Northern Ireland faces loss of doctors

Pay & Contracts
Peter Blackburn

Better pay and conditions south of the border precipitating staffing crisis

Northern Ireland could lose a generation of doctors to services across the border in the Republic of Ireland unless poor pay and conditions are reversed urgently, doctors’ representatives have warned. 

Northern Ireland consultant David Farren (pictured above) told the BMA annual representative meeting in Belfast that consultants starting jobs in the Republic of Ireland could expect a salary equivalent to £189,000 – progressing to the top of the pay scale in just six years to receive £217,000 per annum – and also receive generous pension contributions, study allowances and other benefits.

Dr Farren said every doctor in Northern Ireland knew someone who had moved across the border for work – and said the trend was mirroring a similar staffing crisis in the Republic of Ireland which followed austerity policies and salary cuts implemented from 2009. He said that crisis saw the Republic lose a generation of doctors.

He said: ‘I fully believe the best predictor of future events is the experience of past events. Ireland did not keep pay competitive and lost an entire generation of doctors from their service. This is going to happen in Northern Ireland as well.’

Dr Farren added: ‘The health service is in a constant state of crisis. Everywhere else in the UK has the same problem but in Northern Ireland we tend to lead the curve. As I stand here today, doctors in Northern Ireland are the lowest paid in these islands. Using consultants as an example, we had a freeze on clinical excellence awards for 15 years, we don’t have pensions tax mitigations, and we routinely wait longer for Review Body on Doctors' and Dentists' Remuneration rises. You know that review body rise you had in October last year? We’re still waiting on it.’

Competitive terms

Doctors’ representatives voted overwhelming in favour of a motion proposed by Dr Farren which called for the Department of Health in Northern Ireland to ensure that the terms and conditions and pay for doctors in Northern Ireland are competitive with those in the Republic of Ireland.

It followed Tom Black’s final speech as chair of the BMA in Northern Ireland. Dr Black, who has been in the role for six years, spoke to decry the state of NHS services in the country.

He said: ‘After 14 years of underfunding, inadequate workforce, political instability and overwhelming workloads Northern Ireland now has the longest waiting lists for patients in all four nations. Many of our waiting lists are now longer than the life expectancy of the patients who need those services. Six years for a first appointment to get a knee replacement. Eight years for a first consultant led gynae appointment. Seven years for neurology. Red flags taking as long as six months. It is both disgraceful and demoralising.’

Dr Black added: ‘Our recruitment and retention of doctors has been frustrated by the much better terms and conditions available elsewhere – particularly through Sláintecare [the programme to improve health and social care services] in the Republic of Ireland, but also in the rest of UK and indeed the rest of the world.

‘This perfect storm of lack of funding, understaffing and huge waiting lists will only be solved by radical thinking and actions – increasing funding and training places; recruitment on better terms and conditions; the unfortunate but seemingly inevitable use of the private sector for waiting list backlogs and better cross border working.

‘This job; working as a doctor in the NHS is too difficult and too important to be badly paid.’