Health service must give value for money
The health service in Northern Ireland consumes around half of the total amount of money given to Stormont by the Treasury to run the province. Its budget dwarfs those of every other department, demonstrating its pivotal role in our society.
The demands on the health service continue to rise as the population ages and lives longer. So therefore it is natural to expect the service to work with the greatest possible efficiency.
That certainly is not the case as our story today reveals. More than 153,000 outpatient appointments were cancelled in the year up to last April and the reasons given show a service under enormous strain due in part to poor planning and inefficiency.
Some 53,000 appointments were cancelled because no consultants were available, another 6,000 because of a lack of other medical staff or nurses and, most unforgivably of all, almost 18,000 cancelled through administrative blunders by hospitals or GPs.
The lack of consultants, highlighted recently when it was revealed that some are earning hugely enhanced salaries due to the amount of overtime they have to do, shows inadequate planning by trusts in ensuring that key medical personnel are in post. It has to be remembered that these cancelled appointments are not simple statistics, but represent human beings awaiting investigation of what could be in many cases life-threatening conditions or illnesses.
However, it has to be conceded that patients are also contributing to the problem with 137,000 appointments lost in the last 12 months because people didn't bother to turn up or to cancel in time to allow the appointment slots to be reallocated.
So what can be done to ensure that patients are seen when they are supposed to be? While the UK often smugly compares the NHS with the healthcare in other countries, it actually spends a smaller proportion of GDP than 11 of the top EU countries.
It is clear that the commitments of staff - doctors carrying out private medicine using NHS facilities and nurses travelling to other regions of the UK to earn high rates of overtime - need to be examined to ensure that their primary employer, the NHS, is getting full value for money.
And when Brexit negotiations begin the ability of medical and nursing staff to come from EU countries to work in our hospitals must be a priority. Without them the crisis in the NHS would be even worse.