Background to the ballot
The Doctors’ and Dentists’ Pay Review Body (DDRB) has recommended an uplift of 3.5% for 2026/27.
This is not acceptable; it does not address years of pay erosion or recognise the huge contribution consultants are making to keep the health service in Northern Ireland functioning.
Persistent pay erosion is contributing to early retirement, quiet quitting, reduced discretionary effort, and colleagues leaving the profession. Pay is a key factor in making Northern Ireland an attractive place to train, work and remain in practice.
Following the announcement from the DDRB this year, we met with the health minister to discuss the pay award. We made clear we thought the level of the award does not come close to our expectations of being substantial enough to make credible progress towards achieving full pay restoration to 2008 levels and to prevent pay erosion recurring in the future.
The minister was unable to commit to either improving the offer or even assure it would be paid promptly. Therefore, we decided to move to a statutory ballot of consultant members in Northern Ireland on taking industrial action over pay.
What brought us to this point?
When Northern Ireland consultants came together in 2024 and voted overwhelmingly in favour of taking industrial action over pay, our collective strength achieved so much and without the need to take any sort of strike action:
- The highest percentage uplift in the UK from all national pay negotiations for consultants
- A revised pay scale with higher career earnings and the highest starting consultant salary in the UK
- Agreement that new regulations on employer contribution recycling will be enacted at pace
- Assurances that the Department of Health would continue plans to implement a new CEA scheme for Northern Ireland to reward excellence and innovation for consultants.
This should have benefitted our pay and pensions for years to come and set us on the journey to full pay restoration. Instead, successive, late, sub-inflationary pay awards have undermined morale and served to drive consultants away from the health service and from Northern Ireland, with patient care suffering as a result. The DDRB recommendation for 2025/26 of a 4% uplift was insufficient enough to prompt re-entering dispute with the Department in May 2025.
This year’s award of 3.5% is a further blow to our aims of full pay restoration. Our pay for 2026/27 is still 26.4% lower in real terms than it was 18 years ago (when compared with current RPI inflation), yet we are working harder than ever before.
The above graphs show the range of pay erosion from the lowest percentage in the years with variable pay uplifts to the highest percentage.
In addition to this, delivery on the CEA part of the 2024 pay agreement has been delayed despite continued lobbying of the Department of Health. This is unacceptable.
Unless we stand together and show our strength, pay erosion will continue. We need to demonstrate clearly again to the government that consultants are all willing to take action to restore our value, our pay, our pensions and ultimately protect patient care.
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