There is concern that the vital preparation work which should have gone ahead in the past two months has been derailed.
Top figures also fear that millions of pounds provided to strengthen the health service may be used to cover the cost of the strikes.
The BMA has been urged to stop “putting patients in harm’s way” and end the strikes.
With winter around the corner and the dispute unresolved, a senior figure in Whitehall warned: “We are going into the skid.”
However, the BMA has said it is prepared to “continue striking until the next general election”. Junior doctors first went out on strike in March, with consultants starting industrial action in July.
Managers who should have been working to put winter defences in place have had to devote time to redrawing rosters, re-booking appointments and rearranging annual leave to cope with strikes. It comes as the NHS braces for dealing with Covid, flu and other seasonal illnesses. The Department for Health and Social Care recently announced a £200million booster shot for the NHS to get it through this period.
This came alongside £600million to help with recruitment and retention in the social care sector.
Health Secretary Steve Barclay backed giving early extra funding to support preparatory work rather than waiting until winter hits and pressure mounts.
But there are worries NHS trusts will dip into the new cash to pay “huge sums in overtime to doctors to tackle the extra backlogs in elective treatments caused by strike action”.
Reports of hospitals paying more than £3,000 to cover strike shifts have triggered outrage. A senior Government source said: “Frankly, they are ripping off the NHS.”
Meanwhile, NHS England bosses last week warned that urgent cancer and heart care is being put at risk by the strikes. A source close to Mr Barclay said: “The Government is supporting the NHS’s preparations for winter pressures and making every effort to protect patient safety.
“But more calculated and co-ordinated strikes called by the BMA leadership will have a significant impact and put patients at risk.”
An insider said that while workers in most strikes have an incentive to go back to work to avoid losing pay, doctors could benefit from receiving overtime pay for covering shifts.
The BMA’s “rate card” states that consultants should be paid £161 an hour to provide additional shifts between 7am and 7pm. This rises to £269 for an overnight shift.
The BMA has invited the Government to “end the pay dispute” by taking part in talks with conciliation service Acas.
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