The public health system in Britain has issued a warning that a four-day strike by tens of thousands of doctors could result in the cancellation of some 25,000 medical appointments.

The impact of the so-called junior doctors’ planned strike on Tuesday is anticipated to be much bigger than that of their three-day walkout last month, according to a policy director for the National Health Service on Saturday.

The strike would be the latest in a host of disruptive labor actions by public sector workers demanding pay hikes to offset inflation exceeding 10%, as union wages have fallen in real terms over the past decade.