I’ll get the tired media cliché out of the way now by saying 'there’s a back-to-school feeling for our MLAs at Stormont' because this week the Assembly returns after its summer recess. With 2025-26 being the last full session of this mandate (next year’s will finish in March to allow for the election), it is set to be a busy one.

We begin the political year with concern about the impact of the ongoing delay – yet again – on this year’s pay recommendation reaching the medical workforce. This is despite on-record commitments from the health minister Mike Nesbitt that any pay review recommendation would be implemented in full, as soon as possible. Months on, this has not happened, and the growing frustration felt by members across branches of practice cannot be understated. Our consultant colleagues have already entered formal dispute with the Department of Health.

In June, the minister issued a ministerial direction to seek funding for immediate payment and has asked his executive colleagues for support from other departmental budgets. However, this does not appear to be forthcoming, and we can only surmise he must allocate within his existing budget. The first executive meeting of the session took place last Thursday, and with many other pressing issues on the agenda we have yet to hear if there was any mention of or progress on pay. 

It is only right, therefore, that ensuring this year’s DDRB is paid is the BMA’s top public affairs priority. Having met with the Minister last month where we discussed pay and other issues, we have written to every Executive party leader to seek meetings to press the need for an urgent solution and prevent industrial action.

Collective action measures by our overstretched GP partners began during the summer and will continue until the Health Minister proves he truly values the contribution of GPs by properly investing and giving general practice a funding settlement that adequately reflects the demand on the service.

We’ll continue to watch and work with the minister and department on the Health and Social Care Reset Plan, but as our council chair Alan Stout said, it can’t be delivered without valuing the medical workforce. ‘Shifting left’ to a new neighbourhood model of care just isn’t possible either without properly investing in general practice and a swift resolution to the dispute with GP partners.

Elsewhere on the policy front, here’s what else to look out for at Stormont this year:

In June, the DUP North Antrim MLA Paul Frew launched the consultation on his Duty of Candour Bill, a private members’ bill which proposes an individual duty of candour with criminal sanctions on healthcare staff. The BMA, led by Dr Alan Stout, met Mr Frew regarding his proposed Bill in March, and we remain resolutely opposed to an individual statutory duty of candour with criminal sanctions. We have repeatedly urged the Department of Health to fulfil its commitment as part of the Being Open Framework to legislate for an organisational duty of candour as soon as possible.

Mr Frew’s Bill is one of 27 non-Executive Bills currently proposed by backbench MLAs and, in a letter to MLAs over the summer, Assembly Speaker Edwin Poots MLA warned there was not adequate Assembly time or resources for them all to progress, and that Executive legislation should take priority.

However, the Department of Health, much like the rest of the Executive, has performed poorly in terms of planned Executive legislation reaching the floor of the Assembly. There are a number of proposed Bills that need to commence formal legislative process in this session if they are to have any chance of passing with the level of scrutiny they require before the end of this mandate in 2027.

The Adult Protection Bill, which is so far the only DoH-sponsored Bill presented to the Assembly since it returned, passed its second reading in July. The Bill proposes a legal framework for 'protecting adults from harm' and for safeguarding measures to be 'effectively implemented across the HSC'. Owing to the complexity of the Bill, it is expected committee stage will be extended to March 2026, allowing for a greater period of scrutiny by the Health Committee.  It is expected to complete its passage by early 2027.

Despite the consultation closing almost a year ago and the minister 'optimistically hoping' that the Bill would be drafted 'within the first quarter of 2025', no further progress has ostensibly been made on the Safe and Effective Staffing Bill. The Bill may have an impact on proposals for an organisational duty of candour, and while the Minister says he is still committed to introducing the legislation, it is an important Bill with implications for the entire workforce and needs to be introduced soon. 

Minister Nesbitt first spoke of introducing a Minimum Unit Pricing Bill at his debut appearance at the Health Committee in October 2024 as part of his aim to reduce health inequalities. A disagreement at the Executive may explain the lack of progress on this, as the Minister last updated in April that he had 'requested the definitive positions of all executive colleagues' on the issue. The BMA are strongly supportive of a minimum unit price for alcohol, and our council chair Alan Stout is scheduled to speak in support at an event at Stormont organised by NI Chest, Heart and Stroke in November.

The Public Health Bill, first proposed by former health minister, now South Antrim MP Robin Swann, was the subject of some controversy when it went to public consultation last year to inform its development. The minister last updated in June that a consultation summary document would be published 'in the months ahead' alongside a further update. However, given political disagreement, further progress on this Bill may prove turbulent.

We’ll also continue to press for progress on the new clinical excellence awards for consultants in Northern Ireland. A new draft scheme had been co-designed between the Department of Health and the BMA. However, despite the draft being subject to public consultation almost 18 months ago, the report on that consultation has yet to be published.

Finally, party conference season is almost upon us, and we will be representing members and discussing all of these issues at the DUP conference later this month, followed by both the SDLP and Ulster Unionist conferences in October. The Sinn Féin ard fheis and Alliance conference will take place next spring.

I can be contacted at [email protected] or on X at @pmynes