The NHS “doesn’t just belong” to striking junior doctors and can’t be “switched on and off on whim”, the health secretary said.

Victoria Atkins turned up the heat in the government’s row with the British Medical Association (BMA) as their record-breaking walk-out continues.

Junior doctors in England are in the middle of a six-day strike over pay and conditions, the longest industrial action in NHS history.

A number of hospitals in England have pleaded for medics to leave picket lines and get back to work due to safety concerns, also known as derogation requests.

But this has sparked a row as the BMA has suggested the requests are “politically motivated”.

Ms Atkins promised to start talks with the BMA “in 20 minutes” if the strikes were called off.

Speaking on a visit to London Ambulance Service, she told the PA news agency: “I’ve said throughout this that, please, to the junior doctors’ committee, the moment you call off the strikes, I’ll get back around the table with you within 20 minutes.”

She said the strikes have to be called off for negotiations to happen, “because the NHS belongs to us all”.

“It doesn’t just belong to the junior doctors’ committee, and for the 1.3 million people who work in the NHS, as well of course for the tens of millions of people it looks after, the NHS cannot be switched on and off on whim.”

However, the BMA hit back calling it a “political choice” for Downing Street to “stick rigidly to its dogma of not negotiating while strikes are planned”.

Professor Philip Banfield, BMA council chairman, said: “In the past, the government waived this principle for the barrister strikes, so there is no reason for them to waste time and money by refusing to talk now.

“We are clear: we are ready to talk 24/7. Get back around the table, give us a credible offer and we can end these strikes right now.”

The government gave junior doctors an 8.8% pay rise last summer, with an extra 3% offered during the last round of negotiations towards the end of the year.

But the BMA rejected the 3% offer, saying it does not make up for a real-term pay cut of nearly a quarter for junior doctors since 2008.

They want full pay “restoration” to reverse real-term cuts in pay since 2008-9, a new pay mechanism to prevent any future pay decreases against inflation and the cost of living, and a reformed pay review body to “safeguard recruitment and retention of junior doctors”.

The strikes are a headache for Rishi Sunak as the UK enters an election year.

The prime minister has staked his premiership on five key pledges which include cutting NHS waiting lists.

Although the backlog was at a record high before the industrial action broke out, over one million appointments have been cancelled or rescheduled due to strike action by junior doctors and other workers in the NHS in the past year.

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While the government has managed to resolve other disputes, with a new pay offer recently made to senior doctors, the row with junior medics is showing no signs of abating.

More than 20 derogation requests have been submitted to the BMA for this round of strikes, but so far none have been approved.

The union said that NHS England and some trusts are refusing to provide evidence that they have undertaken steps to show they have “exhausted” all other sources of staffing before recalling medics from the picket line.

In a letter to NHS bosses, the BMA accused health leaders of misusing the system and bowing to political pressure to undermine the strike.

NHS England said they will “continue to engage with the BMA in good faith” and they will address the process for considering patient safety mitigations.

Ms Atkins, echoing Mr Sunak’s comments earlier on Thursday, said she backed NHS leaders in making the mitigation requests but this is being done “completely independent of government”.

She said the strikes are having “very serious consequences”, with 88,000 appointments cancelled during the last set in December.

Health officials have warned that this strike will be worse because it coincides with one of the busiest weeks of the calendar year, due to a rising tide of winter bugs and people storing up problems over the Christmas break.

On the first day of the strike on Tuesday, critical incidents were declared at Queen Alexandra Hospital in Portsmouth and by the NHS in Nottingham.

Meanwhile more than a dozen hospitals said that emergency services were busy, with some reporting “extreme heightened pressure”.