There is “no trust” between junior doctors and the government, a British Medical Association (BMA) leader has said.
It came at the start of a second day of strike action as the bitter dispute over pay shows no sign of being resolved.
The government and the union appeared to be deadlocked after Downing Street insisted there will be no talks unless junior doctors abandon their starting position of a 35% rise and call off the strikes.
But Professor Philip Banfield, chair of council at the BMA, told Times Radio the NHS was “in crisis”.
“We are materially trying to sort out this crisis by suggesting paying someone £19 an hour instead of £14 an hour,” he said.
“There’s no trust between the junior doctors and government. The last time that the junior doctors were in dispute, and they called off their industrial action, they ended up with a contract that was imposed.”
Steve Barclay, the health secretary, has accused the BMA of putting patients at “greater risk” after not agreeing any national exemptions for strike action for some services, such as cancer care.
It has been estimated that some 350,000 appointments and operations have been rescheduled as a result of the action.
The BMA has claimed junior doctors in England have seen a 26% real-terms pay cut since 2008/09 because pay rises have been below inflation.
It has asked for a full pay restoration that the government said would amount to a 35% pay rise – which ministers have said is unaffordable.
The union said junior doctors can earn as little as £14.09 per hour in their basic pay packet.
NHS Providers warned that the 96-hour walkout will cause a “very long, difficult week” for the health service.
And the health service’s top doctor, Professor Sir Stephen Powis, warned that the situation in the NHS will “become more challenging each day this strike progresses”.
“As the week goes on, we expect to see staff cover stretched as those who worked tirelessly over the Easter holiday take leave, which will pose a huge challenge to an already depleted workforce,” he said.