COUNTLESS articles and reports have been written about the appalling health waiting lists in Northern Ireland.
This long-standing issue has been the subject of editorials and platform pieces and quite rightly there is anger and frustration about the outrageous waits for diagnosis and treatment.
Generally, though, this perennial issue is viewed through the lens of adults, usually older adults waiting on orthopaedic or neurology appointments.
A report last week by the Children’s Commissioner turned the spotlight on the youngest members of our society waiting for healthcare assessment and treatment. It presented an alarming picture of thousands of children languishing on spiralling waiting lists.
Between 2021 and 2022 there have been large increases in the numbers of children waiting for consultant-led appointments across all health and social care trusts.
Over 10,000 children have been waiting more than a year for treatment and, shockingly, over 600 children had been waiting more than four years for an appointment.
Many children are living with pain and extreme discomfort, robbed of opportunities to do what others take for granted.
For parents and families this is heart-breaking. Watching your child suffer and being powerless to assist is tortuous.
Emotional support and practical for support for those affected is patchy and inadequate. Children’s voices are often not heard in a system that was not designed around their needs.
Lengthy waits are unacceptable for any patient but for children and young people waits can be catastrophic as many treatments need to be given by a specific age or developmental stage.
It is not the same as for adults. If you miss the right window to treat a child or wait too long the consequences can be irrevocable.
For children there are significant waits in speech and language therapy, community paediatrics, occupational therapy, physiotherapy and neuro-developmental assessments for those with suspected autism and attention deficit hyperactive disorder. Long waits in assessment are followed by long waits for treatment.
Delays to accessing children and young people’s health services can have a profoundly negative impact on an individual child or young person’s educational outcomes, social development and mental health and wellbeing.
For example, long waits for speech and language therapy creates barriers to communicating with peers in social settings and at school, which has a knock-on effect on learning and socialising, as well as a child or young person’s ability to fulfil their potential as an adult. From April 2021 to 2022 the numbers of children waiting for occupational therapy increased by 87 per cent.
In a similar way, delays to Autism Spectrum Disorder (ASD) assessments and diagnoses can have an enduring impact on a child or young person’s life.
Without a diagnosis and appropriate treatment, children and young people with ASD can be treated as having behavioural issues and harshly punished rather than supported.
The potential impacts of a delayed diagnosis on a child’s development are alarming and conversely the benefits of an early diagnosis are wide-ranging.
On a personal level, a delayed diagnosis denies a child or young person the opportunity to understand the factors that are causing them to respond in a specific way. For families this can create undue stress and anxiety.
These waiting times are not just a backlog that can be cleared with additional resources and then we can begin to improve services. These figures are symptoms of a very broken system, indicators that it is unable to meet the needs of its population.
The long-overdue structural reform of health and social care means the problems are increasing year on year, with few if any signs of meaningful change.
Far from tackling the difficulties in accessing care at the right time in the right place, health and social care trusts are struggling to deliver little more than day-to-day firefighting.
If our government does not finally show some leadership and get to grips with the scale and nature of the crisis, we cannot hope for transformation. Long-term challenges such as workforce planning, specialisation, integration prevention and innovation cannot be addressed without long-term strategic planning and investment.
There is significant variation in average and longest waiting times from referral to assessment and treatment across the north. Across most indicators health outcomes are worse for children who live in deprived areas.
A regional approach to children’s services is needed to reduce variation and deliver a comprehensive service that provides effective support for children and young people.
Data and information on children’s health is woefully inadequate. The absence of regional monitoring or reporting of waiting times for community health services makes it impossible to get a clear idea of trends or comparisons. Waiting list data for children’s services are not included in the Department of Health statistical bulletins.
It is extraordinary that in one of the richest countries in the world, for many measures of children’s health and wellbeing, progress has stalled or is in reverse.
The harsh reality is we have a lot of work to do to ensure that our children get the best possible start in life. The commissioner’s report paints a shameful picture of generations being failed.
