Consultants and specialist doctors in Northern Ireland have finally done what 18 years of shrinking paychecks suggested they might: they went on strike. The 24-hour industrial action, which ran from 07:00 BST Thursday to 07:00 Friday, was a historic first for these two groups of doctors in the region. While some routine and elective services were cancelled, the Department of Health assured the public that a solid 90% of services went ahead - presumably the ones that didn't require a doctor's paycheck to function.

Full emergency cover remained in place, and patients were told to attend all scheduled appointments unless advised otherwise. There were no picket line demonstrations, possibly because doctors were too busy calculating how much less they earn than their English counterparts.

Health Minister Mike Nesbitt expressed disappointment, saying he's committed to implementing this year's pay award but can't, due to the absence of an agreed budget. He offered doctors a 3.5% pay uplift, which the British Medical Association (BMA) rejected as insufficient. Dr David Farren, chairman of the BMA's Northern Ireland consultants committee, clarified that the walkout wasn't just about pay - it was also about recruiting and retaining doctors, which apparently requires paying them enough to not flee to England.

The strike caused significant disruption: the Southern Trust rescheduled 143 outpatient appointments and 11 surgeries; the South Eastern Health Trust closed Lagan Valley Hospital's urgent care centre; the Northern Trust postponed 62 outpatient and 64 radiology appointments; the Belfast Trust postponed 569 outpatient appointments and 114 day cases; and the Western Trust cancelled or postponed 321 appointments. In other words, a lot of people got a free day off from their medical worries.

The BMA balloted members after rejecting the 3.5% pay uplift from an independent pay body. Results showed 92% of resident doctors, 79% of consultants, and 90% of SAS (specialist, associate specialist and speciality) doctors voted for strike action, citing "over 18 years of pay erosion." Dr Leanne Davison, chairwoman of the BMA's Northern Ireland SAS committee, noted that the health service can "no longer run on the goodwill of front-line staff" - a goodwill that apparently has an expiration date.

A separate 24-hour walkout is scheduled for Monday 29 June. Dr Clodagh Corrigan, deputy chair of the BMA's NI Council, called the situation "regrettable" but said doctors were left with "no alternative" after "promise after promise that has been broken." Nesbitt warned that going beyond 3.5% would have "significant repercussions" for nurses, teachers, police officers, and the entire public sector - which is a bit like saying you can't give one kid a cookie because then all the other kids will want one too.