THE government’s “business as usual” approach to NHS strike action is “dangerous” and masks the true impact on patients, service leaders warned today.

Calling on ministers to reopen negotiations, the NHS Confederation said the number of cancellations and postponements over the past nine months is just the “tip of the iceberg.”

In a “worst-case scenario,” it said industrial action could have doubled the number of cancellations which were officially reported by the NHS – almost 835,000 appointments postponed due to industrial action since December across England.

NHS Confederation chief executive Matthew Taylor said: “Industrial action damage control has become a dangerous ‘business as usual’ for the NHS – the very situation we warned the government to avoid – and nine months into strike action we are as far away from a solution for doctors as we have ever been.

“We fear this might get worse before it gets better, as the number of cancellations due to industrial action will soon reach one million.”

He said cancellations may have a “two-for-one effect” as rearranging operations usually involves knocking another case.

But “strike data just isn’t recording that so we could actually be seeing, in an absolute worst-case scenario, industrial action causing double the number of cancellations than what is being reported.”

It comes as NHS England warned a four-day strike by junior doctors will likely cause “significant disruption” to patients from 7am on Friday.

Dr Robert Laurenson and Dr Vivek Trivedi, co-chairs of the British Medical Association’s junior doctors committee, said: “This dispute should never have gone on so long.

“It has now been almost three months since the government was last willing to talk to junior doctors about their pay.

“Since then, we have stated repeatedly that our door remains open for talks at any time, as long as we could be presented with a credible offer that would address pay erosion of more than a quarter over the last 15 years.”

The pair said the government has “wasted time,” adding: “Sooner or later the government will accept that they need to work with doctors rather than against them.

“We are here to talk when they do.”

The Department of Health and Social Care said: “We have repeatedly urged the BMA to put patients first by ending their hugely disruptive strikes immediately.”