doctors they still have a future working in this country," the BMA said.

Cumulatively, the NHS, which has provided healthcare free at the point of use since it was founded in 1948, cancelled 1.2 million appointments since strikes began in 2023.

The government, which has agreed new pay deals with other healthcare workers, including nurses and senior doctors in recent months, has resisted hikes it says would worsen inflation.

The BMA abandoned talks with the government after being offered a pay rise of 8% to 10%, and held strikes from Dec. 20 to 23. The union is seeking a 35% improvement, which it says is needed to cover the impact of inflation over several years.

Junior doctors are qualified physicians, often with several years of experience, who work under the guidance of senior doctors and make up a large share of the medical community.

"This January could be one of the most difficult starts to the year the NHS has ever faced," Stephen Powis, its national medical director, said on Tuesday.

"The action will not only have an enormous impact on planned care, but comes on top of a host of seasonal pressures such as covid, flu, and staff absences due to sickness," he said in a statement.

A spokesman for Prime Minister Rishi Sunak said that deals with other healthcare workers' unions showed the striking junior doctors were "outliers", however.

"We have sought to come to a fair resolution - fair for the taxpayer, fair for hardworking doctors and health workers," he told reporters on Tuesday.

"We have achieved that in the majority of cases ... we are willing to have further discussions. But obviously the first thing to do is to stop striking." (Reporting by Muvija M and Alistair Smout; Editing by Ed Osmond and Clarence Fernandez)