Doctors vote to strike again as pension row escalates Tens of thousands of patients were denied a planned operation or medical appointment during last week's strike. Photograph: RayArt Graphics/Alamy Doctors have voted on Thursday to ramp up their pensions dispute with the government by conducting more industrial action that would reduce the NHS to a bank holiday-style service, where only emergency cases would be treated. A large majority of the 500 delegates at the British Medical Association's (BMA) annual conference backed a motion calling for doctors across the UK to escalate the industrial action that last Thursday saw tens of thousands of patients denied a planned operation or appointment with their specialist or GP. But their move came amid some tentative optimism among BMA leaders that a resolution to the year-long dispute may soon emerge from ongoing behind-the-scenes talks. Delegates agreed that more industrial action was "necessary" to try to force ministers to backtrack on plans that have infuriated the profession because they will force doctors to work until they are 68, pay more in pension contributions and lose their final salary scheme perk. The motion they approved said any future action "should be in conjunction with other public sector unions" and that the doctors' union's ruling council "should consider a range of options in defence of our pensions." They included withdrawing from the establishment of clinical commissioning groups, which will become key bodies in the NHS in England next under the coalition's controversial health reforms and "in secondary [hospital] care, withdrawal of labour with emergency cover only." Such a move would see the NHS able to offer only the minimal service it provides on Christmas Day or bank holidays, when only emergency cases are dealt with. The move does not bind the BMA's council, which will discuss what next steps the union should take this afternoon. It was passed despite warnings from delegates, including GP Ivan Camphor, that doctors would risk losing patients' goodwill by taking more action. Dr Kevin O'Kane, a London hospital consultant who proposed the motion with council member Dr Anna Athow, said passing it would show health secretary Andrew Lansley that doctors would "fight" - by taking several further days of action, if necessary - until they received "fair treatment" over their pensions. We need to send out a very strong message to the government that we are serious about this and get another day of action on the books. Let's get more days of action announced and get some momentum around this. Mr Lansley, we are very serious about this and you had better believe it," O'Kane - who chairs the BMA's 32-000 strong London region - told the gathering in Bournemouth. But the conference rejected the part of the motion that called on BMA council to name a date for a second day of action. In doing so they may have been acting on the advice of the BMA's outgoing chairman, Dr Hamish Meldrum who, just before the vote, recommended rejecting that idea. Meldrum _ who earlier this week warned doctors that further action would damage patients' trust in them - indicated to delegates that there might be an announcement soon about progress towards breaking the deadlock. A lot of discussions had been held since last week's day of action and "there may be some news," possibly as soon as lunchtime today, he said. "It may not be wonderful, that things go back to 2008 [when the BMA agreed an updates pensions deal with the then Labour government]," but there might be developments, he added. On Monday Meldrum, who stands down today after five years as the leader of the 140,000-strong BMA, hinted that if ministers agreed concessions over two key concerns that might be enough to persuade doctors to call off the dispute. These concerns are over doctors having to do their usual jobs until they are 68, which some say is impractical for medics such as A&E doctors and certain types of surgeons, and the planned increases in doctors' pension contributions which are due to happen in 2013 and 2014. However, Department of Health sources confirmed today that while the detail of those two issues is still to be agreed, doctors would receive no concessions in response to them taking, or threatening to take, industrial action. A letter Lansley sent yesterday to Unison's head of health, Christina McAnea, who is co-ordinating the 15 health unions' opposition to the pension plans, indicates that there may be some scope for agreement being reached on the two issues identified by Meldrum. We also need to discuss contribution rate increases in years two and three and how this will feed through in tiered contribution rates. This work needs to be taken forward in a spirit of partnership focussed on achieving pension arrangements that will best meet the needs of staff and employers," Lansley wrote. In another seemingly emollient passage, he said: "I recognise that trade unions are particularly concerned about the increase in normal pension age. The implications of this will be considered in the Review of Working Longer and the government has also committed to keep the link under review as recommended by Lord Hutton. Sources involved in the dispute suggested that certain sorts of doctors might be able to do less onerous tasks than usual when they reach their mid-60s as part of a potential resolution of the row. Lansley's letter also makes clear that he is pressing ahead with implementing the shake-up of the NHS pensions scheme, partly because "the majority of NHS staff have not rejected the proposals" in a series of votes, often with low turnouts, held by unions such as Unison, Unite, the Royal College of Nursing and the Royal College of Midwives.