Next steps for resident doctors in Northern Ireland
After our recent 48-hour walkouts, including a pay rally at the steps of Stormont, we met with the new Health minister to discuss pay for resident doctors in Northern Ireland and how we can meaningfully work together towards full pay restoration.
The Health minister advised that if the current referendum in England is successful and resident doctors accept the pay deal on offer, then any pay uplifts achieved in England are likely to be reflected here. He has also stated he is committed to implementing any DDRB pay uplift recommendations.
With pay deals secured for resident doctors in Scotland and Wales and health being a devolved issue, this is of course extremely frustrating to hear. The reason we have been given for this dichotomy with the other devolved nations is that the Health Minister here is awaiting Barnett Consequentials from a potential deal with residents in England before starting talks with resident doctors in Northern Ireland. Northern Ireland also lacks some of the revenue-raising power that the other nations have.
After undergoing recent reconstitution, NIJDC (Northern Ireland resident doctors committee) welcomes a number of new workplace representatives. The first item for discussion by the new committee when it meets on 26 September, will be to review the current position and discuss the next steps in our fight for full pay restoration.
NIJDC chair Fiona Griffin said: “We will not be deterred. Our mandate is clear: Resident doctors in Northern Ireland voted overwhelmingly in favour of taking strike action in their fight to restore 16 years of pay erosion.”
Pay deductions for strike days
We continue to challenge DoH and SLE/NIMDTA (Northern Ireland medical and dental training agency) on the issue of pay deductions from resident doctors who go on strike and the calculation method used for that.
Following the meeting with the Health Minister where we outlined the issue, he immediately called for a moratorium on deductions for the May and June strikes until the correct deduction methodology can be agreed. This issue is now in the hands of BMA lawyers.
If you think incorrect deductions were made from your pay as a result of taking strike action, please contact SLE immediately to flag this up as well as with BMA. You can flag this with BMA by logging your query through our first point of contact service.
What we're asking for
We are asking the Department of Health, the Secretary of State for Northern Ireland, and our Assembly to do the following:
This means:
- Full pay restoration for junior doctors in Northern Ireland to 2008 levels.
Read more on pay erosion to see why we're calling for it.
Trusts to commit to complying with the BMA fatigue and facilities charter, with a focus on urgent introduction of safe working limits to fix rotas.
Here's why:
- Junior doctors in Northern Ireland do not have the same rest protections and rota design requirements as elsewhere in the UK. 49% of trainees in Northern Ireland reported working above their rostered hours – higher than the UK average of 42%.
- Exhausting, understaffed rotas impacts on training time required for career development. Significantly more trainees in Northern Ireland (38%) have reported that rota gaps were not being sufficiently dealt with than in the UK as a whole (29%).
Introduction of a trainee guarantee for access to scheduled training, including study leave for F1s.
Here's why:
- Workload pressures are causing the quality of training to deteriorate significantly, particularly for foundation trainees. Almost half (46%) of trainees in Northern Ireland reported significant increase in workload intensity on dayshifts and on nightshifts (20%).
- Lack of training opportunities impacts trainees’ career progression, creating more staffing gaps in higher grades. 21% of trainees in Northern Ireland reported a lack of protected time for completion of all the mandatory training requirements of their post. This was higher than elsewhere in the UK (17%)
- Training protections will be essential to tackling our waiting list crisis.
Commitment from the Department of Health to entering contract negotiations on a reformed junior doctor contract that improves workplace protections, facilities, working hours and recognition.
Here's why:
- The existing contract does not match the reality of training in 2023.
- A new contract is needed that creates a good working environment conducive to training to incentivise junior doctors to stay in training in Northern Ireland.
Calculating resident doctor pay erosion in Northern Ireland
Our calculations show that our pay has been eroded by 30.7% since 2008 when compared with RPI inflation. This is a huge loss to our pay and our living standards that fails to reflect the responsibility, training, and sacrifices required of our work. It’s causing a workforce crisis as fewer and fewer trainees choose to stay in Northern Ireland to train.
We are not worth 30% less than we were in 2008 and we are not worth less than doctors in other countries. Our basic pay is one of the lowest in the UK.
Northern Ireland (2023/24)* | Wales | Scotland | England | |
---|---|---|---|---|
F1 | £29,566 | £30,477.26 | £31,082 | £32,398 |
F2 | £36,367 | £37,803.49 | £38,553 | £37,303 |
SpR (specialty registrar) | £38,780 | £40,396.56 | £40,995 | £43,923 |
* Payment of the 2023/24 pay uplift in Northern Ireland was delayed until June 2024.
The effects of pay erosion
Our pay erosion isn’t just affecting us. It also has an effect on the health service in Northern Ireland. Sub-inflationary pay increases have meant it is now less attractive to work and train in Northern Ireland. We are seeing a workforce crisis emerge from our eroded pay because there are better options elsewhere. This retention and recruitment crisis facing the health service is a risk to its future in Northern Ireland.
Example
The 2024/25 GP training programme intake has posts for 121 trainees. NIMDTA has recently confirmed that only 109 trainees have been recruited to commence in August 2024.
With better pay, we will incentivise more doctors who studied in Northern Ireland to stay and doctors outside of Northern Ireland to come and work here. With more doctors, our rotas will be less intense and we will all have more time for training.
Northern Ireland was without an active Executive or Assembly until February 2024
A new health minister, Robin Swann, was appointed and immediately said addressing pay was a key issue.
We continue to actively lobby the Minister, health committee members and other MLAs to ensure that they understand the crisis affecting resident doctors and what needs to be done urgently to fix the health service.
We recently surveyed resident doctors about pay, conditions, training what you’d be willing to do alongside us to make things change.
Throughout March and April we held listening sessions in workplaces across Northern Ireland attended by hundreds of resident doctors. In the survey and at the events the message was clear: we are undervalued, underpaid, overworked, and lack good training opportunities.
The list of problems was sobering, ranging from inappropriate last-minute pressure to cover gaps that were known about for weeks, suppression of locum pay, incorrect bandings, huge delays in provision of rotas, and a real decline in the quality of training in recent years.
In January 2023 we submitted evidence to the DDRB with our core pay ask being full pay restoration for all medical staff, including resident doctors.
We continued to participate in the DDRB process, recognising that despite our significant concerns regarding the DDRB’s independence from government, it represents one of the few avenues to achieve a pay rise for doctors in Northern Ireland in the absence of an Executive. We highlighted the dire state of training in Northern Ireland, the pressures we all face, and the workload that is causing so many colleagues to take time out of training or to move abroad entirely. Read our response to the 2023/24 DDRB pay recommendation.
BMA strike fund - donate now
A strike fund is available to subsidise members in serious financial difficulty who otherwise couldn’t afford to take part in any future rounds of strike action.
The strike fund is supported through voluntary donations to make available to doctors in need.
Keep up to date with our campaign on the NIRDC X (Twitter) and Instagram accounts.
Become a pay activist
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Help build a team at your workplace that drives our campaign locally.
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Share your ideas to help BMA Northern Ireland develop our campaign.
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Recruit new BMA members to strengthen our voice calling for full pay restoration.
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Join or start local events, meetings and activities in support of the campaign.
Campaign resources
Download a range of campaign materials to share on social media and in your communal work and rest areas.
We're here to stand up for your rights, support you in the workplace and champion the medical profession.
As of 18 September, all references to junior doctors in BMA communications have been changed to ‘resident doctors’.
Making up nearly 25% of all doctors in the UK, this cohort will now have a title that better reflects their huge range of skills and responsibilities.
Find out more about why junior doctors are now known as 'resident doctors'.