Health trusts taking harsh approach to discipline, union says

Health trusts in Northern Ireland take a punitive approach to discipline, particularly among the lower paid, a trade union has said.

Unison issued a statement after new figures showed 1,834 healthcare workers across the six trusts in Northern Ireland have been dismissed in the last five years over attendance issues.

In the 2024/25 year, 448 staff were dismissed.

Unison said it was "not surprised" by the figures, particularly the staff who have been dismissed from lower pay grades.

"The trusts have adopted a just culture model as regards the disciplinary policy. This change in policy direction is designed to move away from punitive outcomes where appropriate and look at corrective measures," Unison said.

The union said it remained "very concerned that while the trusts at a corporate level say they are bought into the just culture" the "middle management actions say different".

"Namely management seem to be culturally embedded in a punitive approach as a remedy to workplace incidents," Unison said.

The union said it would "continue to press the trusts to change direction and pay closer attention to how the trusts treat the lowest paid staff".

The Belfast Trust said the dismissal figures reflect a small proportion of its overall workforce.

"Reducing sickness absence within the trust is a key priority and all cases are managed in accordance with our management of attendance protocol with the aim of ensuring staff are supported to return to work at the earliest opportunity," it added.

The South Eastern Health and Social Care Trust said "all absences are compassionately managed through a fair and transparent sickness policy", adding that this "lengthy process involves both informal and formal procedures".

"The South Eastern Trust has more than 12,000 employees and the number of staff who have been dismissed, after every avenue has been explored, is very small – 1%."

The Western Health and Social Care Trust said it recognised "illness and health issues can affect anyone, and that some periods of absence are unavoidable".

"Only where all reasonable support options have been fully explored and exhausted do we consider termination, and any such decision is always regrettable," said the trust.

The Southern Trust said "dismissal occurs when all other options, alternatives and improvement measures have been explored in line with the trust's policy".

It added that it was "mindful of the cost of sickness absence in respect of public money" and the dismissal figures reflect a small proportion of its overall workforce.

The Northern Trust also said dismissal is the "last resort" and aims to seek staff wherever possible, including "through training, supervision and improvement measures".

The Northern Ireland Ambulance Service said its "attendance management policy seeks to resolve issues through informal and formal processes".

"However, there are occasions, that as a result of unsuccessful outcomes of these processes, cases may be escalated to formal a disciplinary process," it added.

Last year, Belfast Health and Social Care Trust, which employs about 22,000 people, dismissed 130 staff members. The South Eastern Trust, which employs more than 12,000 people, dismissed 124 staff members.

A total of 74 staff members were dismissed by the Southern Health and Social Care Trust, which employs about 13,000 people.

In the Western Health and Social Care Trust, which employs about 12,000 people, there were a total of 56 dismissals for 2024/25.

Fifty-five staff members were dismissed by the Northern Health and Social Care Trust, while nine staff members were dismissed by the Northern Ireland Ambulance Service.

Since 2020/21, the professional grouping with the highest number of dismissals was social services.

There have been no dismissals for resident doctors or dentists since 2020/21.

These figures have been issued by the Health Minister Mike Nesbitt in response to a written Assembly Question by Social Democratic and Labour Party (SDLP) MLA Daniel McCrossan.