Junior doctors took to picket lines across the UK today as they began a three-day strike in their long-running pay dispute with the government.

The British Medical Association rejected a last-ditch appeal by health secretary Steve Barclay for them to enter into fresh negotiations in an attempt to avert the walkout.

The unions says junior doctors’ pay has fallen in real terms by 26% since 2008/09 and are demanding “full pay restoration”.

Professor Stephen Powis, medical director of NHS England, said it would be “the most disruptive set of industrial action days that we’ve seen all winter”.

But the striking medics say their action is necessary to force the government’s hand.

Here is what some of those striking have been saying from the picket line.

Speaking outside the Queen Elizabeth Hospital in Birmingham, junior doctor Shivam Sharma told the Press Association: “Junior doctors have faced a massive 26% real-terms pay cut over the last 15 years.

“We are not worth 26% less, we don’t do 26% less work, we don’t see 26% less patients. In fact, the work has only gotten harder.

“Currently, 50% of junior doctors are struggling to pay rent, mortgage and bills, and 50% are having to borrow money from friends and family just to make ends meet.

“If you or I were going into hospital critically unwell, we couldn’t want our junior doctor to be worrying about how they’re going to pay their bills.

“So something has to be done – we have to value doctors here if we are going to keep them.”

Paul Smith, a first-year surgical trainee at the Nottingham University Hospitals NHS Trust, said: “I started in my training post in August last year and I’ve spent £3,000 on course fees, professional fees and exams. We can claim some tax back but I’ve still got to pay that upfront.

“Me and my partner managed to save up enough money to buy a house locally and we found a hole in the roof last week.

“We’re genuinely struggling to find the money to fix that at the moment.”

Speaking from the picket line at University College Hospital in London, Rebecca Lissman, 29, a trainee in obstetrics and gynaecology, said: “I still want to work for a service that’s free at the point of use when I’m a fully qualified consultant. We want a health service that works for everyone and that’s why I’m here today.

“We can’t give people the service they deserve and see them as quickly as they need because we are so stretched.

“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.”

Edward Finn, an anaesthetist registrar at the Nottingham University Hospitals NHS Trust, said: “If you look at the overall cost of living, wages that haven’t kept up with that, and we don’t go out for meals, we don’t do anything.

“My wife and I are both part-time – we couldn’t afford to be full-time with the cost of childcare – but we still have to do the occasional extra shift on top of our contracted hours to keep up with things like the electricity bill.

“When you’re talking about somebody who’s been a doctor for 12 years, it’s quite sad really, isn’t it?”

Striking junior doctor Martin Whyte, on the picket line in Newcastle, said the public understood the need for the industrial action.

“We used to say anything above four hours was a breach but we have missed that target so overwhelmingly now, it’s almost not worth counting.

“These systems are failing chronically and I think the public understand that.

“They know steps have to be taken to address that, and that starts with better retention of staff and for that you need better pay. We are seeing a lot of attrition from the workforce.”

The 36-year-old said newly qualified doctors used to talk about the specialism they hoped to work in, adding: “Now when I talk to them they say ‘I’m going to go to Australia’, ‘I’m going to go to Canada’, or ‘I’m going to quit medicine all together’, because the pay relative to the work and the intensity and the hours just doesn’t add up.”

Speaking on a picket line at Leeds General Infirmary, Dr Chris Morris, doctor and British Medical Association rep, said: “It’s really reassuring when members of the public do go past honking their horns, giving us messages of support. It reemphasises why we’re doing this.”

“I don’t think anyone has taken this decision lightly. It’s the last thing we want to do as doctors but we feel that we’ve pushed into this decision by the government.”

Steve Barclay said he wanted to “engage” with the junior doctors to reach an agreement to end the strikes.

He said other health unions had agreed to hold pay talks with him and he called on the BMA to do so “as a matter of urgency”.

It marks a change of tone from December, when Barclay said he could not offer NHS staff more money.