A health board has postponed 80% of planned operations as junior doctors in Wales prepare for three strike days.
British Medical Association (BMA) members called it a last resort to stop more leaving due to pay erosion. Dr Emily Sams said they were offered less than England and Scotland, meaning they “don't need to go halfway around the world to Australia for better pay”.
Health Minister Eluned Morgan reassured people that urgent and life-threatening care will continue to be provided.
“We are disappointed junior doctors have voted for industrial action, but we understand the strength of feeling among BMA members,” said Ms Morgan.
“We would like to address their pay restoration ambitions, but the pay award offer we have made is at the limits of the finances available to us and reflects the position reached with the other unions.
“We continue to press the UK government to pass on the funding necessary to provide full and fair pay rises for public sector workers.”
Ms Morgan encouraged people who need to attend an emergency department to still do so throughout the strike action, and for others to consider “the best option for them”, including using the 111 online or phone service, or go to their local pharmacy.
There are about 4,000 junior doctors working in Wales, making up 40% of its total medical workforce, mainly in hospitals. Nearly a quarter work for Cardiff and Vale health board, which provides a large proportion of highly specialised treatment like neurosurgery and transplants.
It means the impact on planned services will be significant. It is understood 75% of outpatient appointments and 80% of operations will not take place, to free up more senior staff to cover shifts around the clock.
The BMA in Wales has planned a three-day strike from 07:00 GMT Monday January 15 until 07:00 the following Thursday in a dispute over pay. Its members have already been given a 5% rise by the Welsh government, which is below the 6% recommended by the independent remuneration body.
In England, junior doctors have already been given 8.8%, but have rejected an additional offer worth 3% on average. In Scotland, an improved offer of 12.4% has been accepted, while in Northern Ireland a ballot is planned.
Dr Sams is a general surgical trainee and a BMA Wales representative who graduated seven years ago and now works in south east Wales. She said of the colleagues she graduated alongside, 10 have since moved to Australia, many with the intention of staying a year or two, but have delayed plans to return while the pay disparity remains.
“Our doctors are getting paid the lowest rate of any junior doctor in the UK and the work they're doing is no less valuable,” she said.
“We're at a point now in Wales where doctors don't need to go halfway around the world to Australia for better pay and better working conditions.
“Doctors will look across the border to England and Scotland.” She said for a long time Wales had struggled to attract trainees with contracts on offer across the border.
“And the pay now is much worse than it is in England and Scotland,” she added.
“It means we're not attracting the best doctors to Wales. It means there will be more rota gaps. Our patients deserve more, we deserve to have the best doctors working here.”
Health bosses will not know exactly how many staff will take part in the industrial action until the day, but significant disruption is expected.
Donna Coleman, regional director for health and social care body Llais in west Wales, said: “People already know they're going to have sometimes very long waits for some kinds of surgery, so when they see this further disruption on top it's even more devastating for them.
“They just absolutely are at a loss with what to do and plan for their lives ahead.” Industrial action by junior doctors in England featured prominently during 2023, with six days of action at the start of this year, but this is the first time their colleagues in Wales will have taken to the picket lines.
Junior doctor is the broad title given to anyone who has graduated from medical school but is yet to qualify as a consultant, and can include doctors with nine years or more experience.
— CutC by bbc.com