LONDON (AP) — Tens of thousands of junior doctors went on strike across England on Monday to demand better pay, kicking off three days of widespread disruption at the UK’s state-funded hospitals and health clinics.

Junior doctors — who are qualified but in the earlier years of their career — make up 45 per cent of all doctors in the National Health Service. Their walkout means that operations and appointments will be cancelled for thousands of patients, and senior doctors and other medics have had to be drafted in to cover for emergency services, critical care and maternity services.

The British Medical Association, the doctors’ trade union, says pay for junior doctors has fallen 26 per cent in real terms since 2008, while workload and patient waiting lists are at record highs. The union says burnout and the UK’s cost-of-living crisis are driving scores of doctors away from the public health service.

The union said newly qualified medics earn just 14.09 pounds ($17) an hour.

“All that junior doctors are asking is to be paid a wage that matches our skill set,” said Rebecca Lissman, 29, a trainee in obstetrics and gynaecology. “We love the NHS, and I don’t want to work in private practice, but I think we are seeing the erosion of public services.”

“I want to be in work, looking after people, getting trained. I don’t want to be out here striking, but I feel that I have to,” she added.

Other health workers, including nurses and paramedics, have also staged strikes in recent months to demand better pay and conditions. NHS figures show that more than 100,000 appointments have already been postponed this winter as a result of the nurses’ walkouts.

Stephen Powis, medical director of NHS England, said the 72-hour strike this week is expected to have the most serious impact and will cause “extensive disruption.”

He said some cancer care will likely be affected, alongside routine appointments and some operations.

Prime Minister Rishi Sunak told reporters on Sunday it was “disappointing that the junior doctors’ union are not engaging with the government.” The doctors’ union said officials have refused to engage with their demands for months, and that a recent invitation to talks came with “unacceptable” preconditions.

The doctors’ strike this week will coincide with mass walkouts by tens of thousands of teachers and civil servants on Wednesday, the day the government unveils its latest budget statement.

A wave of strikes has disrupted Britons’ lives for months, as workers demand pay raises to keep pace with soaring inflation, which stood at 10.1 per cent in January. That was down from a November peak of 11.1 per cent, but is still the highest in 40 years.

Scores of others in the public sector, including train drivers, airport baggage handlers, border staff, driving examiners, bus drivers and postal workers have all walked off their jobs to demand higher pay.

Unions say wages, especially in the public sector, have fallen in real terms over the past decade, and a cost-of-living crisis fueled by sharply rising food and energy prices has left many struggling to pay their bills.