The NHS faces a “pretty terrifying position” if resident doctors go ahead with a planned five-day strike next week, Health Secretary Wes Streeting has warned, saying he cannot guarantee patient safety as hospitals grapple with a sharp winter surge in flu and other viruses.

Resident doctors in England, formerly known as junior doctors, are due to walk out from 07:00 on Wednesday 17 December until 07:00 on Monday 22 December in a long-running dispute over pay and conditions. The British Medical Association (BMA) is currently surveying members on whether to pause the action after the government made a new offer centred on training posts and fees rather than a higher pay settlement. The indicative survey closes on Monday 15 December.

Speaking in a series of interviews on Friday, Streeting said the combined impact of industrial action and mounting winter pressures could push the health service into dangerous territory. He said he was “genuinely fearful” about the days ahead and described the situation as “one minute to midnight” for the NHS, warning of a “real risk of harm” to patients if staffing levels drop during the walkout.

His comments come as NHS England figures show a steep rise in hospitalisations linked to flu, with leaders describing the current wave as a worst-case scenario for December. Data published this week showed an average of 2,660 hospital beds per day in England were occupied by flu patients last week, up 55% from 1,717 the week before and the highest December level on record. The number of flu patients in critical care rose to 106 from 69 in the previous week. Norovirus and other diarrhoea and vomiting cases also increased, with around 354 beds a day occupied, up 35% week-on-week. November A&E attendances hit a record 2.35 million and ambulance incidents were around 802,500, nearly 49,000 higher than the same month last year, NHS England said.

Streeting said he had offered the BMA the option of shifting the planned walkout into January, proposing an extension of the union’s legal strike mandate into February so the December action could be rescheduled. He said the union rejected that route. The BMA has not accepted the government’s claim that it refused a reasonable compromise, arguing it has repeatedly sought meaningful progress on pay as well as long-term workforce issues.

The latest government offer, announced this week, focuses on addressing a bottleneck in specialty training and what ministers describe as a “jobs crisis” for early-career doctors. Measures include increasing the number of specialty training posts over three years to 4,000, up from 1,000 in the government’s existing 10-year plan, with 1,000 of those posts brought forward to start in 2026. The package also includes funding for mandatory Royal College exam and membership fees and planned emergency legislation to prioritise UK medical graduates and doctors with significant NHS experience for specialty training roles.

The BMA’s resident doctors committee chair, Dr Jack Fletcher, said the offer reflected movement secured through industrial action, including the expansion from 1,000 to 4,000 training posts, but argued it did not address pay and would not increase the overall number of doctors working in England if posts were largely repurposed. The union says resident doctors’ pay remains substantially below 2008 levels in real terms and it is seeking a multi-year path to pay restoration. Resident doctors previously accepted an average 22.3% pay rise over 2023-24 and 2024-25, ending the first wave of strikes under the previous government, but the dispute has since reignited.

Downing Street and the prime minister have also sharpened their public stance. A No 10 spokesperson described the planned timing as “astonishing” and “irresponsible” given the flu surge, while Prime Minister Keir Starmer said it was “frankly beyond belief” that resident doctors could strike at what he called the NHS’s most precarious moment since the pandemic, while maintaining that Labour supports the right to strike in principle.

Public pressure has grown as winter pressures intensify. YouGov polling cited on Friday suggested 58% of respondents oppose the planned strike, with around a third in support.

The Conservatives, now in opposition, accused Labour of failing to avert disruption, with shadow health secretary Stuart Andrew saying patients faced a “nightmare before Christmas”.

Unless the strike is called off, NHS trusts are expected to cancel routine activity and redeploy staff to maintain emergency care, as they have during previous stoppages, including a five-day strike in November. The BMA’s survey result on Monday is likely to determine whether talks can avert action next week or whether the NHS enters the pre-Christmas period facing simultaneous industrial action and a rapidly rising winter infection burden.