Health Secretary Jeremy Hunt is prepared to impose seven-day working on hospital doctors, he will say later.
Mr Hunt will accuse the British Medical Association of being out of touch in his bid to force weekend working.
Talks with the BMA broke down last autumn and with no sign of a breakthrough Mr Hunt is expected to set a September deadline to agree a deal.
If there is no agreement, he will say, he is willing to force different arrangements on new consultants.
The current consultant contract means senior doctors can opt out of weekend work as long as it is non-emergency in nature – although they are still expected to be on call.
Drive up standards
By ensuring all new consultants do not have this right, Mr Hunt believes over the course of the parliament he will gradually get enough senior doctors in place to drive up standards at weekends.
While he is within his powers to impose such a deal, the move threatens to sour relations with the medical profession – especially as a number of hospitals have already started altering rota patterns to create a more even spread of cover.
The BMA pulled out of talks last year amid concerns over workload.
But in a speech in London on Thursday, Mr Hunt will claim 6,000 people die each year because care at weekends does not match that given during the week.
There is robust evidence showing that a weekend admission is linked to a higher chance of death, but what is still not obvious is what exactly causes this.
Research from three years ago published in the Journal of the Royal Society of Medicine showed 1.3% of people who are admitted to hospital die within 30 days.
Death rates were higher for weekend admissions – compared with admission on a Wednesday they were 16% higher for Sunday and 11% for Saturday.
But, crucially, it was not clear to what extent this was down to a lack of experienced staff.
Another factor could have been the fact that people with a greater severity of illness may be admitted at weekends because of a lack of services in the community for those at the end of life.
That in itself is an argument for more seven-day services across the whole health service. But whether that can be afforded is another matter.
“They [the BMA] are not remotely in touch with what their members actually believe. I have yet to meet a consultant who would be happy for their own family to be admitted at weekends or would not prefer to get test results back more quickly for their own patients,” he will say.
“I will not allow the BMA to be a road block to reforms that will save lives.
“Be in no doubt, if we can’t negotiate, we are ready to impose a new contract.”
He will also make pledges about greater transparency and improving the way technology is used in what is being billed as his “25-year vision” for the health service.
The comments come just a month after he tried to entice GPs to move towards more seven-day working by promising to recruit extra staff to relieve the pressure on services.
BMA leader Dr Mark Porter said the union supported more seven-day working but accused Mr Hunt of being “too simplistic”.
The BMA has argued that to improve care at weekends you also need more support services such as diagnostics and pathology as well as care in the community to allow patients to be discharged.
“Today’s announcement is nothing more than a wholesale attack on doctors to mask the fact that for two years the government has failed to outline any concrete proposals.
“How will he ensure there isn’t a reduction in mid-week services or fewer doctors on wards Monday to Friday?” added Dr Porter.
The BMA has also released a survey of 2,000 adults which found two thirds did not believe the NHS could afford seven-day services.