Nurses in Northern Ireland say they don’t want to be “left behind” the rest of the UK, as thousands go on strike again to demand pay parity with their English, Welsh and Scottish counterparts.
Members of public sector union Unison including nurses, healthcare assistants (HCAs), ambulance crews and other health workers, began a 48-hour strike this morning to demand a pay offer for the 2023-24 financial year.
“We’re not asking for much, just proper pay for a job that’s paid significantly more across the water”
Joanne McMurray
The Northern Irish Department of Health said, earlier this year, it would not issue one and nor would it improve upon the 4.75% pay increase implemented for 2022-23 due to financial constraints.
These constraints stem from a budget set by the central UK Government, which took the reigns due to the lack of a functioning executive in the country. UK Northern Ireland secretary Chris Heaton-Harris put forward £7.3bn for health, which the department said would not be enough for an NHS pay award.
Nurses, midwives and other healthcare staff, as a result, have not received any pay rise offers for the current financial year, in contrast to their Agenda for Change counterparts in England, Wales and Scotland, who have received awards.
Mental health nurse Joanne McMurray said the mood was “hopeful” on the picket lines today, and that health staff were prepared to strike until their demands were met.
“We’re all just so burned out,” said Ms McMurray.
“We love our jobs, but don’t feel we can do them right now. We’re doing the same job as people in England, Scotland and Wales – so, why in Northern Ireland are we being left behind again?”
Ms McMurray drew a comparison to the Royal College of Nursing (RCN)’s 2019 dispute in Northern Ireland. At the time, there were similar fears that a lack of a functioning government was leading to Northern Irish nurses being underpaid compared to their other British counterparts.

Unison nursing and other healthcare staff strike in Northern Ireland on 21 September, 2023
She continued: “We’re not asking for much, just proper pay for a job that’s paid significantly more across the water.
“Nursing is a degree-level qualification and it’s one of the lower paid ones as it stands, never mind that discrepancy. We love our jobs, but you can imagine – we’re cross.”
Ms McMurray said colleagues of hers worried about being able to afford essentials, and that foodbank usage had surged among the nursing workforce in Northern Ireland.
She described the situation in Northern Ireland as “frustrating”, adding: “Nursing staff feel they’re being used as pawns to get Stormont back up and running. Political parties are being stubborn.”
Fellow mental health nurse Rachael Young described the personal impact of pay stagnation on her family: “I have children now, and this impacts [them].
“I’m trying to make sure my kids are provided for. And then there is Christmas, as a single parent it’s very tough.”
Ms Young said the situation in the workplace was also deteriorating due to a lack of a pay deal: “You can see the notable difference in terms of retention and recruitment that pay has.
“And it impacts patient care: delayed discharges, staff stress. It can make people feel more at risk, especially in an acute mental health ward.”
Unison Northern Ireland head of bargaining Anne Speed agreed that the prospect of feeling “left behind” was a driver for healthcare workers striking.
“[They are] angry that they’ve been left behind when their colleagues in England, Wales and Scotland have all received pay increases this year,” said Ms Speed.
“While healthcare staff pay is being held down, their bills and living costs are soaring. The UK Government has to step up and make the funding available so staff can be paid properly.”
Tomorrow, Unison health workers will be joined on the picket lines by members of the Royal College of Midwifery (RCM).
Northern Ireland RCM director Karen Murray said midwives had paused strike action earlier this year in “good faith”, but were now frustrated by the lack of a new deal emerging.
“In those six months, all that’s happened is that midwives and maternity support workers have become the lowest paid in the UK and their frustration with politicians has reached an all-time high,” Ms Murray said.
“None of us wants to be on the picket line today, but what choice do we have? Despite pay settlements being reached in England, Wales and Scotland, there is no such agreement in Northern Ireland.”
She described the lack of a deal as “frankly disrespectful”, adding: “What we are fighting for here is safety and fairness.
“The safety of our maternity services is reliant on midwives and [midwifery support workers], but if we don’t pay them fairly, they will leave.
“It’s as simple and as stark as that – and we’re already seeing it happen. Politicians can stem that tide – and they need to do it now.”
A spokesperson for the Northern Irish Department of Health said the organisation “understands the deep-seated frustration” aired by Unison and the RCM over pay.
However, the spokesperson reiterated that the budget it had been given for the 2023-24 financial year had created an “impossible” position which had not left enough money for matching the most recent English NHS Agenda for Change pay offer.
They added: “As has been previously stated, the current budgetary constraints mean that matching the English pay offer for Agenda for Change health and social care staff would require large scale cuts on an unprecedented scale, with severe and lasting implications for services.
“That would be outside the scope of our decision making powers. The department continues to look for ways to address the pay challenge.”