The war of words between doctors and ministers over Thursday's industrial action across the NHS escalated with Andrew Lansley claiming the plans "were pointless" and unfair on patients.
In a bullish speech to NHS leaders, the health secretary portrayed doctors as greedy, unrealistic and out of touch.
"The strike is pointless. It will achieve nothing. All the BMA is doing is creating uncertainty, discomfort and difficulty for patients, most of whom could only dream of getting a pensions like theirs", Lansley told the annual conference of the NHS Confederation, which represents NHS managers.
In a bid to increase the pressure on GPs and hospital doctors ahead of the "go-slow" industrial action in which some will be involved on Friday – the first industrial action by doctors since 1975 – Lansley also claimed for the first time that doctors only contributed 20% of the total cost of their pensions.
"The current estimated cost of paying pension benefits to doctors is about £83bn. Of that, around three-quarters, or £67bn, is likely to have come from the taxpayer", he told the gathering in Manchester.
The Department of Health claimed that research by the Government Actuarial Department showed that "taxpayers are subsidising 80% of doctors' gold-plated pensions" because "the cost of paying pension benefits to doctors is estimated to total £83bn", while "the new figures show that taxpayers are expected to have to fund £66bn of these pensions in direct subsidies, 80% of the total.
The figures show that doctors receive a return on their pension of £5 for every £1 they contribute, contradicting claims by the BMA that their pension scheme is 'in surplus'."
But the BMA, which has called the strike action to protest against changes to doctors' pensions, which the government is imposing despite the profession's vehement opposition, rejected as untrue what the union's chair of council Dr Hamish Meldrum called "the secretary of state's repeated and blatantly misleading comments about the NHS pension dispute [which will] only set back what he purports to seek to achieve – a quick resolution.
"For the thousands of ordinary doctors who will be taking action tomorrow -- the first in almost 40 years – it will sadly confirm that he is simply unable and unwilling to listen to the genuine concerns of NHS staff. This is not good for doctors, the government or, most importantly of all, for patients and the NHS", Meldrum added.
The BMA leader also rejected Lansley's claim that the NHS pension scheme had not been made sustainable by the major overhaul it underwent, by agreement, in 2008.
Those negotiations saw staff accept higher contributions and a higher pension age, and take on the responsibility for any future increased costs caused by rising life expectancy, said Meldrum.
"The scheme is currently bringing in more than it is paying out, removing any justification for the immediate hike in contributions that has been imposed". The Treasury's plans for overhauling all public sector pensions now did not take into account the financial health of the NHS scheme or the 2008 agreement, he added.
Support for the doctors' action is in short supply. Mike Farrar, the NHS Confederation's chief executive, said that, whatever the rights and wrongs of the BMA-government dispute, "I feel passionately that patients should not be dragged into the argument". And while "NHS trusts have been pulling out the stops to minimise the effect on patients … this day will have an impact on the service and will cause disruption for many", he predicted.
Dean Royles, the director of the NHS Employers, said his members were "deeply concerned about the distress it will cause patients as well as the anxiety it will cause to many of out staff who want to ensure their patients are not put at risk." He added: "Doctors also know that public confidence in them may be damaged by this action."
A ComRes poll for ITV News found that 51% of the 2,059 adults involved were against the industrial action, with 32% supporting it and 17% unsure.