A planned five-day strike by resident doctors in England will go ahead on Friday after their union said Wes Streeting had not gone far enough in negotiations to warrant calling off the action.
A letter from Health Secretary Mr Streeting to the doctors - formerly known as junior doctors - was "lacking any substantive proposal on both pay and non pay elements," the British Medical Association (BMA) said in a statement.
The doctors in England had voted to strike following the government's award of a 5.4% pay rise. The union argues this falls far short of the 29% needed to restore their earnings to 2008 levels.
"Our door remains open, and we are glad to have met with the Secretary of State in a constructive spirit. We want to keep talking – but we don’t accept we can’t talk about pay," BMA co-chairs Melissa Ryan and Ross Nieuwoudt said.
Mr Streeting had earlier told the House of Commons he "sincerely hopes the BMA will postpone" the "unnecessary and irresponsible" strikes to continue talks with the Government, which he said had been "constructive" in recent days.
He said, however, the Government stands "ready" and "responsive" for the five-day strike by resident doctors, scheduled to start at 7am on Friday.
Earlier, the BMA said NHS England plans for managing the strike could put patients at risk owing to the fact it has ordered hospitals to continue with as much pre-planned care as possible.
Previous strikes by health workers have seen hundreds of thousands of operations and appointments cancelled, but NHS England is taking a different approach this time to managing the strike.
In a letter to hospital trust leaders, it urges the health system to focus on maintaining emergency care, maintaining the flow of patients and "maintaining elective care to the fullest extent possible" as well as "priority treatments" such as cancer care.
"It will be important for systems and trusts to try and maintain normal levels of booked activity..." it said, adding: "Reducing volumes of bookings and rescheduling of appointments and other activity should only happen in exceptional circumstances to safeguard patient safety."
On Tuesday morning, BMA deputy chairwoman Dr Emma Runswick told BBC Radio 4's Today programme this plan risked patient safety.
She said: "We've had proven systems over the last decade that have made sure that where we have to take strike action, senior doctors cover urgency and critical care.
"This time round, NHS England are pushing for the continuation of non-urgent and scheduled care in a way that we think at best is confusing and will create on-the-day cancellations - and at worst could be risky and lead to harm in emergency departments and on wards, because senior doctors cannot physically be in two places at once.
"We think that a notional guidance from NHS England which is saying that basically all scheduled work should continue to go ahead has potential to be seriously risky for patients...
"Senior doctors are needed to be freed up in order to provide urgency and critical care.
"We think the vast majority of planned and unscheduled care should be shifted."
NHS Providers hit back at the BMA's claims, saying it was the strike itself that posed a risk to patients.
Its chief executive, Daniel Elkeles, said: "The NHS, not the BMA, is putting patients' interests first.
"Given that some patients will be caused undoubted harm if the short-notice strike goes ahead, NHS trusts are doing the responsible thing by not cancelling people's care while talks to avert the strike are ongoing.
"Now is a time for cool heads in the BMA because it's not too late to avoid a damaging, costly strike. NHS trust leaders hope for a breakthrough from talks between Government and the union.
"If the strike goes ahead then NHS trusts will do everything they can to avoid any harm to patients and are planning for as many patients as possible to be cared for."
It comes as a new YouGov poll showed about half (52%) of people in the UK either "somewhat oppose" (20%) or "strongly oppose" (32%) the idea of resident doctors going on strike over pay.
Meanwhile, a third (34%) of the 4,954 adults surveyed either "somewhat support" (23%) or "strongly support" (11%) doctor strikes.
YouGov said the proportion supporting the strike over pay has dropped five points since it last asked the question in May.
