Debate contribution: Junior Doctors’ Pay

Debate contribution by Ms Paula Bradshaw on 21 May 2024.

MLA

Ms Paula Bradshaw

Party at the time

Alliance Party

Date

21 May 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Junior Doctors’ Pay

Assembly identifier

Official Report component 4491949

Read the official Assembly record

Text

Thank you, Madam Principal Deputy Speaker. I thank all the Members who spoke, and the Health Minister for responding. All contributors were united in how they spoke about how valuable our junior doctors and our entire health and social care workforce are. That fact was highlighted by Alan Chambers and the Health Minister. My colleague Nuala McAllister rightly outlined the clinical training that junior doctors go through and the reality of what their week is like in their place of work. Today, I was contacted by a junior doctor who told me that junior doctors are responsible for their fees for their exams. That particular constituent said that they have to find £1,650, and that really cuts to the heart of some of today's contributions on how the strikes were a last resort as a result of their being under so much pressure. We therefore have to be careful how we frame such issues, because, fundamentally, we are talking about patient safety. My colleague Justin McNulty highlighted that point. If we have junior doctors, who are an essential part of our system, becoming tired as a result of impossible rotas and working under unreasonable contracts, it is not just they who suffer but, first and foremost, the patients. Do you want to be seen by someone who is suffering from fatigue, an issue that Alan Robinson highlighted, and who, justifiably, is feeling undervalued, which is the word that Declan Kearney used? Having gone through the rigorous training that Nuala mentioned, junior doctors find that their workplace does not even have a hook for them on which to hang their jacket. Other Members commented on that as well. Low pay is therefore only part of the problem. It is a symptom, however. Pay is now so low and so far behind that of our neighbours that junior doctors justifiably regard it as a core issue. My colleague Danny Donnelly highlighted that point. The Minister is developing a reputation for not wanting to meet anyone. In correspondence, he turned down an invitation to meet the bereaved families of the victims of Dr Watt. Coincidentally, he was willing to meet the junior doctors only when this motion appeared in the Order Paper. What correspondence the Minister has had with junior doctors suggests that a solution could take the form of contract reform, but that has not really started, nor has there been any movement on back pay yet. I was glad to hear today that junior doctors will be receiving that in their pay packet in June, which Alan Robinson mentioned. Alan Chambers rightly pointed out that junior doctors did receive an uplift of 9·1%, and I am grateful for the figure. The Minister said that, in the future, the progressive realisation of back pay would cost £52 million before any other pay settlements. We are dealing with harsh numbers here, colleagues, but it is not remotely good enough to suggest that Northern Ireland cannot advance the issue before —.

Go ahead.

I thank my colleague. I fully agree. The chief executives from the health and social care trusts have been saying for many years that they want to see reform in that space. We need to move forward with this issue. Health is a devolved area, and this is how it works. A number of Members — Nuala McAllister, Alan Robinson and Danny Donnelly — mentioned the fact that it is a national dispute. The Minister said that it will be agreed and settled nationally. He raised the issue about Wales. Wales, in fact, is discussing additionality for 2023-24, unlike here, and it wants to advance negotiations further. The matter has not been settled in Wales, and that fact needs to go on the record. There are different issues in Northern Ireland. Our contracts are more hopelessly outdated, and there is the temptation of working for Sláintecare right next door. Obviously, a lot of large health trusts over in England offer very attractive packages. Morale is, inevitably, much lower here than in other parts of the UK. Alan Robinson highlighted retention as a major issue, as did Gerry Carroll, who called it "forced migration". The Department of Health receives £4,300 for every person in Northern Ireland as a starting point before Barnett consequentials are introduced. That amounts to more than half of the entire devolved Budget. We have seen countless audits of departmental spending, one of which the Health Minister referenced. For example, according to the Fiscal Council, managing hospitals in the same way as they are managed in England would save over £400 million a year while, at the same time, delivering improved patient outcomes. Let me put that another way: we are spending over £400 million a year to deliver worse outcomes. The fact is that we need to see value for our health spend, yet we see money being allocated to outdated systems and approaches rather than to reformed contracts and improved pay conditions for the people working in the health service. Colin McGrath highlighted the fact that we need to focus on ways in which we can incorporate transformation to address the issues that the junior doctors raised with us all. We have said endlessly that no element of our healthcare system is more important than the people working in it. If they feel, justifiably, that they are not being treated fairly and their legitimate concerns are not being taken seriously, there will be no healthcare system left to budget for. Liz Kimmins, Colin McGrath and others raised the issue that junior doctors are taking to the picket lines tomorrow for 48 hours as a last resort. The Health Minister said that he respected their right to strike but raised concerns about the impact that the strike will have on patients. We need to hear less about how £4,300 per person is not enough. We need to hear from the Minister about how he will prioritise his spending so that the key drivers of the system — the people in it — are compensated and treated fairly while the system is transformed to remove waste and deliver better outcomes. The motion is clear in calling for the Minister to:

"urgently and meaningfully engage with the British Medical Association"

to deliver a fair settlement. He indicated that his door was open and that he would be up for independent arbitration. That will, hopefully, be the starting point for the BMA to be able to sit down with the Health Minister and others to mediate that. We cannot see more of our junior doctors and others leaving the health service and working in neighbouring jurisdictions. If that keeps happening, there will be no health service left. The Health Minister's suggestion to the Department of Finance of a review of public-sector pay is certainly welcome, but I refer to my colleague Nuala McAllister's point about putting the business case for more funding to the Finance Minister. That is probably a more pressing matter at this stage. We must consider the priorities that we need. We need to be proactive. After all, if there is no value in the health system, what does that say to the staff working in it? We need to be able to recruit and retain our staff. I think that I have covered most of the debate. I will leave my remarks there, but I hope that we will see movement in this area, because we have to show our junior doctors how much we value them and how much we care that they stay in our system.

1,261 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 10:35 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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