Thousands of junior doctors have begun the first all-out strike in the history of the NHS after the Health Secretary said the Government would not be "blackmailed" into dropping its manifesto pledge for a seven-day health service.

Jeremy Hunt appealed directly to medics yesterday (April 26) not to withdraw emergency cover, which he said had particular risks for A&E departments, maternity and intensive care.

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Doctors striking outside the Princess Royal University Hospital in Farnborough. (c.) Keith Larby/AK Photos

The impasse between the Government and the British Medical Association (BMA) prompted the industrial action, from 8am to 5pm today and again tomorrow.

It is the first time services such as A&E, maternity and intensive care have been affected during the dispute over a new contract.

Speaking on BBC Breakfast, Mr Hunt accused union leaders of trying to "blackmail" the Government with strike action.

He said he could only call a halt to the action "by abandoning a manifesto promise that the British people voted on" at last year's general election.

The Health Secretary said: "It was the first page of our manifesto that we'd have a seven-day NHS.

"I don't think any union has the right to blackmail the Government, to force the Government to abandon a manifesto promise that the British people have voted on."

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Doctors striking outside the Princess Royal University Hospital in Farnborough. (c.) Keith Larby/AK Photos

Despite an intense three days of letters back and forth and a phone call between Mr Hunt and the head of the BMA yesterday, no agreement on a way forward has been reached.

More than 125,000 appointments and operations have been cancelled and will need to be rearranged across England's hospitals as a result of the latest dispute.

The BMA has defended the walkout, repeating its stance that it would have called off the strike if Mr Hunt agreed to lift his threat to impose the contract.

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Doctors striking outside the Princess Royal University Hospital in Farnborough. (c.) Keith Larby/AK Photos

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Responding to Mr Hunt's claim that lives were being put at risk by the strike, he added: "The Health Secretary is trying to find some way to throw mud at the junior doctors of this country who have been providing weekend and night emergency cover since the NHS started."

The strikes will affect Lewisham Hospital, Queen Elizabeth Hospital in Woolwich, Queen Mary's in Sidcup, the PRUH in Farnborough, and Dartford's Darent Valley.