Opinion

ANALSYIS: Waiting list crisis shines a light on mis-managed health service over past decade

Northern Ireland's waiting list crisis has been an ongoing problem for successive Stormont health ministers
Northern Ireland's waiting list crisis has been an ongoing problem for successive Stormont health ministers Northern Ireland's waiting list crisis has been an ongoing problem for successive Stormont health ministers

CHRONIC waiting lists have been a persistent thorn in the flesh of Stormont health ministers for more than a decade.

Back in 2006, direct rule minister Shaun Woodward successfully managed to slash hospital waits - and even meet targets - by throwing money at the private sector to take on NHS work.

Dubbed by critics as the 'sticking plaster' approach, this solution was only ever going to be temporary as budgetary funds dried up and the practice was, for the most part, shelved seven years ago.

The exit of the indepedent sector exposed how badly managed the north's health service had become - one entire ward in a Co Fermanagh hospital was taken over by a private clinic for a year in 2013 - and how much of an overhaul it required.

Yesterday's Assembly address by health minister Robin Swann on the "scourge" of waiting lists is one that could easily have been made five years ago,

The difference is that this time an already fragile health service is emerging from the catastrophic impact of a pandemic, with an exhausted and depleted workforce.

Mr Swann singled out the difficulties of a piecemeal budget from Westminster in tryig to rebuild services and recruit staff.

There's no doubt that budgetary constraints are challenging for long term planning, especially coming out of Covid.

But at a time when many NHS consultants are working in the private sector - which they are entitled to do - a re-examination of how best to utilise the consultancy workforce must surely be on Mr Swann's radar.

The concerns of a severely understaffed nursing workforce - there are more than 3,000 nursing jobs lying empty - must also be addressed if they want to retain highly skilled staff, many of whom are suffering from serious psychological problems in the aftermath of the pandemic.

Multiple independent reports over the past 20 years - going back to the Maurice Hayes review -  have rounded on the top-heavy bureacratic structures endemic to the north's heatlh service.

From Hayes to Compton to Bengoa, these Department of Health commissioned reports have called for a radical shake-up the acute hospital system so that specialist  medical care is more centralised and spread less thinly - a move unpalatable to politicians, especially at election time.

As result of the pandemic, the use of regional services has been hastened with waiting list patients from across the north travelling to the South West Acute  hospital in Ennisklllen for surgery due to pressures in Belfast.

Despite attempts to work differently and reduce so-called postcode lottery waiting lists, the minister warned the health service is in "grave danger" of being unable to deliver on the founding NHS principle of free treatment for all.

The reality of course is that a two-tier system is already in place, as those with the means can see a NHS consultant in a private clinic within weeks.

Poverty continues to act as a barrier for those accessing timely care, with The Irish News revealing last September that neurolgoy patients classed as "urgent", some of whom had suspected Motor Neurone disease and Multiple Sclerosis, were waiting four years to see a consultant in the Belfast trust. 

The enormity of the task ahead for Mr Swann and his department in rebuilding a fractured system cannot be over-stated. It can only be hoped the mistakes of previous administrations will not be repeated.