Editorial: Budget cuts bad for our health as MPs warned we've 'fallen off the cliff edge'

Further damning evidence of the desperate plight facing our health and social care system has been presented to the Northern Ireland Affairs Committee, with MPs being told that it is already "beyond crisis".

Dolores McCormick, speaking on behalf of the Royal College of Nursing, added that "we have fallen off the cliff edge".

Like other Stormont departments, health and social care is coming to terms with the punishment budget set by secretary of state Chris Heaton-Harris.

Although its allocation of around £7 billion is essentially 'flat' compared to last year, in real terms it amount to a cut, thanks to the same cost of living demands being felt by households, families and businesses across the north. The department is also facing a raft of pay demands, which it says it cannot meet without drastically scaling back frontline services. It is an apparently impossible situation.

A particularly distressing example of what this all means for patients – and the staff who care for them – has been experienced at the Ulster Hospital this week. There, a patient with mental ill health has spent at least seven nights in the emergency department.

This is an inappropriate setting for the care of someone presenting with such a condition, and is a consequence of there being no specialist beds available in any of the north's mental health units.

It's a snapshot of the pressures faced throughout the health and social care system and while Mr Heaton-Harris's budget has been profoundly unhelpful, it is also fair to acknowledge that it comes after many years in which MLAs have failed to dispense the difficult medicine prescribed in a litany of reform plans, most recently in the Bengoa report.

That was published in 2016; the lack of committed progress since then bears testament to how Stormont's dysfunction has meant the public is getting sicker.

Only this week, an Audit Office report warned that the successful implementation of a 10-year mental health strategy is at risk unless there is sustained investment. We have a higher prevalence of mental ill health than elsewhere in Britain and Ireland, yet spend less addressing it.

This gap between patients' need and available services is repeated across the health service. As Dr Tom Black from the BMA pointed out: "In England they are working very hard on 18-month waiting lists – we are working very hard on our eight-year waiting lists."

Proper funding and planning – and responsible political leadership at Stormont, willing to take tough decisions – is urgently needed if the health service is to get well soon.