'Do the right thing, not the popular thing': Economist says Northern Irish NHS needs 'courageous' overhaul to centralise services as he rubbishes junior doctors' pay claim

He was speaking as the junior doctors in Northern Ireland were striking from 8am today to 8am tomorrow – the first time they have done so.

About a month ago the BMA (doctors’ de facto trade union) told the News Letter its members want an above-inflation pay increase for 2023/24, and a commitment thereafter to a 30% rise in pay.

This, it said, will bring their salaries back to the level they were at 15 years ago before inflation ate away at their value.

Dr Birnie, who is also a former chief economist for accountancy giant PwC in Northern Ireland and an ex-UUP MLA, said: “Demands for wage growth of up to about 30% are simply not viable.

"I see the department is offering the doctors 9.1%, which is already one of the highest wage growth offers anywhere in the public sector (or, indeed, the private sector).

"The health department keep saying (based partly on an analysis by McKinsey consultants over a decade ago) that health needs a 6% uplift each year just to stand still in terms of services offered.

"Some 6% of the current £7bn implies more than £400m every year.

"It is hard to see how that scale of increase in health spending can be sustained year after year; eventually we would get to the situation that all public spending in NI being absorbed by that one department.

“Significantly, the shadow Labour secretary has been talking about achieving productivity gains of £10bn out of the English NHS budget of £180bn – that’s just over 5%.

"We need to think about similar gains here in NI. This will demand even more centralization of services.

"This will be politically unpopular but here we have yet another area where this new Executive must show political courage: do the right thing, not the popular one.”

• WHAT DO DOCTORS GET PAID?

Being a junior doctor in Northern Ireland begins upon graduation from university.

Initially, it means working as a "foundation house officer" for at least two years, starting at about £27,600.

Pay then rises fast, so by your second you could be earning in excess of £35,000.

Ultimately most junior doctors choose a specialism after a couple of years.

They can then work their way up the payscale as a "special registrar" (a type of junior doctor), where the payscale maxes out at £55,700.

The next levels up from junior doctor are consultant (between £88,800 and £119,700), an associate specialist and speciality (SAS) doctor (£45,300 to £92,500), or a GP (£70,000 to £105,600).

• THE VIEW FROM THE PICKET LINES

Dr Fiona Griffin, chairwoman of BMA’s Northern Ireland junior doctors committee, joined colleagues on the picket line at the Royal Victoria Hospital (RVH) yesterday.

Dr Griffin, who works at Craigavon Area Hospital, said: “There’s many people considering leaving the professional altogether.

“Doctors are feeling really broken. They’re feeling that these problems are insurmountable.

"We want the doctors to remain here. The doctors that have been trained here, we want them to remain, we want them to become senior doctors.

“We are very open to negotiating on pay, we are very reasonable people, we just want an above-inflation pay uplift for this year and then we want to work on addressing the pay erosion of the previous years.”

Dr Steven Montgomery, a paediatrician at the RVH had this message for patients: “I’d like to apologise to those people,” he said.

“I’m so sorry the Department of Health has failed.”

A Department of Health spokesman said in a statement: “The minister [Robin Swann] and department remain committed to negotiations with the BMA junior doctors committee.

“In line with independent pay body recommendations, junior doctors in Northern Ireland have been offered an average pay increase of 9.1% for 2023/24 with those in their first year receiving a 10.7% uplift.

“This award will be backdated to April 2023.”