Lack of cash lies at root of Northern Ireland health service's woes
Shortly before the last Stormont Assembly election and undoubtedly prompted by the fact that I was suffering from flu, I felt compelled to write the following in this column:
"Are we a bunch of hypocrites in Northern Ireland? Where do our values as a society lie? Do we want to cut 3,000 to 4,000 doctors, nurses and other staff in the NHS? Do we want our children, parents and grandparents to suffer a doubling of waiting time for treatment? Would we rather have no water charges and other freebies than protect our health service?"
That was then and this is now, but not much seems to have changed other than that the current health minister, Edwin Poots, is faring little better than his predecessor, Michael McGimpsey, in the courtroom of public opinion and the media spotlight.
Readers may recall that Mr McGimpsey, an Ulster Unionist, was given a hard time by the two major parties at Stormont when he warned that the health service faced a huge shortfall in spending.
The situation was so serious that even the chief executive of the Health and Social Care Board, John Compton, who is about to retire, said services were on the verge of bankruptcy.
His doom-laden prophesy was not fulfilled, but that is cold comfort in 2014 after the controversy in the past week over the accident and emergency department of the Royal Victoria Hospital.
Money lies at the root of the health service's problems not only here, but also across the UK, where the stresses of staffing and funding in hospital care do not gain as much media attention, but nevertheless exist.
Five deaths in questionable circumstances among 80,000 annual admissions to A&E in Belfast are five deaths too many, but still have to be placed in their proper perspective.
No-one wants to see anyone dying unnecessarily through inadequate care, but neither should we ignore the underlying circumstances under which such deaths can occur.
No matter how much money is poured into the health service, it is simply not enough to provide the range of resources which the public expects.
The health service attracts more attention in Northern Ireland. The local media – particularly the BBC – have the resources to investigate.
A devolved administration at Stormont means our hospitals attract closer political attention, especially when an election is just around the corner.
As a consequence, managers in the health service have been subjected to another unmerciful pummelling before microphones and cameras.
The question which is not asked of many complainants is whether they would consider giving up the luxury of free prescriptions and non-means-tested home care, which are benefits the rest of the UK does not enjoy.
Whether they might accept a lifting of the cap on their household rates, or the introduction of water charges – two more generous Stormont benefits – in return for increasing the funding of health.
Perish the thought, do I hear the public's response?
Nor is there much acknowledgment in this divided society that the situation would be infinitely worse for all of us if it were not for the annual £9bn subsidy from London, close on half of which is required to keep health and social care ticking over as well as it does.
It seems everyone has an axe to grind. The minister puts the squeeze on senior management to reform the service and, at the same time, make substantial savings. The management transfers this pressure to the staff on duty, demanding that waiting times are met.
In turn, consultants and doctors complain that they are being put upon unfairly, perhaps even bullied. The health unions wave their placards of protest. So it goes on, a constant battle between all of them, while the public faith in the health service is unfairly and unjustifiably undermined.
It all makes for gladiatorial broadcasting: from the minister to senior officials, another health controversy is played out in radio and TV studios; the Christians dragged into the ring with the lions to be devoured before the serried ranks of a baying public.
The workings of our health services are far too complex and serious to be reduced to an emotional sound-bite inquisition, yet that is how it is in today's world.
There simply appears to be no end in sight until and unless politicians and public alike accept that the health service is under-funded and start putting their money where their mouth is.