Intended for healthcare professionals


How junior doctors in New Zealand fought for better working conditions

BMJ 2016; 352 doi: (Published 25 February 2016) Cite this as: BMJ 2016;352:cf_frame
  1. Kathryn Frame,
  2. specialty trainee year 4,,
  3. renal registrar 1
  1. 1Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust
  1. kathrynyframe{at}


Kathryn Frame reflects on what doctors in England can learn from New Zealand’s 2008 dispute over junior doctors’ pay and conditions

The bitter dispute over the junior doctor contract is making many trainees in England consider a career overseas, where the grass seems greener. I worked in New Zealand after my foundation training, arriving in 2008 to discover that the junior doctors there had just finished their own hard fought battle over a new contract. Industrial action was fresh in their minds and I found their attitudes to be enlightening and in stark contrast to the culture in UK hospitals at the time.

The negotiations in New Zealand occurred in the context of a workforce retention crisis, with large numbers of healthcare professionals having left for higher salaries in Australia. The Resident Doctors Association sought consecutive annual pay rises of 10% for juniors. After an extended dispute and two 48 hour strikes a settlement was agreed. The association achieved an initial pay increase of 8.86%, followed by a further 2% eight months later. They also secured back payments for the duration of the dispute, additional study leave for registrars, and more recognition for time spent in clinical research.

Acting cohesively

My new colleagues were interested to hear how their situation compared to that in the United Kingdom. To their astonishment, I was unable to offer much detail on the pay structure or contractual terms back home. I vaguely recalled having seen my foundation contract for the first time several months into the job. I had worked hard and had been quite well paid, but that was as much thought as I had ever given to it.

One of the registrars explained what had recently happened in New Zealand. She advised that I join the union and collect some extra duty forms. We were encouraged by the consultants to submit claims for working late or taking on extra work to cover the absence of a colleague. There were lots of gaps on the rota, so we often worked beyond our contracted hours, but we were properly compensated. Overall, the junior doctors I met were happy, well motivated, and shared a strong and supportive team spirit.

One of my posts was a “rotator” role, designed to cover doctors on nights or leave. But there was a long term vacancy on the rota and I was usually used to fill that slot instead. My colleagues let me know that this was not permitted and that I should claim all of these shifts as an internal locum, effectively doubling my salary. They were surprised and amused by my embarrassment in doing so. They felt that having been through the uncomfortable experience of industrial action, everyone must continue to act cohesively, to uphold and protect the terms agreed.

Long term effects

There has been much speculation about the long term effects of the recent industrial action on the attitudes and culture within the medical profession in England. In New Zealand, I joined a politically aware and united group of doctors who were well informed about the terms of their employment and not ashamed to defend them. Although we have been similarly activated by our own contract dispute, we have been unable to achieve the same positive outcome of a negotiated settlement. I fear that the lack of closure and the anger this has generated will see many of my current colleagues joining my former ones in New Zealand.


  • Competing interests: I have read and understood BMJ’s policy on declaration of interests and have no relevant interests to declare.

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