The Government has insisted it is "fast approaching" the time when it will implement a new junior doctors' contract.
Health Minister Ben Gummer told MPs "we cannot delay this any longer" as he added latest estimates suggest 2,884 operations have been cancelled ahead of a 24-hour strike by thousands of junior doctors in England on Wednesday.
Labour accused Health Secretary Jeremy Hunt of lacking the "nerve to turn up" to answer questions in the Commons and labelled the Government's approach as an "exercise in using a sledgehammer to crack a nut".
Issues over weekend working continue to remain unresolved.
Replying to an urgent question, Mr Gummer told MPs: "At some point this Government needs to make a decision.
"We have extended time and again the point at which we will introduce the new contract, precisely so we can give time for talks to proceed even though the BMA (British Medical Association) refused to discuss this for several years in a disjointed manner up until this point.
"But at some point we will have to make the changes which are necessary in order to get that consistency of service over the weekends. We cannot delay this any longer.
"No health secretary, no minister of health could stand in the face of the many academic studies which have shown an avoidable weekend effect and say that nothing should happen.
"Of course this should be done in concert with other contract changes, with changing the availability of diagnostics and of pharmacy and other services.
"It is part of the piece, we have always said that, but it has to be done at some point and that point is fast approaching."
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