'Major' disruption as junior doctors strike
Significant disruption is expected in Northern Ireland's health services as junior doctors begin a two-day strike over pay.
The industrial action started at 07:00 BST on Wednesday and lasts until 07:00 on Friday 24 May.
The Department of Health has warned that services will be affected during the strike and in subsequent days.
Strikes will also be held from 6 June to 8 June, after pay talks with the department broke down.
The Department of Health has said it "stands ready" to continue discussions with the Junior Doctors Committee and does not accept that talks have “collapsed”.
Hundreds of outpatient appointments and a dozens of surgeries, as well as other procedures, have been postponed. The Urgent Care Centre at the Lagan Valley Hospital is also closed on Wednesday and Thursday.
Junior doctors previously went on strike for the first time on 6 March.
Why are junior doctors striking?
Dr Fiona Griffin, BMA chair of the Northern Ireland Junior Doctors Committee, was among those on the picket line at the Royal Victoria Hospital in Belfast.
She said doctors were leaving Northern Ireland in their droves to go elsewhere for better pay and working conditions.
She said: “We’ve tried to be amicable. We’ve tried to work with the department but they’ve not been forthcoming with a pay offer.
"Everything is becoming more and more pressured. The working conditions are getting worse. What we are trying to prevent is more doctors leaving.”
Dr Griffen said she understood that patients would be angry about the disruption.
However, she warned this could become common place with not enough doctors to staff hospitals.
Dr Rwsuan Baban was among a crowd of around 40 junior doctors on the picket line at the Ulster Hospital.
She’s from Iraq and previously worked in England.
She said she worried about the impact overstretched doctors had on patient safety.
She said that she routinely works beyond her contracted hours, for no extra pay, and would go home feeling anxious about the treatment she had given to patients.
Dr Steven Montgomery, who works at The Royal Belfast Hospital for Sick Children, also says there is a staffing crisis in Northern Ireland.
"We're losing doctors. We're haemorrhaging them, losing them hand over fist."
Dr Montgomery, who is a deputy chair of the Northern Ireland junior doctor committee (NIJDC) within the British Medical Association (BMA), said their pay was down 30% since 2006 "if you compare to what we were paid for the same job, the same hours, the same work".
"We're not asking for a pay lift, but for our pay to be restored, to be paid the same as what our equivalents got paid in 2008 in real-world terms," he added.
Dr Montgomery said the strike "unfortunately is going to have an impact on patients" and that he was sorry "to everybody that's been affected".
Previously, the BMA said junior doctors' salaries in Northern Ireland had fallen by 30% over the past 15 years.
The current base starting salary for a junior doctor is about £26,000.
However, this does not take into account weekend or out-of-hours work payments.
Dr Niall Doherty was also on the picket line at Belfast’s Royal Victoria Hospital.
He said morale among junior doctors was at an all time low, and that could be seen in the turnout.
He said doctors were working with an ageing population and facing more complex health issues across an increasingly stretched workload.
He said he wanted to see a “sustainable health service” - for both patients and staff.
'Had enough'
Dr Adam Flynn, who is a psychiatry trainee currently in outpatients in Rossdowney House in Londonderry, said he had hoped strike action could have been avoided, but said many junior doctors have had enough.
Speaking from the picket line at Altnagelvin Hospital in Derry, Dr Flynn said many colleagues are overworked and cannot provide the service they want.
“You are seeing people on waiting lists for much longer than they need to be, you are dealing with people on a crisis management basis as opposed to taking care of their long-term health care needs,” he told BBC Radio Foyle’s North West Today programme.
Dr Flynn said many junior doctors are living “pay cheque to pay cheque” and wages are big talking point among colleagues.
Have any appointments been cancelled?
All five of Northern Ireland's health trusts have said that some level of significant or major disruption to services is expected.
The South Eastern Health Trust has asked patients to attend appointments unless contacted by the trust to advise otherwise. However the Urgent Care Centre at the Lagan Valley Hospital is closed on Wednesday and Thursday. The trust said this was "unavoidable in order to maintain patient safety, which is always the trust’s priority". Details of other care options can be found here. Postponed services include 581 outpatient appointments, 45 endoscopy procedures, 28 day case procedures and 45 surgeries.
The Southern Health Trust said that patients and service users should attend their appointment unless contacted by the trust to advise otherwise. There are 275 outpatient appointments postponed and 33 surgeries postponed. The trust said it was "working hard to prepare and maintain safe services where we can", but expects major disruption not only on strike days but also on the "preceding and subsequent days as we plan and recover from industrial action, especially as we are then entering into a Bank Holiday weekend". You can get more information on services here.
The Northern Health Trust said patients and service users should attend all scheduled appointments unless contacted by the trust to advise otherwise. Fifteen community outpatient appointments, 349 hospital outpatient appointments, 26 endoscopy procedures and 23 surgical procedures have been rescheduled. The trust said the focus would be on "maintaining safe services for acutely unwell patients within our inpatient facilities and protecting urgent and emergency care".
The Western Health Trust said patients should attend all scheduled appointments unless contacted by the trust to advise otherwise. 1681 outpatient appointments and 221 inpatient/day case procedures have been postponed. They said that anyone who required urgent medical or mental health help during the duration of the strike action should attend the emergency department or call 999 but that services were expected to be busier. They are encouraging those with an urgent or minor matter, which is not life-threatening, to use the Phone First service.
The Belfast Trust said that any patients affected by the industrial action would be contacted directly and an alternative date would be arranged in due course. Patients should attend their scheduled appointment unless they have been directly contacted to advise it will be rescheduled.
What is a junior doctor?
Junior doctors are qualified doctors who are still involved in clinical training, according to the BMA.
Patients may be treated by a junior doctor in a hospital or general practice setting.
All have completed a medical degree and can have up to nine years' of working experience as a hospital doctor or up to five years working and gaining experience to become a GP.
They work under the supervision of a senior doctor.
In England, junior doctors have agreed to meet the government for fresh talks in their pay dispute.
The Welsh government are in talks over pay with junior doctor representatives while junior doctors in Scotland voted to accept a pay offer from the Scottish government last August.
What does Northern Ireland's Department of Health say?
The Department of Health said there had been some progress, including reform of the current junior doctor contract in Northern Ireland.
The department added that it has offered a process of independent arbitration "but this has not been taken up to date".
"When the ballot for industrial action was launched, junior doctors - like the rest of the NI health service staff – had received no pay award for 2023/24.
"That is no longer the case. The 2023/24 recommendations of the national pay review body, the DDRB, have now been implemented in Northern Ireland. The award will be paid in the June pay run, landing in pay packets next month.
"For junior doctors in Northern Ireland, it will bring an average pay increase of 9.07%, with those in their first year receiving a 10.68% uplift.
"The department cannot resolve the BMA demand for pay restoration – for a pay settlement that reverses public sector pay limits over the past decade and more."
Previously the Department of Health said junior doctors in Northern Ireland had been offered an average backdated pay increase of 9.1% for 2023-24, with those in their first year receiving a 10.7% uplift.
