Opinion

ANALYSIS: Reliance on private sector to solve waiting list scandal will come at major cost if surgical training crisis and nursing shortage not tackled

The private sector has been employed by the health service to carry out hip replacements on waiting list patients
The private sector has been employed by the health service to carry out hip replacements on waiting list patients The private sector has been employed by the health service to carry out hip replacements on waiting list patients

IT'S almost a decade since a private healthcare company was leased an entire floor of a new NHS hospital to carry out hundreds of operations and slash waiting lists.

There was an outcry over the move, with unions branding it a "step too far" and saying it represented the private sector "mainstreaming" public space.

The facility in question was the the South West Acute Hospital (SWAH) in Enniskillen, a £276m new-build which a former trust chief executive declared was like "no other public hospital in Ireland" at its opening in 2012.

Reliance on the private sector to reduce spiralling NHS waiting lists for operations such as hip and knee replacements had become the norm in Northern Ireland by that point, with tens of millions of pounds set aside in yearly budgets.

However, by 2014 the well had run dry and lucrative contracts with private firms were axed - sparking fears that delays for operations and hospital appointments would escalate even further.

Those fears were well founded as even before the pandemic hit, patients were waiting five years for back surgery forcing many into borrowing money to 'go private' while others resorted to travelling to Eastern Europe for cut-price surgery.

On Monday however, health minister Robin Swann announced that the private sector had been brought back as part of an "initiative" to clear the backlog for planned orthopaedic procedures and had performed 21 hip replacements at SWAH over the past week.

There is no doubt the surgery will dramatically improve the lives of the 21 patients stuck on waiting lists for years, but the development coincides with a severe shortage of training opportunities for the north's orthopaedic surgeons.

In yesterday's Irish News, it was reported that Mr Swann has been alerted to the crisis with one medic revealing how "poorly prepared" they feel and warned of the consequences for future services.

The cancellation of many planned operations and redeployment of staff - particularly theatre nurses - due to Covid meant young surgeons lost out on vital training to perform procedures such as hip and knee replacements.

It has transpired that the £1m contract with the private healthcare firm - which is owned by an NHS surgeon and two doctors from the north - to carry out multiple orthopaedic operations at SWAH excludes any training opportunities for younger colleagues.

Last night, heath chiefs said the SWAH scheme was a "temporary" one but added that "training may be built" into other initiatives for new surgeons with "wider discussions ongoing as to what follows thereafter".

Mr Swann has repeatedly expressed his commitment to addressing the waiting list scandal and while using the private sector may be necessary, surely he must prioritise the needs of his workforce and allow them the necessary training to ensure they are competent in their field.

Mistakes of previous health ministers who cut student nurse places to make short-term savings - a catastrophic decision that led to a workforce crisis - cannot be repeated.

As one senior medic put it: "No training today, no surgeons tomorrow".