The 'morally reprehensible' British Medical Association is acting like a cartel and threatening the future of the NHS, Wes Streeting has said.

The Health Secretary warned the union is inflicting 'damage and disruption' on the service with repeated strikes, with another five-day walkout of resident doctors planned from 7am on Friday.

It is expected to cost the NHS £240 million but he told delegates at the NHS Providers’ conference in Manchester that the Government would not 'be held to ransom' by the BMA and it is clear the organisation is no longer a professional voice for medics.

Mr Streeting last week wrote to resident doctors - previously known as junior doctors - offering more specialist training places and help with paying their exam fees and professional membership dues if they aborted industrial action.

He highlighted that they had received a 28.9 per cent pay rise over the past three years and insisted taxpayers could not afford more.

But the BMA's resident doctors committee rejected the offer within just a few hours, without consulting the wider membership, whose support for strikes is waning.

Mr Streeting was asked during a question and answer session at the conference whether there was a case for making it illegal for doctors to strike in the same way that the police are banned from striking.

'Unsurprisingly, as a Labour politician, that’s certainly not my instinct and there’s a reason why we support people’s right to withdraw their labour,' he said.

'What I’d say to the BMA is, with that power comes a responsibility and a duty of care to patients.

'And honestly, look at the turnout in that latest ballot, and look at the level of mandate they got for it.

'A majority of resident doctors didn’t vote for this strike action.

'I cannot think of a precedent in British trade union history where, after that level of pay rise, people have then chosen to walk out on strike.'

He warned the walkout 'causes untold misery and disruption to patients who could do without it' and puts 'untold pressure on other NHS staff who are picking up the pieces for the damage and disruption that resident doctors and the BMA are inflicting on the service'.

Mr Streeting also took aim at consultant members of the BMA.

He said: 'Let me tell you, when we ask some of the wealthier to pay more, some of the most effective lobbyists against paying higher tax are the BMA consultants committee and the BMA pensions committee.

'So what they effectively do is say, "We want other people to pay the higher salaries for doctors" and, as much as a cancer survivor I think my surgeon is worth his weight in gold, we have to be honest and realistic about the challenges in the system, the challenges of public finances and the challenges facing every family, and it’s time for the BMA to get real.

'But one way or another, we’re not going to be held to ransom. We are going to plough on regardless.

'And I think it’s become increasingly clear that the BMA is no longer a professional voice for doctors.

'They are increasingly behaving in cartel-like behaviour, and they threaten not just the recovery of the NHS under this government, they threaten the future of the NHS full stop. And I think that is a morally reprehensible position to be in.'

NHS figures show that consultant average full-time equivalent earnings are £127,540 a year.

Mr Streeting was applauded by the audience of NHS executives, including by NHS England chief executive Sir Jim Mackey, who delivered a speech a short while later in which he described strikes as ‘irritating’ and ‘disruptive’.

He said he is aware patients worry about the effect on services and said doctors should appreciate the ‘benefits and privileges’ that come with their job.

Earlier in the day, Mr Streeting took the airwaves to make a last minute plea to resident doctors to call off the strikes but said the NHS will ‘do everything we can to keep the show on the road’.

Sir Jim has written to NHS trust leaders urging them to keep the majority of services operating during the strike and said rescheduling appointments and operations should 'only happen in exceptional circumstances to safeguard patient safety'.

He called for a 'laser focus' on four priority areas, including maintaining emergency care and maternity services, ensuring efficient discharge of patients fit to go home, and 'maintaining elective care to the fullest extent possible – with at least 95 per cent of elective activity continuing compared with what would otherwise have been expected’.

Matthew Taylor, chief executive of the NHS Confederation, said: ‘No one wins if these strikes go ahead.

'We hope the BMA’s leadership will take serious note of this damning assertion from the health and social care secretary before it proceeds with its next round of industrial action.

'If not, these strikes will do nothing but risk exposing patients to avoidable harm and as was announced, weaken what the government can then afford to offer resident doctors in response to their demands.

'The BMA must stop these strikes and accept that resident doctors have already received a significant pay increase. With further funding just not available, there is neither the financial nor moral case for these walk outs.'

Daniel Elkeles, the chief executive of NHS Providers, which represents NHS trusts, said Mr Streeting was 'right to warn there will be no winners if this week’s walkout by resident doctors goes ahead'.

He added: 'It’ll be a major headache which could bring the progress made on patient care, safety and NHS finances grinding to a halt.

'We’re getting ready to make the NHS as ‘winter-proof’ as possible, but a costly five-day strike could wipe out productivity boosts in a flash.

'We all want to improve the working lives of valued resident doctors and it’s not too late for talks between the union and Government to avert more days of disruptive strikes.’

A BMA spokesperson said: 'The BMA is advocating effectively for doctors to find a solution which gets doctors into jobs so that they can see patients and reverses lost pay so that it keeps them in the workforce now and in the future.

'The Secretary of State should recognise the importance of demonstrating that the Government values the NHS workforce, not blaming them for taking action when their pay’s value remains a fifth below where it was in 2008, and doctors struggle to find work even as patients wait many months to see a doctor.

'There will be a way to end this dispute, and like any professional association and trade union, we are first and foremost interested in getting back around the table with Government to negotiate properly and reach a solution on both jobs and pay for the benefit of all.’