I am sure Telegraph readers will be frustrated and angry this morning at the decision of the BMA resident doctors committee to call completely unnecessary strikes. Believe me when I say I feel exactly the same.

Some members of the BMA may giddily talk about their excitement at engaging in unreasonable industrial action but it comes with a very real price. Industrial action should always be the last resort, not something to be enthused about. Strikes are not cost nor consequence free – for patients, for other staff, for the NHS, or for our economy as a whole. We are doing everything we can to minimise disruption they will cause to patients but it would be ridiculous to pretend there won’t be some. And there will be a financial cost to the NHS of these strikes.

Everybody knows that, even with the record investment we are putting into the NHS, money is still very tight. And money that is wasted on dealing with strikes, by definition, means less money to spend elsewhere – on things that actually matter to patients, to other NHS staff and to resident doctors themselves.

The BMA’s leadership, who I believe are badly letting down both their members and the health service, will find that the costs of the strikes are that they now have a secretary of state who has both less appetite and less ability to work with them on the kind of measures we were having constructive discussions about last week that would materially improve the working lives of resident doctors and leave them with more money in their pockets.

I thought that the discussions we had with the leadership of the BMA’s resident doctors were genuinely constructive. They included things like extra roles to deal with the bottlenecks that hold back doctors’ career progression; tackling costs of mandatory exams and equipment; and work to tackle the additional burden of rotations they undertake.

I have been up front with the BMA from the start that I could not go further on pay than we already have this year. Resident doctors have had a 28.9 per cent pay hike over the last three years and the highest pay rise across the whole public sector for the last two. It is completely unreasonable for the BMA’s leadership to demand another 28 per cent on top. The country cannot afford it. It’s also not fair to patients, nor to other NHS staff, many of whom earn a lot less than doctors.

The BMA has misjudged me and this Government and they have squandered a great deal of goodwill in the process. It cannot be patients and taxpayers that continue to pay the price for the damage the BMA leadership’s actions will cause. By walking away from the table, they have cut off their nose to spite their face.

The BMA has launched an advertising campaign saying newly qualified doctors earn less then their assistants.

Physician associates - whose name is being changed to physician’s assistants - start their careers earning £24 per hour, they say, while newly qualified doctors can expect £18.62.

BMA resident doctors committee co-chairs Dr Melissa Ryan and Dr Ross Nieuwoudt said: “Pay erosion has now got to the point where a doctor’s assistant can be paid up to 30% more than a resident doctor. That’s going to strike most of the public that use the NHS as deeply unfair.”

The union said it was asking for an extra £4 per hour to restore pay to levels from 2008.