Health Secretary Wes Streeting warned resident doctors they were “shooting themselves in the foot” as he urged them to call off strikes due to start on Friday. In a last-ditch plea to the British Medical Association (BMA), he said industrial action would cost the NHS £250 million and force him to cut planned investment in the health service.

Mr Streeting spoke as the BMA vowed to press ahead with a five-day walkout. Resident doctors are objecting to what they say is a lack of training places and demanding a 26% pay rise. According to the Patients Association, the strikes at the start of the flu season “will create a cascade of delays extending well into the new year”.

Mr Streeting said he would not move further on pay, arguing resident doctors had enjoyed a 28.9% increase under this government. He said: “What’s frustrated me most of all is I have offered to go further on things that are out of pocket expenses for resident doctors to create the jobs that they’re crying out for. And what they often come back with is: ‘but you’re not moving on pay’.

“They’ve had the highest pay rise in the entire public sector two years in a row, and I’ve got responsibility to nurses, supporters and NHS staff, who, at the height of their career earnings, will never earn as much as the lowest-paid doctor.

“So I say, with respect to resident doctors, you’ve done well out of this Government so far – it is a journey, it’s not an event, we can’t just do everything all at once.”

The Health Secretary said he planned to create 1,000 extra training places, cancel exam fees and cut other expenses incurred by resident doctors.

But he said: “I’ve got to be honest, if they are out on strike this week, costing us just shy of a quarter of a billion pounds, some of the things I’ve offered as additional will no longer be affordable this year.

“So they’re not only setting back the NHS recovery, they’re not only disrupting care for patients, they’re also shooting themselves in the foot.”

He spoke at the NHS Providers’ conference in Manchester and took part in a series of media interviews, which had been arranged before stories emerged on Tuesday night that Number 10 officials were accusing him of plotting to replace Prime Minister Sir Keir Starmer. The developing Labour civil war threatened to overshadow his message, and Mr Streeting told BBC Radio 4: “It’s bad enough when events knock you off course, to get your message across. It is worse still when self-defeating briefing knocks us of course.”

BMA resident doctors’ committee chairman Dr Jack Fletcher said: “I made clear to the Secretary of State this morning that without movement, we would be forced to go ahead as planned.

“We want to reach a deal on both pay and jobs, that delivers for doctors and patients, but the Government seems intent on preventing this.”

Some patients “will come to harm” if the strikes take place, according to Daniel Elkeles, chief executive of NHS Providers, which represents health trusts.