After four Royal Colleges and the BMA warned that Stormont’s paralysis could cost lives on International Nurses Day on Thursday, Lisa Smyth looks at the chances of change while in political limbo
The message to our politicians from doctors and nurses couldn’t be clearer — form an Executive to stop more patients needlessly coming to harm.
The irony cannot be ignored that on the same day Northern Ireland celebrated its incredible nursing workforce, five organisations representing staff on the frontline felt it necessary to take the unusual step to unite and make a direct appeal to our politicians over the state of the NHS.
Sadly here in Northern Ireland, we are accustomed to lurching from one political crisis to the next — the latest coming as a result of the DUP’s stance over the Northern Ireland Protocol.
While there is no doubt the protocol is creating issues for businesses and shoppers alike, do they really compare to the pain and anguish being suffered by patients and NHS staff?
The DUP remained silent on this last night. Asked whether it was prioritising the protocol over addressing the issues facing the health service, the party didn’t respond.
It is worth noting the DUP didn’t attend a hustings event organised by the Royal College of Surgeons and Royal College of Nursing ahead of the May 5 elections.
A party spokesman subsequently said a “diary mix up” meant there was no DUP candidate present but gave an assurance “the party has regular contact with the royal colleges and this will continue throughout the next Assembly term”.
So, will they heed the message coming from the health professionals appealing for some political stability?
The reality is that, without it, the health service will continue to teeter on the edge. The fact that it hasn’t collapsed already is down to the sheer dedication and hard work of staff. So, why is it so important that an Executive is put in place and what impact does the current hiatus have on the ability of the service to function?
Essentially, we are back where we were prior to the election, with Robin Swann carrying out an almost caretaker role.
He can keep things ticking over but making more significant or controversial decisions is somewhat more challenging without an Executive.
We know that budget uncertainty is creating a massive headache — in fact, on the same day that voters went to the polls, a Belfast Trust official warned of the dire situation in the absence of a fully functioning government.
“We actually don’t have a budget because of the collapse of the Executive,” the board was told. Preferably health bosses would like a three-year budget to enable them to plan ahead — after all how can they establish services and put in place meaningful plans to address the likes of hospital waiting lists without the assurance of long-term funding?
Addressing the finance conundrum will not be a panacea, however.
Sitting in the health minister’s in-tray is a range of proposed changes to health service delivery — many of which are regarded as crucial in establishing a safe and sustainable NHS.
Some can be approved and put into place fairly easily, others are likely to face significant opposition.
Take the commissioning of abortion services, for example. Robin Swann has argued he needs Executive approval on this so it’s unlikely there will be any movement on this.
What about proposed changes to breast cancer services?
Clinicians have said a reduction in the number of sites where treatment is delivered will result in better outcomes overall, but a petition against the plans has amassed thousands of signatures.
As a result, this could be considered a controversial matter, which by its nature, means Mr Swann should really seek Executive approval before any changes are made. Without this, he could be more open to a legal challenge, although he could argue service reconfiguration is required for patient safety.
The question is, at what point would this protection kick in? Can he make changes in a planned way or will he have to wait until a service is at the point of collapse before he has ample reason to act?
With the health service quite clearly on its knees and an exhausted workforce burnt out by the demands of the pandemic, now more than ever, it is time to listen to those on the frontline.