‘Why I’m voting yes to strike action’

by David Pelan

As Northern Ireland junior doctors begin balloting for strike action this week, David Pelan explains why he is choosing to vote yes

Location: Northern Ireland
Published: Monday 15 January 2024
Doctor Talking To Member Of Public about BMA juniors Pay campaign

No healthcare worker takes the decision to ballot in favour of strike action lightly, and junior doctors are no exception.

We have never been balloted for such action before in Northern Ireland, but pay and conditions are so dire here that many of us – myself included – feel we have no choice but to vote yes.


Working conditions

As a doctor in training, I have to balance my clinical duties and service provision responsibilities with the training and portfolio requirements of my programme. However, it is becoming increasingly difficult to meet these requirements owing to service-provision needs.

Be it from inadequate staffing, staff illness owing to burnout or sheer volume of work required of service provision responsibilities, I struggle to get my scheduled training time or indeed any consistent training time. I have had to miss mandatory training sessions with my specialty owing to service-provision needs that couldn’t be met by other medics in the team I work with.

This issue is of paramount importance to me and affects most doctors in training working in Northern Ireland. It is something which has been consistently neglected and needs to be addressed to ensure we retain juniors within our medical personnel.



As has been irrefutably documented, there is a significant pay disparity between doctors in Northern Ireland and the rest of the UK.

As a specialty trainee 4 doctor, junior doctors of the same grade in England earn nearly £8,500 more on their base salary than what my base salary is in Northern Ireland.

Additionally, we would both have the same costs in professional fees, eg: GMC registration, Royal College of Physician membership, specialty society membership fees, yet a higher proportion of my annual salary goes on sustaining memberships, which I need to continue practising medicine versus other doctors throughout the UK.

I cannot reconcile this monumental difference in how two doctors of the same grade in the same specialty are valued so differently between Northern Ireland and England. I am not worth less than my compatriots across the water. Pay restoration is essential to avoid medics leaving in droves from Northern Ireland to other areas of the UK or further afield for better pay.


Work-life balance

As a result of the COVID pandemic, I had to wait several years before entering into a specialty training programme, along with many junior doctors throughout the UK.

During that waiting period, I worked as a locum specialty doctor which granted me a much better work-life balance.

Since entering training, my work life balance has been significantly negatively affected owing to the volume of work and frequency of out of hours’ commitments.

I knew there would be a significant change in my life by entering into training again, although I could never have imagined such detrimental change. I come home from work exhausted most evenings, with days off typically used for either recovery or to catch up on additional work tasks such as formulating teaching presentations for medical students/staff or studying for exams/training portfolio requirements.

At this point in their training, many doctors are already feeling very burnt out with little hope for change. There needs to be a focus on better work-life balance for junior doctors to ensure we are able to keep working and so we can stay mentally and physically healthy. A fully funded workforce planning strategy with a priority on adequately resourced training posts will allow for better distribution of responsibilities across many doctors in training rather than be shouldered by so few as it is.

The BMA Northern Ireland junior doctors committee has taken every opportunity to negotiate on many of the issues I and many other junior doctors are concerned about. However, there has been little to no movement from the powers that be. While my preference would be that of a negotiated solution, we will not get the changes we want to see without decisive action. As such, I fully support strike action and encourage all my colleagues to do the same by voting yes.


David Pelan is a specialty trainee 4 in a Northern Ireland health trust

Learn more about the ballot for junior doctor pay restoration in Northern Ireland