Belfast Telegraph

In 2012, one Northern Ireland A&E unit was compared to a war-zone... five years on, there's still no ceasefire in sight

Lisa Smyth has experienced the problems plaguing the NHS both as a journalist and as the mother of two young children. She says if you think this week's waiting list revelations were bad, the reality is even worse.

We woke up to headline news this week that Northern Ireland has the worst waiting times for routine operations in the UK.

The BBC has collated NHS waiting time statistics dating back five years and compared the four UK regions for performance.

It found that Northern Ireland's hospitals have consistently failed to meet Government targets relating to emergency care, cancer treatment and routine operations.

While it was certainly depressing, it was hardly a shocking development.

During my time as a health journalist, I have regularly written articles about spiralling waiting lists in Northern Ireland and the effects on patients.

As long as I have been writing health stories, in fact, Northern Ireland seems to have fared worse than its UK counterparts.

As far back as 2012, a prominent GP made headlines when he compared the emergency department at Antrim Area Hospital to a war-zone.

Dr Brian Dunn was so concerned by the conditions and the waits faced by people at the unit that he said it reminded him of the A&Es in Belfast during the height of the Troubles.

And, in March that year, one of the most senior doctors in Britain lambasted the health service in Northern Ireland - saying patient safety was being jeopardised by long waiting lists.

Dr Laurence Buckman, the chair of the British Medical Association's (BMA) GP committee at the time, said waiting times for hospital appointments here were the worst in the United Kingdom.

He told family doctors attending a conference in Newcastle, Co Down, that his patients in England would never accept the waits that had become commonplace in Northern Ireland.

It is difficult to make comparisons between waits five years ago and now, because the way statistics are released have changed over the years.

However, anyone in Northern Ireland who has had an interaction with the health service over the last 12 months will know only too well how bleak the situation has become.

Turning to my own personal experience, my husband - who had a stroke in 2014 when he was 36 - was referred urgently to neurology at the end of last year as his GP was worried he was suffering from mini strokes.

He waited eight months to see a consultant.

In May, I was rushed by ambulance over the Glenshane Pass when I went into labour as the hospital I was in had no free neonatal cots for my premature baby.

And only this week, I was told I will wait six months for an abdominal ultrasound scan.

Of course, my family's experience is by no means unique - there are tens of thousands of people around Northern Ireland languishing on waiting lists, all the while getting sicker and putting even more pressure on an already overstretched resource.

Less than two weeks ago, John Compton, the former head of the Health and Social Care Board, said vulnerable patients are dying while waiting for a hospice bed.

His comments reveal that the failings go further than just outpatient appointments and emergency departments.

The whole health and social care system is currently at tipping point.

The worst part of all of this is that the statistics that made the headlines this week aren't actually a genuine reflection of how much the health service here is struggling to cope with demand.

Firstly, waiting times for review appointments are not monitored at all.

Officials only collect the number of people waiting over a specified period of time for an appointment, be that a first outpatient appointment, or a diagnostic test.

Furthermore, they don't record the total waiting time from the point a person is referred by a GP to the time they receive treatment.

The statistics the Department of Health do release are grim - but they would be truly shocking if they properly captured the whole patient journey.

But, if we listen to the GPs who make the referrals, they are very clear that the situation is declining rapidly and the service is at breaking point.

An increasing number of their patients can expect to wait up to five years for an operation, from going to their GP in the first place.

So, what can be done to resolve the situation?

With a growing ageing population living with chronic conditions, increasing expectations and medical advancements, the fact is there isn't enough money to meet the growing demand being placed on the health service.

I have interviewed countless medical professionals over the years and they are all very clear that we need to be smarter about how the health service is run.

Multiple reviews of the service in Northern Ireland over the years - including the Hayes Report, Developing Better Services, and Transforming Your Care - have all said the same thing.

The latest of these, the Bengoa Report, published in 2016, warned that change was required urgently to ensure the future of the health service.

Launching the document, the then Health Minister, Michelle O'Neill, warned: "If we persist with our current models of care, even with the best efforts of all staff and more investment year-on-year, waiting lists will continue to grow, our expertise will continue to be diluted and the best possible outcomes for patients will not be realised.

"This is both unsustainable and unacceptable."

More than a year on, however, and the momentum has stalled. The urgency expressed by our politicians seems to have vanished completely as they continue to argue over the terms that will make it agreeable to return to government.

Of course, some good work has been done to advance the recommendations in the Bengoa Report.

But progress can only ever be finite without the money to fund transformation and - most importantly - a Health Minister to make the crucial decisions needed to bring our health service into the 21st century.

As long as the political vacuum at Stormont continues, the health service in Northern Ireland will continue to make the headlines - and for all the wrong reasons.

Lisa Smyth is a freelance journalist specialising in health issues

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