The Government tore up a potential agreement with medics over a new junior doctors' contract, triggering a row with the British Medical Association (BMA) which could lead to strike action, a former health minister has claimed.
Dan Poulter, who was in the Department of Health when contract negotiations began, said the doctors' anger was understandable and based on "valid" concerns that the deal set to be imposed on junior medics could endanger patients.
The Department said the former minister's claims were "incorrect" but the BMA said Dr Poulter had given a "damning account" of how badly the Government had handled the negotiations.
Junior doctors in England are to be balloted for industrial action because the Government wants to impose new terms and conditions on trainees' contracts from August.
Dr Poulter wrote in the Guardian: "Junior doctors are not easily roused. They are rightly upset about proposed cuts to their pay, but the recent unprecedented decision to ballot for strike action is not fundamentally about money.
"It is rooted in very valid concerns about a contract that could compromise patient safety.
Dr Poulter, a former junior doctor, wrote in the Guardian that when he was overseeing negotiations over the contracts last year, the coalition government had reached "many areas of broad agreement with the BMA" including on the need to improve training and to find a better way of remunerating medics for on-call work at night and at weekends.
But instead of building on the basis for an agreement that had emerged in September 2014, the contract the Department of Health now seeks to impose is very different, he said.
"Then there was no talk of 90-hour weeks, no talk of large numbers of junior doctors having their pay cut.
"There was instead a recognition by the Department of Health that now appears to have been lost: that better pay and work-life balance incentives were needed to ensure doctors were attracted to A&E and other gruelling specialities.
"Now we are seeing junior doctors, for the first time ever, balloting for strike action over their contract of employment."
Dr Poulter claimed the change was motivated by a need to cut costs, with the contracts a "crude lever" available to Health Secretary Jeremy Hunt "looking for ways to close the gap".
The change was also motivated by reforms including the drive to a truly seven-day NHS, he said.
"However, I am unclear how a new junior doctor contract that will cut the pay of doctors entering GP training, cut the pay of psychiatry registrars because they are classified as being non-resident when on call, and cut the pay of A&E doctors, will help to deliver a seven-day service," he said.
"In my view it will further discourage doctors from choosing careers in specialities already facing acute recruitment and retention challenges."
Johann Malawana, chairman of the BMA junior doctors committee, said: "This is a damning account of how badly the Government has handled the junior doctor contract.
"Rather than working with the BMA to agree a contract that is safe, fair and values the vital contribution junior doctors make to the NHS, the Government is riding roughshod over the process and trying to impose a contract that would be bad for patients, junior doctors and the NHS as a whole.
"'The outpouring of anger from junior doctors in recent weeks shows just how let down they feel by the Government's proposals, which could see many junior doctors choosing to vote with their feet and leaving the NHS.
"This would be a disaster at a time when we need more doctors, not fewer, if we are to meet the enormous challenges facing the NHS.
"We have said throughout this process that we want to reach a negotiated agreement but this is only possible if the Government is prepared to enter into a genuine negotiation, in good faith and provide us with the concrete assurances we need to get back around the table. Without these, we will continue with our plans to ballot junior doctors on action."
A Department of Health spokesman said: "These claims are incorrect. Our proposals will mean average pay will not go down and there is no intention to increase working hours.
"In fact, we want to offer more safeguards over total hours worked for junior doctors than ever before. We call on the junior doctors committee to re-enter negotiations and work with us to put in place a new contract that's safe for patients and fair for doctors."