Belfast Telegraph

Editor's Viewpoint: Fix for health service rests with Stormont

'As one GP - who, after all, has first-hand experience of this issue - said, those most inclined to miss appointments are those most in need of help and are people who often lead chaotic lives' (stock photo)
'As one GP - who, after all, has first-hand experience of this issue - said, those most inclined to miss appointments are those most in need of help and are people who often lead chaotic lives' (stock photo)

Editor's Viewpoint

Asking the public for ideas on how to tackle the financial crisis in the NHS in Northern Ireland is an attempt to engage the most important stakeholders in the service. Surprisingly, it seems that members of the public are prepared to countenance unpopular measures including prescription charges, higher car-parking charges at hospitals and fining patients who fail to keep GP appointments.

These suggestions from people in Fermanagh to the Western Local Commissioning Group might seem the way forward at first glance, but deeper examination shows flaws in the reasoning.

Charging for prescriptions is reasonable if it only applies to the occasional low-cost item, but for someone on expensive repeat medicines the cost would be prohibitive.

A similar argument applies to car-parking charges at hospitals which may be acceptable for occasional users but for those attending regularly would be a penalty.

While it has been argued that fining people for failing to keep GP appointments is another seemingly attractive option, it is practically unworkable and potentially very unfair.

As one GP - who, after all, has first-hand experience of this issue - said, those most inclined to miss appointments are those most in need of help and are people who often lead chaotic lives.

There are myriad reasons why someone may miss a GP appointment and it can be difficult for them to get through to doctors' practices to inform the GP that they will not be attending at the appointed time.

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The doctor also pointed out that imposing fines would be a logistical nightmare.

Who would police it or enforce it, and who would decide if a patient had a valid reason for non-attendance - for example, worsening health or a domestic crisis, or lack of transport?

There is one suggestion for improving the health service in the province which this newspaper has repeated many times. That is for the political parties to end their current impasse, form a new power-sharing administration and appoint a minister of health.

That person could then implement the Bengoa Report which put forward widely praised ideas for streamlining the health service and improving its efficiency.

Going back into government and doing the job for which they were elected - and continue to get paid - would benefit patients without inflicting pain on them.

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