Junior doctors march for pay restoration

by Jennifer Trueland

Stormont sees hundreds of disaffected doctors gather to seek fair remuneration

Location: Northern Ireland
Published: Friday 7 June 2024
ni strike crowd

Hundreds of junior doctors from across Northern Ireland gathered at Stormont on Thursday to demand full pay restoration.

The rally took place on the first day of their latest 48-hour strike which saw juniors walk out of hospitals and GP practices from 7am on 6 June to 7am on 8 June.

Fiona Griffin, chair of BMA Northern Ireland’s junior doctors committee, said urgent action was needed now, and she called on newly-appointed health minister Mike Nesbitt to listen and act.

With creatively designed placards and well-choreographed chants, the doctors marched from the gates of Stormont, where the Northern Ireland Assembly is sitting again after years of political stalemate.

Dr Griffin urged them to raise their voices so that the politicians could hear their demands and recognise the strength of feeling. MLAs from different parties addressed the rally and most pledged their support – but there was no sign of Mr Nesbitt, nor of any of his colleagues on the Northern Ireland Executive.

‘We’ve seen our pay eroded by more than 30 per cent; inflation has soared, but our pay has not kept up,’ said Dr Griffin.

‘Today’s rally is about showing those in power that we need urgent action now on our pay asks if they are serious about saving and futureproofing the health service as we know it. We are extremely disappointed that this latest 48-hour walkout could not be averted but there has still not been any progress in our pay negotiations.’


Not going anywhere

Vivek Trivedi, co-chair of the UK junior doctors committee, also joined the demonstration. To loud cheers from a crowd that included babies, children and dogs, he said: ‘We’re standing here at Stormont to tell the people in power that you will not go anywhere, you will be heard, and things must change.’

Demonstrators who spoke to The Doctor at the event expressed concern and outrage about their pay and conditions. Ciarán Mooney, an SHO at Belfast’s Royal Victoria Hospital, was particularly enraged about under-staffing, and its impact on patients. Why, he asked, did ministers care about safe staffing levels only on strike days, not every other day?

Blánaid Canavan, a registrar in cardiology at Altnagelvin Hospital in Derry, graduated in medicine eight years ago and worked in Australia for five years. Although she had qualified as a specialist in Australia, she has to spend a further three years sitting UK exams before she can progress. This is obviously hitting her hard in the pocket. ‘I came back because I wanted to be nearer to my family,’ she says. ‘But I’m taking strike action because we’re not paid enough. I had £50 left in my bank balance before I got paid. I’m working long hours, 12 days in a row, but feel like I’m being paid for a nine-to-five, five days a week job.’

Rhys Kelly, a specialty trainee 4 in anaesthetics, also at Altnagelvin Hospital, said that hospitals were staffed on ‘goodwill’, but, with so many doctors leaving to work elsewhere, this was not sustainable. ‘A lot of people are going away,’ he says. ‘And who can blame them? From Altnagelvin it’s a short drive to Letterkenny [in the Republic of Ireland] where junior doctors can earn triple what they get here. Doctors are burning out – we need to attract more people to come back here, and that means better pay.’

jaq Michael MICHAEL: Friends in Australia

Jacqueline Michael, a senior house officer at Belfast’s Royal Victoria Hospital, studied medicine in Sheffield before being posted to Northern Ireland for her foundation jobs. Although she likes living and working here, she admits she is looking elsewhere. Carrying a placard that reads: ‘All work and no pay makes doctors fly away’, she added: ‘I have friends who have gone to Australia and their lives are so much better. They get paid more and the conditions are better.’

The Northern Ireland Department of Health warned patients that there would be disruption to services as a result of the strike, which runs until 7am on Saturday 8 June. A spokesman said that a backdated pay award would be paid to junior doctors this month, in line with pay review body (DDRB) recommendations.

The BMA says that junior doctor pay in Northern Ireland has eroded by 30 per cent since 2008, and that junior doctors were undervalued, overworked and lacking in training opportunities.


Further afield

oisin fearon

Oisín Fearon is considering his future – and chances are it won’t be in Northern Ireland. Having finished his foundation training, the Queen’s graduate is spending a year working as a locum – in part, because it has better pay and more flexibility than a training programme, but also because he needs the money.

‘Everyone at medical school accumulates debt,’ he says, adding grimly that he doesn’t dare look at the total outstanding. ‘It’s in the tens of thousands of pounds. So that comes out [of my salary] every month.’

His fiancée is in her second foundation year at the moment, and they are waiting until she finishes to decide their next move. ‘I can’t quite go to Australia yet and leave her here. But we’re getting married next year and we’re both going to locum and see how it goes. It will either be Australia or going into training here – I can’t say for definite, but I’m considering options abroad.’

Dr Fearon, who is 28, is earning more as a locum than he would in a training post and is trying to save up, both to get married and eventually to pay for a deposit on a house. He is aware that taking time out of training is potentially holding back his career – especially as he hopes to specialise in cardiology, which can be a long training programme.

But as well as the increased pay packet from locuming, the flexibility it brings is also important to him. ‘I know people [in training posts] who have even found it difficult to get time off for their wedding day,’ he says. ‘I’d rather avoid that. And even if I’m not progressing in the world of medicine, if you like, I feel I’m progressing a bit in life.’

At the moment, he can’t see a realistic future for himself in Northern Ireland. ‘I don’t see myself working here long term, unless things change substantially,’ he says.

When he left school 10 years ago, and started medical school, he had no idea how much pay and conditions for doctors would worsen. ‘I would have had higher expectations for pay, and wouldn’t have realised how hard it would be to get time off,’ he says. ‘You have to fit your life around your job – it’s more all-encompassing than most other careers; it really takes over your life.

‘You have to make a lot of sacrifices – I used to play Gaelic football, but it was difficult to keep doing it, and you lose the social side as well. There’s a lot of change in your life, a lot of sacrifice, and I was quite shocked at the wages. The pay is crap, it really is. I remember realising on a Christmas shift or at New Year that I was easily the lowest paid in the hospital. It’s just not sustainable.’


'Evermore people leaving the profession'

Tim neill

As a medical student in Belfast during the pandemic, Tim Neill (pictured above) worked as a health care assistant. Now in his first foundation year, as a qualified doctor, there are days when he earns less than he did as a band 3 HCA.

‘On a Sunday, I would have been taking home more than I do now,’ says Dr Neill. ‘When you look at our hourly pay – and there’s a difference in contracts between England and Northern Ireland – we are still on a basic wage of about £12.70 an hour. And yes, there’s banding on top of that, but that’s to compensate for the out-of-hours commitment, which is huge.’

Rotas are difficult to generalise about, he says, but it’s likely that in four-month FY1 job, he will have three or four sets of nights, including at least four weekends. ‘And there isn’t a single week where I don’t have at least one 12-hour long shift, and usually two or three,’ he adds.

Although this takes his monthly wage packet up, it isn’t enough to move on and begin to do the ‘adult’ things that most graduates in their early 20s aspire to. For example, he and his girlfriend have been together for seven years, and have considered moving in together, but financially, it doesn’t make sense. ‘We’ve looked at pay, and don’t really think we could get any reasonable deal on a mortgage – we might manage it together, but I certainly couldn’t manage it by myself.

‘It’s difficult, because you do get to a stage when you think you’d like to have your independence, and your own space, but the way that training works – and the fact that you’re going to be bounced around different hospitals, so I just don’t know where I’m going to be in the next few years – means it’s not feasible to put a deposit down and settle in one area.’

It’s cheaper to study medicine in Northern Ireland than it is in England because university fees are partly funded by the education department. Nevertheless, Dr Neill reckons he has student debt of around £35,000 to pay off. He is also aware that he has to fund courses and exams himself, on top of other costs such as GMC registration fees and medical indemnity organisation fees.

He would like to specialise in general practice, but currently can’t make any decisions about where he is likely to work. ‘I’d like to stay in Northern Ireland because of family commitments,’ he says. ‘But like the majority of colleagues I’m working with at the moment, I can’t confidently say that I’ll be staying to work here. I could be in Dundalk [in the Republic of Ireland] in the same amount of time as I could be in Belfast, so it would be very easy for me to take up a post in the Republic of Ireland where I could be being paid two to two and a half times greater salary and still live in Northern Ireland where living costs are slightly cheaper.’

His girlfriend is an aerospace engineer – which he says has opened his eyes to how poorly employees are treated in the public sector, compared to some private sector employees.

Dr Neill is the first medic in his family, and was attracted to the career because he likes connecting with people and was keen to help co-ordinate and deliver good care for people. ‘You want to do your best for people, but that’s increasingly difficult to do,’ he says. I don’t think when I went into it that I expected it to be quite as harsh as it has been to try to deliver that care.’

He is reluctantly taking strike action because he feels that the current situation is unsustainable, and that the health service needs to improve, both for the sake of patients and doctors. ‘We know that action is not taken without consequence, and it’s taken with deep regret by the workforce, but you have to look at the bigger picture.

There are three major issues going on: doctors aren’t joining training posts because, a) there aren’t enough training posts, and b) you might be posted to somewhere that’s 100 miles away from where you’re living, so there’s no attraction to training to be a consultant or GP.

Secondly, doctors don’t want to stay and work here. Local universities are training doctors who are graduating and seeing that other countries across the world appreciate their medical workforce more deeply and remunerate them more appropriately – that’s magnified in Northern Ireland because of the ease with which we could go across the border down south and get treated better.

‘And the third thing, and the saddest of all, is that there’s ever more people leaving the profession. It doesn’t take a genius to work out that we’re haemorrhaging staff left, right and centre. Things have to change – and that’s why we’re taking industrial action.’