As Chair of the Northern Ireland Hospital Dental Services Forum (NIHDSF) which brings together all aspects of hospital dentistry to examine, discuss and seek solutions, I work with the committee to represent all cohorts, at all levels. It is time for the Department to sit up, notice, and take fair and decisive action to rectify the problems.
Northern Ireland hospital dentists: Pay disputes and industrial action
Hospital dentistry is facing a litany of issues, including pay across all cohorts from Consultants to Dental Core Trainees (DCTs). Now, Speciality and Associate Specialists (SAS) will ballot for industrial action in the autumn.
It is time for the Department to sit up, notice, and take fair and decisive action to rectify the problems.
Consultants ballot
The hospital dental consultants ballot closed on 10 June, with 93.3% in favour of industrial action from a 65.2% turnout. BMA also balloted its consultant members seeing remarkably similar results with 92% in favour and a 69% turnout. Northern Ireland’s hospital dental consultants will strike from 7am on 26 June to 7am on 27 June, with Christmas Day cover provided during the strike period.
Junior dentists
Earlier this year, we balloted our Dental Core Trainees (DCTs) and Speciality Training Registrars (StRs) in Northern Ireland. The ballot closed on 19 February, with 100% voting in favour of industrial action from a 90.9% turnout. DCTs and StRs have already taken action alongside Junior Doctors in March, May and June, with more action anticipated. On 6 June, our members and families also joined a rally to the steps of Stormont.
SAS grades
The SAS cohort in Northern Ireland, though small, is unhappy. They will ballot in the autumn regarding pay, delays in developing Specialist Grade positions, and issues with terms and discrepancies in contracts dating back to 2006 and 2011.
Lack of pay parity with other nations is concerning.
Four country comparison
Northern Ireland remains the ‘poor relation’ in terms of pay and conditions for Consultants, SAS, DCTs and StRs. The recent Doctors' and Dentists' Review Body (DDRB) pay lift, backdated to April 2023, has yet to be paid (although we are assured it will feature in June pay slips). The 6% pay uplift (and additional £1,250 for junior dentists) is being applied, although a lot later than other nations. Lack of pay parity with other nations is concerning, and there has been no commitment to match the English Consultants’ pay deal.
England and Wales
In England, two out of three cohorts have settled. In Wales, an offer for all three cohorts is on the table, endorsed by the BMA. It looks likely the deal will be accepted. In contrast, we face a “no more money” stance despite the health service crisis. The new Health Minister has even used the word “catastrophic”.
10 years of pay erosion
Hospital dentists and doctors in Northern Ireland have endured over 10 years of pay erosion, making recruitment and retention more difficult. The fact that there are 310 miles of border with an EU country, where you can step across to Slainte Care and earn circa two times your salary or relocate to Great Britain for better pay and conditions exacerbates the issue. The notion that ‘Northern Ireland is a nice place to live and cost of living is lower.’ is no longer enough. Recruitment and retention of hospital specialists is having a serious, detrimental impact on the delivery of health services.
Recruitment and retention of hospital specialists is having a serious, detrimental impact.
Workforce matters
I have raised concerns with the Strategic Planning & Performance Group about the lack of a Dental and Maxillo-facial Radiologist or dedicated Regional Cleft Orthodontist in Northern Ireland. The comprehensive response is an example of how NIHDSF raises important issues with decision makers. We also speak to Members of the Legislative Assembly, requesting oral and written Assembly Questions to be placed. As progress is likely to be slow, we are requesting that these matters are added to the Department’s Regional and Trust specific ‘risk register.’
On the upside
NIHDSF, formed just over a year ago, has already achieved considerable successes. Following an evidenced based assessment of the revised national curriculum for post graduate dental trainees, the department has revised pay scales for DCTs.
The incoming cohort of trainees at DCT 1, DCT 2 or DCT 3 level will be placed on the appropriate pay point of the StR pay scales. For postgraduate dentists further pursuing specialty training, their previous service in DCT should be recognised in terms of their starting pay on the StR scale.
We have written to the Northern Ireland Medical and Dental Training Agency to ensure that this new approach is applied fairly and that there are no unintended consequences or oversights.
We will continue to strive for justice and fair treatment for all dentists working in hospitals under difficult circumstances – you have our word.
