The haemorrhaging of junior doctors from the Northern Ireland health service will intensify if their calls for a “reasonable” pay uplift are not listened to, striking medics have warned.

Recently qualified doctors across the region took to the picket lines on Wednesday in their first industrial action over pay.

A 24-hour walkout began at 8am, affecting hospitals and GP surgeries.

At one of the main picket locations, dozens of junior doctors gathered outside the Royal Victoria Hospital complex in Belfast to demand action on pay.

The medics chanted and held up placards, and one played the bagpipes, as passing motorists honked their horns in support.

Ahead of the strike, Stormont Health Minister Robin Swann warned that the disruption caused would be significant and would lead to thousands of missed appointments and procedures.

The strike action was called after 97.6% of junior doctors balloted by BMA Northern Ireland voted in favour of industrial action.

The union has called for a commitment to a full pay restoration to 2008 levels.

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

She said they felt they had been left with no choice but to stand up for themselves.

Dr Griffin, who works at Craigavon Area Hospital, said some newly qualified doctors were earning £13 per hour in Northern Ireland.

“Our pay has been eroded by 30% over the past 15 years,” she told the PA news agency.

“So for every time inflation goes up and our pay doesn’t match inflation, it’s effectively a pay cut. So our pay has been cut by a third in that time. My colleagues and I have decided that that’s no longer good enough. And that’s why we’re out here. We’ve asked for an above-inflation pay uplift and we’ve asked to have some of that eroded pay restored.

“There’s many people considering leaving the professional altogether. We really are at a crisis point. And I know we say that a lot in Northern Ireland, but we genuinely are at a crisis point. The way we are working at the minute, it is not sustainable.

“Doctors are feeling really broken. They’re feeling that these problems are insurmountable. And we’ve decided as a union to come together to say actually we want the Northern Ireland health service to work for doctors. 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 want to serve the populations that we’ve been trained to serve yet here we are on strike today – we’d all prefer to be inside looking after our patients, going through our clinics and getting trained, but we’re in this position only because we’re not being heard.”

Dr Griffin added: “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.

“We want to work on those things together, we’re not being greedy, we’re just asking for things that are reasonable and that are going to actually keep doctors in post in Northern Ireland.”

Dr Steven Montgomery, a paediatrician at the Royal Belfast Hospital for Sick Children, acknowledged the impact on patients.

“I’d like to apologise to those people, to say I’m so sorry that it has come to this,” he said.

“I’m so sorry the Department of Health has failed. I’m so sorry that you’re waiting too long for these appointments. And I’m so sorry that we’ve had to resort to this action because the lack of willingness from the Department of Health to negotiate with us. We are more than happy to come back round the negotiating table as soon as the Department of Health is willing to talk.

“I’m hoping this will be our first and last strike action. We don’t want to be here. This is the first time we’ve had strikes in the BMA in Northern Ireland and it just shows you how seriously and how much of a last resort this option is.”

Dr Montgomery said junior doctors were busier than ever.

“We are struggling to fill jobs here in Northern Ireland. We have over 15% of junior doctor vacancies. One of the major factors that we’ve got too many vacancies is because of the current pay and conditions in Northern Ireland,” he said.

“My fear is that at the minute we’re haemorrhaging staff, and my fear is that if things don’t improve, we’ll continue to lose staff, situations will become more unsafe, staffing levels will become worse, burnout will increase and we’re already at the highest rate of burnout out of all the devolved nations at the minute.”

A Department of Health spokesman said the industrial action would cause significant disruption to patient care.

“The minister and department remain committed to negotiations with the BMA junior doctors committee,” he said.

“This offers the best prospect of de-escalating the situation.”

The spokesman added: “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 and should be viewed in the context of pay settlements across the wider Northern Ireland public sector.

“In relation to 2023/24 pay, the department is only in a position to implement the recommendations of independent pay review bodies or mirror pay settlements in England.

“This approach is being applied to all health service staffing groups. It is not possible to make exceptions.

“While there are clear limits in relation to 2023/24, there are grounds for productive negotiations with the BMA junior doctors committee on a number of fronts.

“These include 2024/25 junior doctor pay; potentially reforming the current junior contract in Northern Ireland; and addressing areas of concern on working conditions and other non-pay issues.”