At times, the junior doctors’ strike proposed for Tuesday and Wednesday – the first strike to include doctors who are meant to be providing emergency care – has sounded a little bit like one of the regular tube strikes to which Londoners are grumblingly accustomed. It’s all about safety, the union explain, but those safety concerns would, apparently, go away if their members were to be paid more. That position is rather hard to justify – is patient safety really dependent on whether the doctor treating them is on overtime wages or standard pay?

Even if that were to be the case, it is hard to see any safety justification in taking strike action which threatens the safety of patients who need emergency care tomorrow or the day after – the BMA’s argument about the “long term future of the NHS” is unlikely to prove very reassuring to those sitting in A&E departments without the doctors who are meant to be working there.

The Health Secretary has taken a brittle line in response to the dispute from the outset – a position the strikers see as an unforgivable lack of flexibility but which he argues is essential to providing a truly seven-day NHS service.

The politics of the dispute became even more complex over the weekend, with the publication of a third option involving a trial of the new contracts in some NHS Trusts, and for the resulting impact on weekend services to be assessed. Heidi Alexander, the Shadow Health Secretary, released that letter – further confusing Labour’s position on the issue, given the Opposition supposedly opposes the contract and fully backs the strikers. Furthermore, it was co-signed by Dan Poulter, a Conservative MP, Norman Lamb of the Lib Dems and the SNP’s Philippa Whitford (despite the contract not touching on the Scottish NHS in any way).

Notably, the BMA does not appear to have endorsed this plan, saying that if Hunt agreed to it then they would be willing to meet to discuss the strike – which is not a huge offer in return for what would be a sizeable concession.

Hunt himself responded to Alexander’s proposal on Twitter:

In essence, the Government is saying that its plans already mean a gradual introduction of the contract – and therefore that Alexander’s compromise proposal is no such thing.

So it seems that the strike will go ahead – Hunt will be further blamed by the doctors, the BMA opens itself up to the charge that it is behaving irresponsibly, and Labour secured a couple of headlines over the weekend at the cost of further confusing their position.

The stated belief of Downing Street and the Department of Health is that moving the NHS closer to a seven-day service will improve care and save lives, and that this contract is a crucial step towards delivering that improvement. The BMA has made clear that it is not willing to accept the changes, and essentially challenged the Government to decide between keeping doctors happy or pursuing what Ministers feel to be in the interests of NHS patients. It was an unwise decision. Forced into a binary choice, what else could the Government do but press on?