Debate contribution: Strike Action: Junior Doctors
Debate contribution by Mr Robin Swann on .
- MLA
- Mr Robin Swann
- Party at the time
- Ulster Unionist Party
- Date
- 20 February 2024
- Type
- Debate contribution (made as a minister)
- Business
- Question for Urgent Oral Answer
- Heading
- Strike Action: Junior Doctors
- Assembly identifier
- Official Report component 4381067
Read the official Assembly record
Text
I am acutely aware of the pressures faced by doctors and the concerns raised about pay. I have been clear that resolving the ongoing pay dispute is my immediate priority, and that is why I have tasked my officials to move to immediately implement the Review Body on Doctors' and Dentists' Remuneration (DDRB) recommendations for 2023-24 pay for all doctors employed in health and social care. For junior doctors, that will bring an average pay increase of 9·07% in 2023-24, with those in their first year receiving a 10·68% uplift. That is not an insubstantial pay award when viewed across the public and, indeed, private sectors, and will be backdated to April 2023. The award will bring junior doctor basic pay above the level in Wales and closer to the rate in England. As Members will be aware, there is a different contract in place for junior doctors in England, so precise like-for-like salary comparisons are not possible. Basic pay, however, is not the whole picture when estimating take-home pay for junior doctors: all junior doctors receive further allowances, ranging from an additional 20% to 100% of basic pay, depending on their rota. My Department has also engaged with the BMA to discuss the way forward on outstanding issues. That includes a commitment to further engagement on pay, and this will, of course, be better informed when there is greater clarity on the outcome of the current industrial action being taken by doctors in England. However, my Department is committed to ongoing engagement. Extra funding has been secured for public-sector pay for this year alone. The agreement on the allocation of £550·6 million to my Department for pay awards and other pressures allows my Department to continue to move forward in its negotiations with unions, and we remain hopeful that a satisfactory solution for all parties can be reached. It must be recognised that the funding will have to be shared across all the different sections of the workforce. The reality is that implementing the recommendations of the independent pay review bodies to mirror the 2023-24 pay settlements in England is at the very limit of what can be afforded at this point. As Members, we should also be very mindful of the impact that the significant disruption of further industrial action will have on a wide range of our core health and social care services, not least on elective activity. The debate this morning clearly illustrated the need to ensure that no opportunity for capacity is wasted, and that is why I again appeal to the BMA to recognise the financial limitations in which all Departments are operating and to acknowledge that further action at this time, before a final outcome on pay has even been reached, would be highly damaging.
I thank the Member for his supplementary. I will deal with the last point first. I do not have any allocation for next year, never mind honouring the pay commitments that I am making this year. Of the £660-odd million that was given out by the Finance Minister this year, I received £550·6 million for those pay awards and other pressures, and that allows my Department to move forward.
I appreciate the political points that the Members has tried to score on this issue. I can assure him of my commitment to all our health and social care workers.
That is why I have moved to implement DDRB, which has moved the junior doctors to where they are now. I also continue to engage with all my Agenda for Change (AFC) unions to make sure that I get a proper recompense to them, as supported by Executive colleagues.
The Member raises a valid point. I am keen to continue that engagement with BMA across its central committee and across all other disciplines to make sure that we, as a health service, recognise the pressures that staff are under. That pressure is because not just of the financial situation that we are currently in but workload pressure. We recognise how much we ask of those in our workforce and how much we depend on them. It is about how we engage in all aspects of those negotiations. That is why I am content to continue that engagement with BMA.
I will be honest. It has been impactful on waiting lists. That is why I encourage junior doctors not to take that industrial action in March. I am aware that the ballot was taken while this place was not sitting. That is the point that the Member needs to reflect on: two years have been missed. The DDRB and Agenda for Change pay awards could have been implemented during the past two years, rather than being left until this late stage.
My officials continue to engage with the BMA. I have a call out to meet the chair of the BMA council next week, and that will be scheduled for discussion when we meet. I have always had a good working relationship with all the healthcare sector unions. Our workforce is at the core of what we do. I have always been, and I continue to be, open to engaging with them, but there has to be a two-way street.
I thank the Member for that valid point. I am very keen to discuss a new contract for our trainee junior doctors. Their contract was last updated in 2002. It no longer reflects the way in which a modern health and social care system works. The current contract gives a trainee junior doctor a basic salary, with an additional supplementary payment for out-of-hours work and the frequency of weekends that are worked. That supplements the ranges that I mentioned by anything from an additional 30% to an additional 100%. That is added to their basic salary as a multiplier of their pay point, which has resulted in a lower basic salary and a higher variable supplement. That has led to a large variation in pay. I have already received evidence from trainees and employers that indicates that that system of payment does not adequately reflect the work that is undertaken. The contract was changed in England to recognise that. It introduced a higher basic pay and a lower variable rate, which has provided trainees and junior doctors with a more stable income. I would like to review that in any contract negotiations.
The Member's last point is valid. As I said in my answer to Mr Chambers about looking at the contract, it is about getting a balance between their basic pay and the supplements they get and realigning that, similar to the way it is done in England. A considerable piece of work has to be done on that. The last contract review was in 2002, which is over 22 years ago. Some of our junior doctors would not have been about at that time. Something can be done on the contract. As regards the spend of other moneys, I will always make bids for areas in which I think the money can be spent. I received £550·6 million in regard to those pressure points to honour the 2023-24 pay awards, which I am moving to do.
I thank the Member for her valid point. Since I have come back into office, I have had the same conversations with some of our consultants who have travelled to other hospitals to provide support and been put into the inadequate, substandard accommodation that has been used by our junior doctors. We have a duty of care to provide comfort to our junior doctors and other health service workers who have to work weekends and night shifts and all the rest of it. I think that it was raised in yesterday's debate that junior doctors are concerned about the fact that they cannot leave behind personal possessions — coats, handbags, purses, wallets and all the rest of it — because they are in fear of them being stolen when they are on the wards providing a duty of care. That has been raised with the trust. I would like officials to further engage with the BMA and junior doctors on those ongoing issues. It is not just about pay. There is so much more that we can talk about to support them.
I thank the Member. In this morning's debate, we spoke about the support that we need to give to our all our healthcare workers, including junior doctors. In my initial answer, I acknowledged that further action at this time will be highly damaging, because it will mean not just the removal of the junior doctor workforce from our wards, A&Es and GP practices but their posts having to be backfilled by consultants and other doctors, who will have to be moved away from their service. That is why I, again, ask the BMA to recognise the financial limitations that Departments are operating under and acknowledge that further action at this time, before a final outcome on pay has even been reached, will be highly damaging.
1,505 words. Text as published by the Northern Ireland Assembly.
Assessment
Awaiting analysis
This record has not been analysed yet. It is not counted in any total until it has been assessed.
Disagree with this assessment?
Classifications can be challenged. A person reviews every challenge, and any change is recorded publicly above with its reason.