Debate contribution: Health and Social Care Pay Awards 2025-26

Debate contribution by Mr Gerry Carroll on 23 September 2025.

MLA

Mr Gerry Carroll

Party at the time

People Before Profit Alliance

Date

23 September 2025

Type

Debate contribution

Business

Private Members' Business

Heading

Health and Social Care Pay Awards 2025-26

Assembly identifier

Official Report component 5129774

Read the official Assembly record

Text

Thank you, Mr Deputy Speaker. It is worth reminding ourselves that healthcare workers in the North are among the lowest paid across the entire public and private sectors. NIPSA reports that the NHS here is the only — I will repeat that: the only — public-sector employer paying below the real living wage for its lowest-paid staff. Ambulance Service workers in Unite and NIPSA have been engaged in industrial action for better conditions and safe staffing for almost three years now. Poor pay is a major driver of the staffing crisis in the NHS. Both are connected. Shamefully, this is the third year in a row that pay parity has been broken; the third year in a row in which health and social care workers have been put in that unacceptable position. Over the past two years, uplifts were paid in instalments, with the final instalments being paid at the very end of the financial year. A non-consolidated lump sum for 2023-24 was paid in August 2024, six months after the end of the financial year. This is worth asking: what is the excuse this time? The Executive have been up and running since February 2024. There has been plenty of time to prepare and find the money to make sure that such a shambles did not happen again, yet here we are. In 2022, MLAs from Executive parties joined healthcare workers on various picket lines demanding fair pay. Those same MLAs and Ministers are now in a position to deliver pay parity, but they refuse to do so. They have fallen silent or are pointing the finger at others. All the rhetoric about joined-up working and delivery has gone completely out the window, and it is back to doing what the Executive do best: siloed working and playing the blame game. Achieving pay parity should be accounted for in every year's Budget, but it is not. Pay parity does not by itself reverse a decade of pay freezes and below-inflation increases, but it is the very least that our health and social care workers deserve. We are talking about a very modest pay offer of 3·6%, which is below the rate of inflation and well below the increase that NHS staff in Scotland accepted. Failing to deliver even that paltry sum is a damning indictment of an Executive who treat healthcare workers as second-class citizens and not worthy. Placing all the blame on Westminster will simply not wash this time, not when the Executive are funnelling money out of the NHS and into the private sector. 'Belfast Live' recently reported that, between 2020 and 2025, our five healthcare trusts spent at least £302 million on private healthcare appointments. That is a shocking figure. The Health Minister's plan to tackle waiting lists includes even more reliance on the profiteering private healthcare sector. MRIs, CT scans, ultrasounds and X-rays are being outsourced to private firms, throwing good money after bad. Treatments and surgeries in orthopaedics, dermatology, gynaecology and much more are being delivered by profit-making organisations. Those private providers are raking it in; they are profiting from the crisis in our NHS. That is completely unacceptable. Procedures that should be done through the NHS are being outsourced. Staff who would otherwise be working in the NHS are working in private clinics. The maths is simple: the more money that the Executive pour into the black hole of private healthcare, the less that there is to invest in the NHS. The Executive's underfunding of public healthcare got us into this mess in the first place. More of the same will not get us out of it. Relying on the private sector to tackle waiting lists is a doomed strategy for multiple reasons. Private companies with profits to boost and dividends to pay will always choose a private patient over NHS work because there is more money to be made from privately insured or self-paying patients. Some people have been languishing for years on waiting lists. Those who can afford it have already opted for private treatment, so I ask whether our private hospitals even have the capacity to take on further NHS patients. The private sector does not train its own medical staff; instead, it poaches staff who have been trained in the NHS. It relies on the NHS. It cannot survive without it. Workers who would normally do extra hours in the NHS are paid more for straightforward procedures, such as cataract operations, in the private sector, but that means that other more complex procedures are not being done for the NHS. Those with more complex conditions — they are usually working-class people from communities such as mine and elsewhere — are left languishing on waiting lists because of the proliferation of the private sector. Would those hundreds of millions of pounds not be better spent on our overworked and underpaid healthcare staff? It will cost around £200 million to honour pay parity this year. At least £300 million has been sunk into the private health sector in the past five years.

If we were to stop the nonsensical and unethical stealth privatisation of our health service and invest directly in the NHS, we could put an end to staff shortages and the workforce crisis.

It is an insult to imply that industrial action would undermine waiting list initiatives and exacerbate the healthcare crisis. Health and social care workers are being forced to pay for a crisis of the system that has been handed down from Westminster and implemented by Stormont. It looks like those workers will soon be striking to save the NHS, as they have done repeatedly since 2019. They will strike for better, safer services for us all. There is no way to achieve that without investing in the workforce through fair pay and better conditions. I hope that Members will support the amendment.

976 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 13:11 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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