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Stormont impasse 'should not prevent NHS transformation'

Professor Rafael Bengoa pictured at Parliament Buildings. Picture by Mal McCann
Seanín Graham

THE expert who headed up a reform plan to overhaul the Northern Ireland health service has insisted the absence of power sharing should not prevent NHS 'transformation'.

Professor Rafael Bengoa, who published his ambitious report just months before the collapse of Stormont, conceded however it would "probably help" if a health minister was in post.

The former Basque health minister - who acted an an advisor to the Obama administration and the World Health Organisation - was in Belfast yesterday to deliver a speech marking the 70th anniversary of the NHS.

During a press briefing, he said there were only "five or six countries in Europe" that have a health minister who "knows where they are going".

"So if you have ministers who don't know where they are going, where they are just saying 'I am going to survive for four/five years', then they are not going to be on a transformative agenda," he said.

"What's really good here (in Northern Ireland) is that you are on a transformative agenda even without a government."


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Like previous independent reviews of the health service over the past two decades, Professor Bengoa concluded there were too many "services based around buildings" and called for a greater concentration of care in the community setting.

When asked about the political will to close hospital A&E units or downgrade services given the unpopularity of such decisions among voters, the medic stressed it was "not about closing down" but "reconfiguring services".

Earlier this week a £1.6m investment was given to Daisy Hill Hospital in Newry, a year after its casualty unit came under threat due to staffing problems.

Campaigners hailed it as a victory for 'people power'.

Professor Rafael Bengoa is a former Basque health minister. Picture by Mal McCann

Professor Bengoa said he accepted that change cannot be immediate but must take place "little by little".

"For 70 years we have been doing that (focusing on hospital services)... to leave 70 years of investing in an acute service model, to pretend to be able to transform that overnight, is unreal," he said.

The international expert cited a group of 18 hospitals in London offering specialist stroke services which reduced care into just six hospitals and improved patient outcomes.

"How did they do that? By reconfiguration. People were not fired and patients are getting a much better treatment today than they were before," he said.

"Now I don't see why that can't be done in Paris, why it can't be done in Belfast."

But he warned that the massive demand on services due to increased life expectancy - pensioners in the north are expected to outnumber children by 2028 - will require change.

"We're going to have the same impact over the next eight years that we've had in the last 40 years... so we have to move quicker into a different model of care.

"We don't have 25 years to be able to manage this transformation, we have to go fast."

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