Belfast Telegraph

Difficult financial decisions to be made by incoming health minister

Julian Smith visits Northern Ireland...Northern Ireland's new Secretary of State Julian Smith arrives at the Guidhall, Londonderry, Northern Ireland, during his first visit to the region since his appointment. PRESS ASSOCIATION Photo. Picture date: Friday July 26, 2019. Mr Smith earlier held a series of separate meetings with the five main parties in Belfast. PA story POLITICS . Photo credit should read: Brian Lawless/PA Wire...A
Julian Smith visits Northern Ireland...Northern Ireland's new Secretary of State Julian Smith arrives at the Guidhall, Londonderry, Northern Ireland, during his first visit to the region since his appointment. PRESS ASSOCIATION Photo. Picture date: Friday July 26, 2019. Mr Smith earlier held a series of separate meetings with the five main parties in Belfast. PA story POLITICS . Photo credit should read: Brian Lawless/PA Wire...A
Lisa Smyth

By Lisa Smyth

The British and Irish governments have published their expectations for the future health minister and executive.

To say they are ambitious is an understatement, to say the least.

A new power-sharing government here will be expected to deliver pay parity to bring an immediate end to the strike by health staff, sweeping changes to the way healthcare is delivered in Northern Ireland and the introduction of a plan to address the waiting list scandal.

In fact, no-one waiting over a year at the end of September last year for outpatient or inpatient treatment will still be on a waiting list by March next year, according to the New Decade, New Approach deal.

But can the goals be achieved?

First of all, the person who takes up the health portfolio at Stormont is going to need a huge cash injection if they are to deliver the New Decade, New Approach wish-list.

Yesterday evening, the Secretary of State Julian Smith had not revealed how much money Westminster is willing to make available.

However, in December, the Belfast Telegraph revealed that NHS officials need £50m a year for the next seven years to bring hospital waiting lists under control and £150m a year for the next five years in order to push through the recommendations from the Bengoa report.

They are truly eye-watering sums and while tackling waiting lists and reform of the health service are crucial to reducing the misery for patients and staff and building a robust and sustainable health service, there is no doubt that the new health minister will have difficult financial decisions to make.

The reality is, no matter how much money they are handed by Westminster, they will still have to prioritise their spending.

Looking to the aspirations for waiting lists, additional funding will be important, but capacity - or lack of it - is also at the heart of this issue.

A lack of nurses, doctors and beds have played a role in the spiralling waiting lists.

Increasing the number of beds can be easily achieved, increasing staffing levels is a different matter altogether and it will take years to see the benefit of additional training places.

So, we will have to turn to the independent sector, but that will also take time.

Tenders will have to be made, contracts agreed, patient details delivered to private hospitals, appointments will have to be offered under the partial booking system, this all takes time.

It could be six months before the independent sector can start to deliver services to NHS patients.

Meanwhile, the row over doctors' pensions is rumbling on and that is having a significant impact on consultants' availability for clinics.

Another important question - what happens to the unknown number of people who have been waiting a year for their appointment since the end of September last year?

Also, what effect will the plan to offer appointments to the 108,000 patients waiting longer than a year in September have on everyone else in the system?

There is no doubt waiting times must be addressed, but it cannot happen to the detriment of the rest of the service and it must be done in parallel with reform of the health service.

The Bengoa report had overwhelming cross-party support prior to the collapse of the last Assembly and its implementation is key to the future of the NHS. However, will the new health minister be willing to potentially put their career on the line to press ahead with some of its more controversial proposals?

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