The decision to not offer nurses in Northern Ireland a pay deal has caused “absolute anger and outrage” across the profession, a nurse leader has warned.
Dolores McCormick, associate director for employment relations and member services at the Royal College of Nursing (RCN), gave evidence yesterday to the UK Government’s Northern Ireland Affairs Committee about the funding and delivery of Health and Social Care (HSC) services in the country.
“The inability to offer a pay settlement to Northern Ireland has caused absolute anger and outrage across the nursing profession”
Dolores McCormick
Ms McCormick warned MPs that the state of the health service in Northern Ireland was “beyond crisis” and that nurses were facing daily “moral distress” when trying to deliver care to patients.
“That is where we are at, a workforce that’s stretched and broken, and an inability to do what it is we came into the profession to do,” she said.
Ms McCormick gave evidence, alongside representatives from the British Medical Association (BMA) and the Royal College of Surgeons (RCS).
MPs were told by all the representatives that the lack of a functioning government in Northern Ireland was the main reason why issues within HSC were not resolved.
Northern Ireland has gone more than a year an executive due to a boycott by the Democratic Unionist Party (DUP) of power-sharing arrangements with Sinn Féin in defiance of the post-Brexit Northern Ireland protocol.
Ms McCormick said that the political situation in the country had “halted” progress on strategies and innovations which could positively impact the nursing workforce.
She added: “We have a lot of examples of things from the nursing world which impact across healthcare, where if we had our own executive up and running we could make things happen.”
The lack of a functioning government in Northern Ireland has also meant that nurses have been unable to negotiate an improved pay award like their colleagues in the other UK countries have.
This week the Department of Health in Northern Ireland confirmed that it would not be making a pay offer to nurses for 2023-24, due to budget constraints.
Not only will nursing staff not receive a pay offer for 2023-24, but there will also be no improvement on the average 4.75% pay award that was implemented last year for 2022-23 – equivalent to a £1,400 uplift.
Ms McCormick said: “The inability to offer a pay settlement to Northern Ireland has caused absolute anger and outrage across the nursing profession.”
The 2023-24 budget was set by the UK secretary of state for Northern Ireland, Chris Heaton-Harris, who suggested that any Barnett consequentials given to Northern Ireland would be spent on clearing £297m of debt from the previous financial year.
During the committee session, Jim Shannon, a DUP MP, said that paying off the overspend from last year with money that could be put towards HSC pay would “put greater pressures upon the health system”.
“They’re going to leave the system because they have lost hope in the system in Northern Ireland”
Tom Black
He also warned that the lack of funding for a pay award was driving staff out of the health service, resulting in an increasing reliance on agency staff.
Mr Shannon said: “The agency staff who we’re recruiting heavily [are] costing more to run…it just doesn’t add up economically and financially.
“If you paid all the nurses a wee bit more, the agency staff would be reduced, you’d have more nurses and therefore the financial equation would work out to your advantage.”
Ms McCormick agreed, describing how Northern Ireland had “an overwhelming nursing agency bill that has ran out of control”.
She cited figures from the Department of Health in Northern Ireland, which revealed that there are almost 3,000 nursing vacancies within HSC.
Ms McCormick said: “To plug the gaps, this culture of using agency staff has crept in and has spiralled.”
However, she warned that pay and terms and conditions were “the elephant in the room” when talking about why nurses turn to agency work.
Meanwhile, Dr Tom Black, the BMA’s Northern Ireland council chair, also echoed concerns around the wider HSC workforce during the session.
He added that HSC was at “a cliff edge of a huge problem” where people were moving from Northern Ireland to the Republic of Ireland in search of better pay and terms and conditions.
Dr Black said: “They’re all applying for jobs, they’re looking at the rates and the rates [in the Republic of Ireland] are double what they’re paid in Northern Ireland.
“There is the possibility for a lot of our consultants in the border counties to move.
“Nurses will do the same, physios will do the same [and] radiographers will do the same.”
Speaking to Nursing Times last week, RCN chief executive and general secretary Pat Cullen raised similar concerns about nurses from Northern Ireland being drawn to the Republic for better pay.
Meanwhile, during the committee session, Dr Black warned that the ongoing lack of pay negotiations for HSC staff in Northern Ireland would drive more clinicians away from working in the country.
He said: “They’re going to leave the system because they have lost hope in the system in Northern Ireland.
“So it’s a very, very difficult year ahead of us.”