With junior doctors downing tools for the second national strike over the ongoing contract row, Dr Rachel Clarke – who works at the county’s hospitals – explains why doctors are heading to the picket lines this morning

Difficult decisions are an essential part of medicine – to treat or not to treat; to try surgery or medicines; to keep on striving to save, or to ensure that the end of life comes with peace and dignity.

As a junior doctor, what matters to me more than anything is working closely with my patients and their families so that these decisions are shared, owned by them as much as us.

But now, on the eve of our second national strike, I have had to decide alone. The choice to strike – to leave the patients I care about so deeply – has kept me lying awake for nights.

My duty as a doctor is to protect my patients at all costs, so how, you may ask, can I possibly be striking and abandoning them?

Jeremy Hunt, the secretary of state for health, would have you believe the dispute over junior doctors’ contracts is about nothing more than our pay packets.

But doctors aren’t money-motivated people, and no-one goes into medicine to get rich quick. We choose medicine because we want to help people.

We are striking this week because we genuinely believe the effects of the government’s new contract on the NHS will be disastrous.

They will cause so much harm to patients in the long term, we believe, that it’s our duty to strike in the short term.

Pay is not the real issue, and nor is an unwillingness to work on Saturdays. What’s really at stake is the dishonesty of a government pretending to care about patient safety at weekends, while not being willing to fund any actual improvements in weekend services.

The government’s election “mandate” for a “seven-day NHS” is not matched by one single extra pound of funding towards new, improved weekend activities.

There is no money for the extra doctors, nurses, porters, technicians, radiographers and therapists needed for seven-day services.

Instead, Jeremy Hunt plans to stretch the existing workforce even more thinly over seven days, not five.

That, frankly, is dangerous. Already, I will often work on-call shifts that can stretch into 14 or 15 hours straight, without even a break to eat.

I will find myself almost too tired to string a sentence together, let alone make life and death decisions with confidence. Recruitment of doctors in some areas is now so dire that gaps in our on-call rotas force us to cover two people’s jobs, with twice as many patients’ lives in our hands.

We are exhausted, demoralised and quitting the NHS in increasing numbers. The profession is at breaking point.

In this context, if the government persists in trying to impose their new contract, they will alienate a whole generation of young doctors.

The gaps in the rotas will increase, and you will be cared for by ever more broken doctors. Patient safety can only suffer.

Contrary to what Mr Hunt wants you to believe, I am more than happy to work the weekends, nights and Bank Holidays I do to ensure my patients receive excellent care around the clock.

I don’t want special treatment. I know that thousands of people from all walks of life work at nights and weekends just like doctors.

But I cannot allow Jeremy Hunt to impose a contract that threatens my patients.

The government could end this dispute tomorrow. If only they would actually fund the new weekend services they claim to desire, then this strike would be called off in a moment.

I can only hope for my patients’ sakes that they stop spinning and start genuinely prioritising public safety.