An increasing number of doctors in Northern Ireland are considering moving away or retiring early due to their frustrations over pay, a prominent GP has said.
Dr Tom Black also said the health service was now "running on goodwill" as a survey carried out by the BMA NI showed that more than half of doctors would be willing to take some form of industrial action over pay.
The poll of more than 1,000 doctors working in the region showed that 85% of respondents said a proposed pay uplift of 4.5% was too low.
The discontent rose to 93% among junior doctors.
The survey also showed unhappiness among doctors due to the lack of an Assembly and Executive in Northern Ireland, with 89% of respondents saying the inability to apply the uplift had decreased or significantly decreased their morale.
When asked about their intentions as to the likelihood of them continuing to work in Northern Ireland, 72% of junior doctor respondents were either "more likely to leave" or "much more likely to leave" due to the proposed pay award.
More than 55.71% of consultants, 53.26% of SAS (speciality and associated specialist) doctors and 52.57% of GPs said the inability of the Executive to make the award made them more likely or much more likely to leave the health service.
More than a quarter of consultants (28%) said they now intended to reduce their hours and 18% of consultants and 20% of GPs said they now intended to retire earlier than planned.
Dr Tom Black, BMA NI Council chair, said: "These are very stark figures.
"The level of dissatisfaction, low morale and burnout among doctors is probably higher than I have ever seen it.
"We are doing our best to meet the needs of patients but are under pressure from all sides and a low pay award combined with an inability to actually get the award paid is another blow.
"This is a real terms pay cut on top of many years of pay erosion.
"Working as a doctor is becoming increasingly unappealing with rising patient numbers, but complete stasis in terms of transforming our health service and addressing many of the issues it is facing."
Dr Black added: "We cannot afford to have our younger doctors leave for other countries or our more experienced doctors leave early.
"Of the medical students who responded to the survey, 28% said below inflation pay rises meant they would seek work outside of the UK, only 7% said they would want to work here regardless. That is extremely worrying."
Asked about their willingness to take industrial action, over 50% of respondents indicated they would be willing to take some form of action that impacts on services to patients with junior doctors most likely to take action.
Dr Black added: "Our health system is broken and is essentially running on goodwill.
"We need to take action to improve the working lives of doctors and pay is one element of that.
"Unfortunately the working lives of doctors have become more stressful due to waiting lists, excessive workloads, staff shortages, inadequate funding, unfair pension rules and pay.
"Doctors are now considering a choice between emigration, resignation or retirement.
"Our committees will now be looking at what action their members are willing to take.
"We are clear that we will not put up with this situation and that we need to see change on the ground before it's too late."
Last week Health Minister Robin Swann said he did not have the money to implement the recommendations of the independent panel on health workers' pay, never mind any additional uplift health unions are asking for.
A Department of Health spokesperson said: "Our health service is facing an unprecedented period of budgetary pressures and uncertainty, with a major overspend projected for the current financial year.
"The health minister has made clear that he does currently not have the funding to meet national pay review recommendations, let alone make an enhanced offer.
"Despite this, the Department of Health has undertaken significant work to seek to alleviate the workforce pressures across the Health and Social Care (HSC) system.
"In response to the pressures facing general practice, the department is continuing to invest in our GP workforce and has increased the number of GP trainees by over 70% since 2015 levels.
"Most recently, the minister announced an immediate increase of 10 additional GP training places as an interim measure for the 2022/23 academic year bringing the total number in Northern Ireland to an all-time high of 121 training places this year.
"He also approved an additional 13 medical specialty training posts for 2022/23 as well as a further 22 positions on the Northern Ireland Medical Foundation Programme.
"The minister has made clear that he is very mindful of the cost of living pressures on health and social care staff and across the wider community.
"The minister has also said that he will continue to do the best he can amid ongoing budget uncertainty but is unable to implement any pay awards locally as Northern Ireland still does not have an agreed Executive Budget for 2022/23."
Stormont is currently without properly functioning Executive due to the DUP's decision to block its operation in protest at Brexit's Northern Ireland Protocol.
There is no first or deputy first minister in place, and, while other ministers are in post, they are limited in the decisions they can take.
Northern Ireland has the longest waiting lists in the UK.
Mr Swann is also facing the prospect of widespread industrial action by healthcare staff later in the year as several unions demand inflation-proofed pay increases.
Last week, the Royal College of Nursing announced it was joining colleagues elsewhere in the UK in balloting members on strike action.
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