Protest in person

When Northern Ireland’s senior hospital doctors went on strike yesterday there was a particular irony in where they chose to share their message.

Leaders of the BMA Northern Ireland consultants and specialist, associate specialist and specialty committees (pictured top) went to the Parliament Buildings at Stormont to meet the chair and deputy chair of the Northern Ireland Assembly health committee, to hand in a letter explaining their position, and to provide an opportunity for media interviews.

The strike – the first time senior hospital doctors have walked out – was about pay. According to the BMA, consultants and SAS doctors in Northern Ireland have suffered 18 years of pay erosion, and their salaries lag substantially behind those of their peers in the other countries of the UK.

Members of the Northern Ireland Assembly ought to have some sympathy with this (this is where the irony comes in). Earlier this year, their own newish independent remuneration body proposed a near-27 per cent pay increase for them, increasing their salaries by £14,000 to £67,200.

This, the body said, was a ‘corrective measure’ after a decade where the system wasn’t working properly, in other words, pay restoration. The increase also takes into account elected members’ pay in other parts of the UK and in Ireland, which is higher.

‘It’s one rule for them and another for us,’ says Dr Siobhan Quinn, an associate specialist in emergency medicine in Belfast and deputy chair of the NI SAS committee. ‘Their review body looked at their pay, said they were underpaid, that they’d had pay erosion, and that their pay wasn’t comparable to what was paid in England, Scotland and Wales, so they deserved 27 per cent. And they gave it to them. But we’ve suffered pay erosion too, and they’re doing nothing about it.’

In some ways this dispute has been coming for a long time, but the ultimate catalyst was this year’s DDRB-recommended uplift of 3.5 per cent. Consultants and SAS doctors say it isn’t enough to make credible progress towards achieving full pay restoration to 2008 levels.

There’s also the question of when and if they will actually receive even that uplift, explains Dr David Farren, chair of the NI consultants committee. ‘Our minister has told us he will pay it if and when he gets a budget,’ he says. ‘We are aware that colleagues in England, Scotland and Wales have already received the pay increase, or will receive it in the coming days, so again, consultants in Northern Ireland are disadvantaged.’

The impact of late pay awards on consultants can be profound, he adds, because depending on when it is paid, individuals can be hit with a large bill due to pension tax. ‘The more the pay uplift is delayed, the more likely it is that we’ll have a significant tax bill that will remove the uplift, effectively giving us a pay cut.’

Doctors do not want to strike, he says, but they feel they have been left with no choice – although in fact the action takes the form of Christmas Day cover, so care will still be provided in emergencies.

‘I’m honestly disappointed that we’ve had to do this. I had hoped the minister would have been able to prevent the strike action, but he hasn’t.’

Dr Clodagh Corrigan, deputy chair of the NI SAS committee and NI Council, agrees. ‘We notified the minister two weeks ago that we’d be taking industrial action, and there’s been no engagement since then. He hasn’t made any attempt to negotiate with us, or try to postpone or delay or cancel the strike. Nothing, nothing at all. That says to us that the minister doesn’t care, that he doesn’t value us in any way, shape or form.’

Dr Quinn agrees. ‘I’ve been a doctor for 30 years and I’ve never been on strike, so I think that says something. But I think colleagues are simply frustrated, and they don’t believe the minister will do anything for us. We’ve spoken to him several times and he always says his hands are tied, so that’s why we thought we’d speak to the health committee. They had some good questions, which we were happy to answer, and I think they recognised that our pay has fallen behind.’

Dr Stephen Moore, deputy chair of the NI consultants committee, is another who sees striking as a last resort. As a psychiatrist, he has witnessed the impact of staff shortages both on patients and on the doctors that remain.

‘There are massive unfilled vacancies in ever trust, particularly in my specialty of psychiatry,’ he says. ‘We can’t recruit people, and when we recruit, we can’t retain them. We’re at the point where the health service can’t get enough consultants to provide care for patients, and things are at breaking point.’

Trusts that neighbour the Republic of Ireland are in particular difficulties, he adds, because, given the choice, many doctors will choose to work across the border for substantially more pay. ‘I’m on strike today because the alternative is that I don’t go on strike and in five years’ time I’m the last man standing.’

Dr Corrigan agrees. ‘I'm on strike today because I'm seeing the health service crumbling around me. I'm seeing colleagues leaving. I'm seeing students that don't want to work in the health service. 54 per cent of fourth and fifth year medical students in Northern Ireland do not intend to work in our health service.

'They plan to leave. I'm not just a doctor, I'm also a patient. I fear for the future of my health service. I worry I will not have a health service that's free at the point of access within the next decade, we are losing staff so quickly.

'We are seeing within Northern Ireland that one member of staff calling in sick has resulted in services shutting, we're running on a knife edge, and that is a consequence of years and years of pay erosion, of undervaluing our doctors, and not paying us what we're worth. Our pay has reduced, our conditions have worsened, we can't maintain the status quo. We’ve tried negotiating and it hasn’t worked. We have to do something different.’