The doctors union “will lose a war with this government”, Wes Streeting has said, adding that the NHS is ready to tough out a prolonged series of strikes by the British Medical Association (BMA).

In his most outspoken comments so far about the dispute involving resident doctors in England, the health secretary vowed that Labour would never give in to their demand for a 29% pay rise.

However, in a plea to the BMA, he urged it to agree a deal based on tackling other frustrations those doctors have, separate to their salaries, in which both sides would “win the peace”.

Fresh talks are planned next week. For these to have any chance of success, Streeting said, the BMA should agree it will not call any more strikes and accept that other NHS staff deserve decent pay increases too, not just medics, who are already paid more than many colleagues.

“It should be clear to the BMA by now that they will lose a war with this government. It’s not too late for us both to win the peace,” Streeting said in an opinion piece for the Guardian.

It comes after the end of a five-day stoppage by thousands of resident doctors that disrupted NHS services including cancer care between last Friday and Wednesday morning.

“All I ask of the BMA is two things. The first is to drop this unnecessary and unreasonable rush to strike action. It mars doctors, it harms patients and it is fundamentally self-defeating because it leaves the NHS with less money to address the issues that doctors care about,” Streeting said.

“The second is to recognise that this government has a responsibility to all NHS staff and, above all, to patients. We can’t fix everything for everyone everywhere all at once.”

The chances of the negotiations succeeding appear slim. Rejecting a potential deal based on non-pay issues such as doctors being able to access hot food at night and having part of their exam fees covered, a BMA spokesperson said: “This is still primarily a pay dispute and we don’t accept there is no room to budge on pay. We need a credible offer on a path to pay restoration.”

The BMA says resident doctors deserve such a hefty pay rise, despite having received an uplift of 22% over the last two years, because the real-terms value of their salaries since 2008 has been heavily eroded. The union has pledged to strike until it achieves “full pay restoration”.

Dr Ross Nieuwoudt and Dr Melissa Ryan, the co-chairs of the BMA’s resident doctors committee, insisted that Streeting must find some way of upping their 5.4% pay award for 2025-26. The end of the five-day strike must be “a moment for the health secretary to reconsider his strategy,” they said.

If he does make an undefined “credible offer” on pay then they said this week’s walkout – the 12th by resident and formerly junior doctors since 2023 – could be their last.

In Streeting’s article, he also:

• Accused the BMA of causing “damage” to the NHS through its “reckless” long walkout.

• Claimed it deliberately sought to ruin through strikes the NHS’s effort to cut its 7.4m-strong backlog of care, which Labour has pledged to eradicate by 2029.

• Said the BMA’s 29% demand and strike had left other NHS staff “dismayed and appalled”.

Streeting, a kidney cancer survivor, related how he had spoken last weekend to a patient with the same disease whose operation was postponed until late next month because of the strike. Patients whose care had to be rescheduled ended up with “fear and anxiety” as a result, he stressed.

In remarks that may be interpreted as implying the BMA’s 29% demand is greedy, Streeting pointed out that other health unions such as the Royal College of Nursing (RCN) and Unison were unhappy with their members’ pay award – of 3.6% – but were not seeking the same huge uplift as the BMA and were not engaged in the same “rush” to industrial action.

The RCN will on Thursday publish the outcome of an indicative vote it has run among nurses in England, Wales and Northern Ireland, which is already known to have resulted in a majority coming out against the 3.6% award.

Hospital bosses have made clear to the BMA that it must accept what Streeting has repeatedly insisted and that resident doctors will not force him to give a bigger pay award for this year.

Rory Deighton, the acute and community care director at the NHS Confederation, which represents NHS hospital trusts, said: “After a week of disruption to services, health leaders will be pleased that the BMA wants to resume talks. But it has to recognise the red lines set by the government, as the NHS must live within its means.

“We hope that this [exchange of letters] marks the beginning of a dialogue that can resolve this issue without further walkouts which would only see patients end up suffering the most.”