February health summit must bring results

Next week could be pivotal for Health and Social Care in Northern Ireland.

The panel of experts on healthcare reform currently investigating how best to solve Northern Ireland’s growing health crisis will hold a summit with the major political parties on Wednesday 17th.

Their aim is to build a common front among our elected representatives in order to get past the current situation which has bred only inaction and an inability to make required decisions.

The panel was one of the recommendatons in December 2014’s Donaldson report and – with some departures from the report’s suggestions - was finally announced by Health Minister Simon Hamilton in January this year, and is chaired by Prof. Rafael Bengoa of the Deusto Business School in Spain.

Mr Hamilton was on Talkback on Monday to discuss healthcare reform, and said that the summit will take place next Wednesday. It is an opportunity not to be missed.

Scope has written an entire series of articles about the general direction of the Northern Ireland health system - on Transforming Your Care and Donaldson and similar – and has done so because this is the single most important piece of policy currently under the control of the Northern Ireland Assembly.

One of our key points has always been that the public are fundamentally mistaken about the consequences of health reform (and the consequences of no health reform) and that the public debate (fomented by politicians in many instances) has been misleading.

We previously looked at the large campaign to retain services at the Downe Hospital as a great example of political weakness, with major parties talking out of both sides of their proverbial mouths in order to please whatever audience or score whatever political point.

The Downe campaign has not gone away – but has anyone been brave enough to really try and explain that the well-meaning people working so hard to save all services at their one local hospital are taking no heed of the bigger picture, and perhaps working directly against the best interests of themselves, their community and Northern Ireland at large?

Straightforwardness and honesty is required to beat this impasse. The Minister is to be commended for his attempts to have this debate in public, which have been far more apparent than recent predecessors.

On message

Talkback also featured input from Ian Williamson, the Chief Officer of Greater Manchester Health and Social Care Devolution.

He has pushed back against political opposition, fought against and overcome judicial review, and now is in charge of a devolved health structure in Greater Manchester – an area with similar demand issues to Northern Ireland.

He said he plans to improve services “by concentrating emergency surgery in a smaller number of hospitals than currently takes place.

“That meant some hospitals losing those services but by talking through with the politicians and particularly emphasising what’s going to improve in general practice, in social care, in community-based services, then we’ve been able to come up with an overall package that people can believe in, saves those lives, and can deliver those services.”

During the Radio Ulster show at the start of the week, Mr Hamilton told William Crawley that his vision for HSC was along the same lines as in Manchester.

“It’s very similar to the approach I’ve been taking since announce series of radical, far-reaching reforms in November last year.

“Ultimately in my view the biggest obstacle to achieving that… was likely to be failure to get political consensus around an agreed set of principles and actually the actions that needed to be taken.

“They [they expert panel] have started their work and they will be holding a political summit next week, on the 17^th, to get the major parties around the table to see if it is possible to agree a way forward for health and social care in NI that can deliver better results for our people.

“There’s been some initial support for the direction of the panel’s work. All parties have met or have at least had discussions with Rafael Bengoa and his team, and that will obviously accelerate next week with the political summit.

“The choices are quite stark here… If we don’t reach some agreement like they did in Manchester then the dangers of our system, which has served us well but is under immense pressure and… the pressure is coming from the fact we have a growing and ageing population and a rise in chronic conditions, and all of this happening at a time whenever resources are tight.

“If we don’t take some big decisions and start taking those decisions very quickly then the system that we all love and that we cherish is not going to be able to withstand those sorts of pressures and challenges that it is facing.”

The undeniable problem

A growing and ageing population – specifically, a population which is seeing a boom in the number of people living into old age, in significant part due to the good service HSC has provided to this point – and a rise in per capita demand due to an increase in chronic conditions means the overall need for health provision is shooting up at a rate far beyond what our wildest dreams can expect for the economy.

Therefore, if we keep the same health model, spending would have to increase at the same rate to have any chance of matching this demand – and this is simply impossible.

Moreover, Northern Ireland has its own specific health issues in rural areas, where even services such as general practice are struggling because young doctors do not want to work there.

The current model will be on its knees sooner rather than later. It cannot be sustained.

Railing against reforms without offering an alternative solution to Transforming Your Care is stupid. And no-one has a good alternative.

Something has to give. Political failure would be unforgiveable – not a word to be used lightly, but fitting in this case.

Time is short. Next week is vital.