Fighting for full pay restoration has rightly been front and centre of the BMA Northern Ireland resident doctors committee's work for the past few years. But it is important not to lose sight of other issues which affect our working lives and which are long overdue for reform.
A central issue is the current resident doctors’ contract of employment, which dates from 2002. As you would expect from a contract that was agreed the year many of the new foundation year 1s were born, it no longer matches the reality of training and education in 2025, nor does it reflect the pressures and complex workloads of the modern-day health service that we are working in. The clinical workforce has not risen in line with the changing patient demographic, the change in how healthcare should be delivered or the expectations of the patient population.
Residents are now expected to work across multiple wards and work successive unsociable shift patterns and to be in multiple places at once. They are chastised for not maximising training opportunities at outpatient clinics yet simultaneously being unable to leave the ward due to the service provision demands.
Safety at work
Safeguarding measures to mitigate against workload pressures are woefully lacking in the current contract. There is no ‘exception reporting’ in Northern Ireland like there is in England. The current contractual safeguard of rota monitoring is universally derided by residents who view it as a process favouring employers that does little to ensure fair recompense for working significant additional hours.
For residents working in England, there is a ‘Guardian of Safe Working’ that oversees compliance with the safeguards of the 2016 contract and acts as a champion of safe working hours for resident doctors. Doctors in Northern Ireland have no such guardian to approach in difficult circumstances, and often find they are raising working safety concerns to their educational supervisors who are also responsible for signing off portfolios. This can create an environment where doctors may resist raising concerns for the risk of and adverse training outcome.
If you were employed as a resident in Scotland your contract would stipulate you worked no more than seven consecutive shifts, with a ban on doing more than four consecutive shifts longer than 10 hours in any seven-day period. No such protections in our contract.
Fair pay matters, but it is equally important to have a contract that ensures a safe workplace and safeguards residents' training from being compromised by service demands.
What are the next steps?
As part of the pay deal for resident doctors accepted earlier this year, NIRDC and the Department for Health have agreed to open discussions on negotiating a new contract of employment for us, with negotiations due to start in the coming months. NIRDC has appointed a fantastic team drawn from the current committee reps who will lead on contract negotiations, with initial planning meetings currently taking place ahead of negotiations beginning in the Autumn.
Your feedback
However, before we commence this process, it is imperative that we hear from resident doctors across Northern Ireland on what you think a new contract should look like. The first stage of this will be the launch of an online survey on 20 August that will be open to all resident members and non-members for three weeks. I would encourage you all to make time to complete this survey when it appears in your inboxes and encourage your resident doctor colleagues to do so as well. It should take you less than 10 minutes to complete and will give you ample opportunity to tell us what our priorities should be for the new contract.
We will also be holding a series of in-person events in workplaces across the country where you can share your thoughts on what a new contract should look like. Dates for these events will be announced soon.
As ever, in solidarity!
Fiona Griffin is chair of the BMA Norther Ireland resident doctors committee